The aim is to study the action mechanisms of the Rapitalam pharmaceutical substance using Parkinsonian syndrome models.

Materials and methods. Various effects of a new pharmacological substance, N-chlorophenylmethyl-dihydro-methoxy-methylphenyl-oxopyridazine carboxamide (Rapitalam), were studied in male laboratory mice and rats. During the experiment, the various models of the Parkinsonian syndrome were reproduced: the simulation of the Parkinsonian syndrome by administering 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP) neurotoxin, the simulation of haloperidol-induced catalepsy, the simulation of apomorphine-induced stereotypy and the simulation of oxotremorine-induced tremor followed by tests. The following tests were carried out in order to determine the Rapitalam efficacy with regard to symptoms manifested after the MPTP administration in animals: the open field test, the rotarod performance test, as well as the evaluation of the grip strength and the degree of rigidity using the stride length. When simulating the haloperidol-induced catalepsy, a horizontal bar test was performed. After the administration of apomorphine, the severity of stereotypy was assessed in scores. A simulation of oxotremorine-induced tremor in rats was used to study the cholinergic link. After the administration of oxotremorine, the severity of tremor was assessed against the background of administration of the test compounds.

Results. During the analysis of the data obtained in the open field and rotarod tests as well as the stride length and the grip force when simulating the Parkinsonian syndrome by introducing MPTP, no intergroup statistical differences were found. Thus, the tested Rapitalam substance in doses of 2 mg/kg, 6 mg/kg and 20 mg/kg and the Levodopa reference drug at a dose of 60 mg/kg had no effect on the indices of motor activity and motor coordination in mice when administered orally for 10 days. Rapitalam in doses of 1 mg/kg, 3 mg/kg and 10 mg/kg as well as the Levodopa reference drug at a dose of 50 mg/kg, did not affect the severity of haloperidol-induced catalepsy and apomorphine-induced stereotypy in rats. Under the administration of oxotremorine to laboratory animals, a statistically significant decrease in the severity of tremor was observed during the Rapitalam administration in doses of 3 mg/kg and 10 mg/kg.

Conclusion. Rapitalam is established to have no effect on motor impairment due to dopaminergic mechanisms. The tested substance is characterized by a pronounced cholinoblocking effect at doses of 3 mg/kg and 10 mg/kg.

Conflict of interest: the author declares no conflict of interest.

The aim was to study the gender characteristics of the heart rate variability (HRV) in young people depending on physical loading (FL), associated with habitual physical activity (FA).

Materials and methods. 98 practically healthy students of a medical high school with different levels of habitual FA were examined. HRV was studied at short 10-minute intervals at rest and after intense FL with the energy consumption of 72–88 kcal.

Results. HRV changes are determined, which depend not only on the FL intensity and the training level of young people, but are also gender-associated. At rest, less pronounced sympathetic tone (LF/HF 0.86±0.04 versus 1.05±0.04, p<0.05) and the predominance of the central mechanisms of the heart rhythm over the autonomous ones (ID 75.3±5.7 versus 55.8±5.5 units, p<0.05) were observed for female respondets as compared to the young men. After intense FL, a more pronounced inhibition of the parasympathetic tone (pNN (50%) 5.4±1.2 vs. 10.2±1.9%, p<0.05) and a more pronounced functional intensity of adaptive reactions (ID 176.6±17.9 against 101.4±14.4 units, p<0.05) were noted for the female respondetns as well.

Conclusion. Changes in HRV parameters, which reflect the beneficial effects of physical training on the adaptive responses of the cardiovascular system, have been found in young people with constant, habitually high FA. The application of the HRV research methodology for short periods in dynamics is justified in the practice of health-saving preventive and rehabilitation measures, since it allows the process of optimal adaptation of a person to physical loading to be controlled.

Conflict of interest: the authors declare no conflict of interest.

The aim is to investigate the adaptive capabilities of the organism during university study on the basis of the analysis of functional changes in central hemodynamics in university students suffering from early cervical osteochondrosis,

Materials and methods. The students selected for the research were divided into groups depending on the severity of radiographic changes in the cervical spine. Group I (n=28) included students with a distortion of spinal statics. The second group (n=36) was represented by students with degenerative-dystrophic processes. Group III (n=17) combined students with radiologically significant changes. For research purposes, a comparison group of practically healthy students was recruited (group IV, n=30). The adaptive potential (AP) was calculated using the R.M. Baevsky method in scores: less than 2.1 — satisfactory adaptation; 2.11–3.2 — stressed adaptation mechanisms.

Results. Male students in the first group are found to manifest mild clinical symptoms of cervical osteochondrosis (ceased within a short period of time), compared to female respondents, who in 23.5% of the cases reported moderately expressed complaints for a prolonged period time. Female students in the groups II and III, manifested the clinico-neurological symptoms of cervical osteochondrosis in 60.9% and 100%, respectively. In the group III students, radiologically significant changes in the cervical spine were accompanied by moderately severe complaints in 75% of cases, with 25% of the students reporting minor complaints. Thus, the differences in cardiohemodynamics are found to correspond to the obtained data on AP, where the greatest stress of adaptation mechanisms was found in students comprising groups I and II.

Conclusion. The present study has allowed us to identify one of the reasons affecting the adaptive capabilities of the organism and, as a result, successful learning and the quality of life of young students. For the prevention of psychosomatic disorders (against the background of circulatory disorders in the vertebrobasilar basin) in the presence of early cervical osteochondrosis, Х-ray examination should be performed.

Conflict of interest: the authors declare no conflict of interest.

The aim is to develop and propose a scale for assessing the risk of neurological complications as a result of surgical treatment in patients with the post-traumatic deformations of the thoracic and lumbar spine.

Materials and methods. An analysis of the treatment of 124 patients (70 men and 54 women) aged 18–54 with post-traumatic deformations of the thoracic and lumbar spine was carried out. The patients were operated during the 2003–2017 period. Repeated surgeries were performed after the period from 6 months to 14 years after injury. In 63 cases, spinal deformation was the result of unsuccessful surgical treatment, while 61 cases were due to diagnostic errors and/or inadequate conservative treatment.

Results. The analysis of the clinical data identified factors affecting the manifestation of neurological complications, as well as 46 assessment options for risk gradation.

Conclusion.The proposed scale can be used for a rapid assessment of the risk of neurological complications of surgical treatment of patients with the post-traumatic deformations of the thoracic and lumbar spine.'

Conflict of interest: the authors declare no conflict of interest.

The aim is to carry out an automated analysis of biological liquids for the estimation of metastatic neogenesis in ascitic exudates.

Materials and methods. A retrospective analysis of 40 case histories of patients with the ascitic syndrome of non-tumour (cirrhotic) and tumour genesis was performed. Traditional cytology was accompanied by an automated analysis of exudative fluids. The final diagnosis was verified using instrumental and pathomorphological methods. The processing of statistical data included an assessment of the intergroup difference significance.

Results. Compared with cirrhotic ascites, the following parameters of the automated analysis of biological fluids are found to be statistically significant (p30% in the atypical cell screening system has been established. In the absence of an acute inflammatory reaction, the presence of eosinophils in the exudate should be interpreted as an indirect marker of a tumour process. According to the data obtained, the content of neutrophils, lymphocytes and monocytes in ascitic fluids does not depend on the nature of the process (p>0.05).

Conclusion. The diagnostic capabilities of automated analysis of ascitic fluids are analysed. In the system of differential diagnosis of tumour and non-tumour processes, the following parameters are established to possess the greatest informative value: TCN, HF, and the presence of eosinophils (EO).

Conflict of interest: the authors declare no conflict of interest.

The aim is to identify the connection between the presence of peritoneum adhesions and the laparotomic wound healing, as well as to find a way to prevent the adhesive disease.

Materials and methods. The treatment of 149 patients with purulent peritonitis in the main and control groups was performed. In the main group, the laparotomic wounds were sutured by removable draining muscular aponeurotic sutures. In the control group, the laparotomic wounds were sutured with monofilament interrupted sutures in layers, with the edges of the dissected peritoneum being seized into the aponeurotic suture.

Results. The suppurations of laparotomic wounds in the control group were 34.7%. In the main group, where the laparotomic wounds were sutured with removable draining muscular aponeurotic sutures (RDMAS), the suppuration occurred only in one patient (2.2%). The abdominal adhesive disease was observed in 19.4% cases in the control group, with 4 patients (2.0%) having been operated. In the main group, only 2 cases (4.3%) of the abdominal adhesive disease treated without surgical intervention were detected.

Conclusion. One of the main causes of the postoperative abdominal adhesive disease with advanced peritonitis is the suppuration of the laparotomic wound. The use of RDMAS during the surgical treatment of advanced purulent peritonitis not only prevents the suppuration of laparotomic wounds, but also significantly reduces the development of all types of adhesive disease caused by visceral and parietal peritoneal adhesions.

Conflict of interest: the authors declare no conflict of interest.

The aim is to study the analgesic and anti-inflammatory activity of an innovative molecule under the ZC02-0012 laboratory code belonging to the group of selective blockers of the TRPA1 ion channel.

Materials and methods. The study of the ZC02-0012 analgesic activity was carried out by the hot plate and acetic acid writhing tests. The hot plate test was performed on white laboratory mice. ZC02-0012 substance was administered in doses of 1, 3 and 9 mg/kg. Ketorol at a dose of 3.48 mg/kg was chosen as the reference drug. To study the analgesic effects in the hot plate test, intact white laboratory mice were placed on a preheated at 55°C plate to determine the base level of pain sensitivity. Then the test substances were administered to the animals divided into groups, and the hot plate test was repeated after 30, 60, 90 and 120 minutes. To study the analgesic effects in the test of acetic acid writhing, white laboratory rats were injected with the ZC02-0012 substance at doses of 0.46, 1.38, and 4.15 mg/kg. Ketorol at a dose of 1.6 mg/kg was chosen as the reference drug. 30 minutes after intramuscular injection and 60 minutes after intragastric administration, the intraperitoneal administration of a 0.75% solution of acetic acid was carried out at the rate of 1 ml per 100 g of animal weight. Counting the number of writhings started 15 minutes after the injection of acetic acid and continued for 30 minutes. The anti-inflammatory effects of the ZC02-0012 substance were studied using a model of acute exudative inflammation in response to the subplantar introduction of 0.02 ml of 2% formaldehyde aqueous solution into the right hind paw of the mouse. 4 hours after the phlogistic introduction, the mass of the edematous paw was evaluated. ZC02-0012 substance at doses of 1, 3 and 9 mg/kg and the Diclofenac reference drug at a dose of 13.91 mg/kg were administered intragastrically or intramuscularly 45 minutes before the introduction of phlogistic. The presence and severity of anti-inflammatory activity was judged by the inhibitory effect, expressed in percentage.

Results. The analgesic activity of ZC02-0012 is found to exceed that for Ketorol in both the intramuscular and intragastric ways of administration according to the results of hot plate tests in doses of 3 and 9 mg/kg and acetic acid writhing in doses of 1.38 and 4.15 mg/kg, while the anti-inflammatory activity of ZC02-0012 at doses of 3 and 9 mg/kg is shown to be comparable to that of Diclofenac. Conclusion. The innovative molecule under the ZC02-0012 laboratory code is established to exhibit a pronounced analgesic and anti-inflammatory activity, thus being prospective for further research.

Conflict of interest: the authors declare no conflict of interest.

The aim is to optimize the treatment of patients with postoperative ventral hernias, anterior abdominal wall deformations and cholelithiasis.

Materials and methods. 36 patients with complicated forms of postoperative ventral hernias, anterior abdominal wall deformation and cholelithiasis aged 36–74 years, under the 12:24 male/ female ratio were studied. According to the classification of Toskin — Zhebrovsky, smallsized, medium-sized, extensive and gigantic hernias were observed in 3 (8.3%), 12 (33.3%), 15 (41.7%) and 6 (16.7%) patients, respectively. According to the SWR-classification, the hernia of the median, lateral and combined localization was observed in 14 (38.9%), 7 (19.4%) and 15 (41.7%) patients, respectively. All patients were operated. Both autoplastic and prosthetic techniques of operations were used. Various forms of the anterior abdominal wall deformation were eliminated with the help of abdominoplasty. Laparoscopic cholecystectomy was performed simultaneously in all patients.

Results. Postoperative complications occurred in 11 (30.5%) patients, with persistent seroma prevailing (6–54.5% of patients). In 3 (27.2%) patients wound suppuration was observed, in 1 (9.1%) — early postoperative intestinal obstruction. Postoperative pneumonia was observed in one patient.

Conclusion. Success in the surgical treatment of such patients is determined by whether an individualized differentiated approach was used in choosing the method of surgery and the management of patients in the postoperative period.

The aim was to assess the impact of emergency and planned tracheostomy on the main indicators of inpatient treatment in patients with contact mediastinitis.

Materials and methods. This work was performed on the basis of the Department of Maxillofacial Surgery of the Kursk Regional Clinical Hospital. In order to conduct a comparative assessment of the treatment results, the patients with contact mediastinitis (46 people, surveyed period 2008–2017) were divided into 2 subgroups: control (25 people, 7 women, 18 men), who were treated without a tracheostomy; and the main group (21 people: 9 women, 12 men), with tracheostomy performed. The etiological and microbiological characteristics of the disease, the total duration of inpatient treatment, the length of stay in the resuscitation and intensive care units (bed-days), the dependence of the disease outcome (death, recovery) on the form of surgical intervention (tracheostomy) were evaluated.

Results. A statistically significant effect of tracheostomy on the total duration of hospitalization and mortality rate was established (p0.05). Consequently, at present this issue cannot be resolved unambiguously and requires further research and mathematical analysis.

Conclusion. The implementation of tracheostomy significantly increases the duration of inpatient treatment of patients with contact odontogenic mediastinites (p0.05).

Conflict of interest: the authors declare no conflict of interest.

The aim was to investigate the acute toxicity of the AX-554 compound following its intragastric administration, as well as to determine the effective cytotoxic concentration and dose of this preparation.

Materials and methods. The study was performed using 76 nonlinear white laboratory mice of both sexes weighing 18–22 g, 150 male mice of C57BL/6 line and LCC tumour cell culture. The acute toxicity of the AX-554 4-alkyl-substituted compound in the form of granulated pellet mass was studied following its intragastric administration, with the results being analysed according to Litchfield and Wilcoxon. The effective dose of the substance was determined using a syngeneic tumour model in C57Bl/6 male mice with inoculated Lewis lung carcinoma. The effective concentration of the compound was determined in a tumour cell culture.

Results. Our study of the acute toxicity of AH-554 after its intragastric administration in the form of granulate tablet mass have confirmed AH-554 to be a non-toxic substance. In doses ranging from 21.2 to 384 mg/kg, AH-554 is observed to suppress tumour growth in mice with syngeneic lung carcinoma at a level from 20 to 90%, with the highest therapeutic dose exceeding the minimum effective one by more than 18 times. This pattern is also observed when AH554 is applied in the culture of tumour cells. The results of this study can be used for developing a pharmaceutical based on the AH-554 compound.

Aim. The present work assesses the effect of internship on the adaptive capabilities of turner trainees according to the dynamics of the regulatory and adaptive status.

Materials and methods. In 30 turner trainees at the age of 18, internship adaptation was studied according to the dynamics of the index of the regulatory and adaptive status (IRAS) and heart rate variability. IRAS was determined using the sample of cardio-respiratory synchronism. The use of IRAS allows the regulatory-adaptive capabilities to be assessed quantitatively, classifying them as “high” (with an index of the regulatory-adaptive status >100), “good” (50–99), “satisfactory” (25–49), “low” (10–24) and “unsatisfactory” (≤ 9). In accordance with the Strelau temperament inventory, genetically determined types of higher nervous activity determine the ability of an organism to adapt to changing environmental conditions. Following this notion, the trainees were divided into the groups of less adapted (melancholic, choleric, sanguine/choleric, melancholic/choleric) and more adapted (phlegmatic, sanguine, phlegmatic/ sanguine, phlegmatic/melancholic) individuals.

Results. The groups of more adapted and less adapted individuals showed a decrease in IRAS by 24.4% and 38.8%, respectively. Accordingly, the regulatory and adaptive capabilities of the organism in the more adapted group remained “good”, while in the less adapted group they became “satisfactory”. Variation pulsometry indicated an increase in the stress index at the end of the internship, especially for less adapted turner trainees.

Conclusion. The dynamics of regulatory and adaptive capabilities allows the adaptation to internship among trainees to be assessed.

Conflict of interest: the author declares no conflict of interest.

The aim of the present work was to study the pharmacological activity of a low-molecular arginase II selective inhibitor (low-molecular compound with laboratory code ZB49) with the chemical formula 2-{1-[3-(3-[chloroisoxazole-5-yl) propyl] piperidin-4-yl}-6-(digibroxyboryl) norleucine dihydrochloride) using a model of monocrotaline-induced pulmonary hypertension

Materials and methods. The work was performed on 40 adult male Wistar rats weighing 180– 220 g. The simulation of monocrotaline pulmonary hypertension was performed on 20 animals using a subcutaneous injection of an alcohol-aqueous solution of monocrotaline (MCT) at a dose of 60 mg/kg in a volume of 0.5 ml per animal. 7 days after the MCT injection, the administration of the studied pharmaceutical substance (PS) (laboratory code ZB49) was started at a dose of 5 mg/kg. ZB49 was administered intragastrically, once a day with the administration duration of 21 days.

Results. Under the intragastric FS ZB49 administration at a dose of 5 mg/kg, a statistically significant decrease in the coefficient of endothelial dysfunction, systolic right ventricle pressure (SRVP), average the right ventricle pressure (ARVP), diastolic right ventricle pressure (DRVP), maximum contraction rate (dP/dt max) and minimum contraction rate (dP/dt min) was established at the background of the simulation of monocrotaline-induced pulmonary hypertension. At the same time, a statistically significant positive effect of ZB49 on the blood gas composition was established.

Conclusion. The study has confirmed the possibility of using arginase inhibitors to prevent the development of endothelial dysfunction and the disorders of nitric oxide metabolism in pulmonary arterial hypertension. Among the substances of this group, arginase II selective inhibitors should be considered as the most promising.

Conflict of interest: the authors declare no conflict of interest.

Aim. The present work was aimed at studying and analysing the serum level of advanced oxidation protein products (AOPPs) and the total superoxide dismutase activity (total SOD) in patients with chronic heart failure (CHF) with a preserved and low left ventricular ejection fraction, depending on the stage of the disease.

Materials and methods. Patients with CHF (n=280) were divided into groups depending on the left ventricular ejection fraction (patients with a preserved and low left ventricular ejection fraction) and the stage of the disease (I–III). The control group consisted of somatically healthy individuals (n=60). The level of the activity of all three types of SOD (Cu/Zn-SOD+MnSOD+Fe-SOD) and the level of AOPPs were analysed in the serum by enzyme immunoassay.

Results. All CHF patients as compared to somatically healthy individuals showed an increase in the level of AOPPs and a decrease in the activity of total SOD, being more pronounced in patients with a low left ventricular ejection fraction. In the subgroups of patients with a more severe CHF stage, a statistically significant increase in the level of AOPPs and a decrease in the activity of total SOD as compared with subgroups with a less severe CHF were observed. Patients with a low ejection fraction of the left ventricle of I, IIA and IIB+III stages experienced higher levels of AOPPs and lower levels of total SOD than patients with a preserved left ventricular ejection fraction of the corresponding stages of the disease. A correlation analysis revealed the presence of statistically significant correlations of medium strength in patients with CHF with a preserved and low left ventricular ejection fraction with the clinical manifestations of CHF.

Conclusion. The dynamics of the total SOD and AOPP levels, depending on the left ventricular ejection fraction and the stage of the disease, indicates the association of the CHF severity with that of oxidative stress. 

Conflict of interest: the author declares no conflict of interest.

The aim of this work was to determine the specific characteristics of the career of a physician in medical organizations, as well as to develop organizational and methodological tools for monitoring its success and improving its management.

Materials and methods. A retrospective anonymous survey and expert interviews were carried out among administrative medical staff. The state of career management in the field was analyzed, along with the availability of relevant documents in medical organizations.

Results. The distinctive characteristics of the career of a physician (goals, principles, predictors of career advancement, types, basic models) have been established. The effectiveness of professional training, differentiated by functions, for managers in medical organizations has been shown. The possibility of changing the duration of modules included into the curriculum of study is substantiated. Evaluation tools have been developed to monitor and facilitate the carrer management of physicians.

Conclusions. The results of this study enhance the current understanding of the career of a physician in medical organizations and its management. In addition, a number of applied issues accociated with career management improvement in medical organization can be solved.

Conflict of interest: the authors declare no conflict of interest.

The aim of this work was to identify the characteristics of the cytokine status and state of the pro- and antioxidant systems in patients of late reproductive age with endometrioid cysts and determine their role in changing the ovarian reserve.

Materials and methods. A total of 89 patients with endometrioid ovarian cysts (EOC) were examined. The control group consisted of 35 healthy patients admitted for surgical sterilisation. Peripheral blood was collected before surgery, while the peritoneal fluid collection was performed intraoperatively. In peripheral blood and peritoneal fluid, the level of cytokines was determined. The calculation of the anti-inflammatory index was performed, along with the evaluation of the content of lipid peroxidation products and the antioxidant activity. The analysis of the ovarian reserve parameters was conducted.

Results. In patients of late reproductive age suffering from EOC, a decrease in the ovarian reserve is observed under the preserved hormonal background. The presence of EOC is accompanied by the activation of lipid peroxidation, both at the systemic and local levels, under a pronounced inhibition of the antioxidant defence link. At the systemic and local levels, patients with EOC experience an imbalance in the cytokine system with a significant activation of the pro-inflammatory component.

Conclusion. The disruption of oxidative homeostasis and activation of immune inflammation, detected in patients of late reproductive age with EOC, may lead to the damage of the structural cell components of the functional ovarian tissue, thereby reducing the ovarian reserve.

Conflict of interest: the authors declare no conflict of interest.

The aim of this study was to identify the distinctive features of the course of anesthesia and the structure of critical incidents (CI) in patients with various functional states (FS) during surgical interventions aimed at eliminating acute colonic obstruction.

Materials and methods. 146 patients having undergone emergency surgical interventions aimed at eliminating acute colonic obstruction were examined. On the basis of the constant potential (CP) value, 3 groups were identified. Group 1 (n=66) was characterized by the CP value of -30 mV and below (FS subcompensation). Group 2 (n=44) included patients with the average negative CP values from -15 to -29.9 mV (FS compensation). Group 3 (n=36) comprised patients with the low negative and positive CP values of -14.9 mV and above (FS decompensation). The connection of FS with the frequency of the CI development was studied. The recorded CI included hemodynamic: hypotension — hypertension — bradycardia — arrhythmia — tachycardia; respiratory: hypoxemia — hypercapnia — the need for a prolonged mechanical ventilation of lungs in the postoperative period; metabolic: hypothermia — retarded recovery of the neuromuscular conductivity — delayed postoperative awakening.

Results. CI occurrence is found to be different in patients with different FS. Hemodynamic CIs were noted in all the studied groups; however, their proportion in patients with high and low negative and positive CP values was significantly higher. Their formation was accompanied by violations of the adequate course of anesthesia, namely, the hypokinetic state of the blood circulation and aerobic metabolism. In addition, this group showed an increase in the frequency of a slow recovery of the neuromuscular conduction and delayed postoperative awakening.

Conclusion. The most adequate course of anesthesia has been observed in patients with moderate negative CP values.

Conflict of interest: the authors declare no conflict of interest

This article provides a brief literature review on congenital cholesteatoma of the temporal bone. Existing theories describing the development of this pathology are analysed. The diagnostic criteria of congenital cholesteatoma are presented, along with a comparative analysis of the characteristics of various instrumental research methods used in the verification of this disease. Issues involved with the surgical management of such patients are considered.

A conclusion is made that, due to the rare occurrence of the congenital cholesteatoma of the temporal bone, diverse theories of its etiology, the lack of clear criteria for its diagnostics, this pathology requires further research to elucidate the nature of the disease and identify the risk groups of its occurrence.

Conflict of interest: the authors declare no conflict of interest.

The aim is to describe modern approaches used in the diagnostics of cholelithiasis in pregnant women.

Results. Cholelithiasis diagnostics in pregnant women is a rather difficult task, frequently taking a long time and significantly worsening the prognosis for both the mother and the fetus. Abdominal ultrasound is the “gold standard” for the diagnosis of cholelithiasis in pregnant women, allowing the diagnosis to be clarified and the treatment tactics to be adjusted. The possibilities of such modern methods as endoscopic ultrasound diagnostics, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and laparoscopic ultrasonography used in difficult diagnostic cases are presented.

Conclusion. The use of a maximal range of diagnostic studies in pregnant women makes it possible to establish the diagnosis as soon as possible and to reduce the frequency of surgical and related perinatal complications. As a result, the prolongation of pregnancy and a decrease in maternal and intrauterine mortality can be achieved.

Conflict of interest: the authors declare no conflict of interest.

Familial hypercholesterolemia (FHC) is a common monogenic disease that occurs with a frequency of ~1:250 and is characterised by a high content of low-density lipoprotein (LDL) in the blood. This disease leads to the early development of atherosclerotic cardiovascular diseases (ACVD). Although the screening and diagnostics issues concerned with FHC are well developed and the modern lipid-lowering therapy can significantly improve the prognosis, the detectability of this disease remains extremely low. In recent years, the concept of FHC has undergone significant changes under the influence of large epidemiological studies, including verification of the FHC diagnosis using genetic tests. The article is aimed at discussing the clinical manifestations of FHC, as well as modern medical and extracorporal approaches to its treatment.

Conclusion. Until the advent of modern lipid-lowering drugs, FHC had remained to be a disease with a poor prognosis due to early ACVD and the associated premature death. Today, the diseases is amenable to successful treatment, which, though not eliminating the genetic defect, allows almost the same life duration as in the general population to be achieved. However, all the possibilities of modern approaches to the treatment of this serious disease can be realized provided that a state-level screening program for such patients has been implemented.

Conflict of interest: the authors declare no conflict of interest.

The aim of this work was to elucidate the modern concept of retinal vein thrombosis.

In the literature review, the retinal vein thrombosis is considered as a disease with a variety of clinical forms, course types, complications and frequently an unfavourable prognosis in terms of the preservation of visual functions. There is a clear connection between eye vascular pathologies, somatic diseases and cerebrovascular pathologies.

Conclusion. The analysis of scientific sources has shown that many aspects of retinal ischemia are yet to be understood. Of particular importance is the development of effective treatment and rehabilitation schemes, including drugs for intravitreal use.

Conflict of interest: the authors declare no conflict of interest.

The results of the most discussed randomized trials of percutaneous coronary intervention (PCI) in comparison with drug therapy (COURAGE and FAME 2) and PCI imitation (ORBITA) in patients with stable coronary heart disease are analyzed. Information on the ongoing ISCHEMIA trial is presented. Different points of view are compared concerning the results of the most important PCI research projects. Factors that can distort the results and the possibilities of their elimination are discussed. The main provisions of the American (2017) and European (2018) Guidelines on myocardial revascularization with a focus on PCI in patients with stable coronary heart disease are described.

Conflict of interest: the authors declare no conflict of interest.

The review deals with the problem of carbohydrate metabolism disorders in patients undergoing corticosteroid therapy, relevant for specialists in various fields. The article describes the epidemiology and risk factors for the development of carbohydrate metabolism disorders when using glucocorticosteroids. Contemporary information is provided about the diagnostics, prevalence and pathogenesis of steroid-induced hyperglycemia. A particular attention is paid to current data on various disorders of carbohydrate metabolism in patients with a therapeutic profile. Main approaches to the correction of glycemia in the steroid-induced disorders of carbohydrate metabolism using modern therapy are considered elucidated.

Conclusion. The widespread use of glucocorticosteroids, significant prevalence of the steroid-induced disorders of carbohydrate metabolism, features of the pathogenetic mechanisms of steroid-induced diabetes mellitus determine the need to create algorithms for the diagnosis and treatment of these conditions. A conclusion is made that rational glucose-lowering therapy that takes into account the pathogenetic and clinical aspects of the steroid-induced disorders of carbohydrate metabolism, can reduce the rate of macro- and microvascular complications.

Conflict of interest: the authors declare no conflict of interest.

The article is a review of Russian and foreign publications on the use of social networking technologies in medicine. The analysis of social networks involves a special methodology that permits communications between the participants of social networks to be studied in a formalized way. The article presents the main terminology and history of the problem, as well as the interpretation of its key definitions (homogeneity, multiplicity, reciprocity/mutuality, bridge, density, distance, clustering coefficient, centrality). It is noted that the methods of social networking analysis are rarely used in the Russian healthcare system, compared to other countries. At the same time, existing social networks have an important impact on health-related behaviour, particularly in terms of contraception, the risk of contracting HIV infection and sexually transmitted diseases, smoking, obesity, physical activity and psychoactive drug consumption. It is important that social networks can be used to accelerate behavioural change, reduce undesirable consequences arising from the spread of negative behaviour, improve social changes and promote innovations. This technology referred to as network interventions, along with its methodology, is described in the present article. In addition, the results of studies into the application of this technology abroad are presented.

Conclusion. The use of networking analysis in the domestic healthcare system, focused on Internet communities, can significantly improve the effectiveness of state programs aimed at improving population health.

Conflict of interest: the authors declare no conflict of interest.

The aim was to analyze the course of pregnancy and childbirth in a woman after a severe spinal injury.

Materials and methods. A patient, who became pregnant after a severe spinal injury, was examined and provided with obstretric aid. Her medical documents (medical history) and an individual card of the pregnancy course were examined.

Results. The outcome of pregnancy and childbirth was determined for the patient and the fetus after a severe spinal injury.

Conclusion. This case demonstrated the course of pregnancy and childbirth in a patient with serious complications arising from a spinal injury. However, despite the severe extragenital pathology, and thanks to the efforts of relevant specialists, the patient endured the pregnancy and was delivered by cesarean section at 37 weeks of gestation, with the birth of a live fullterm newborn. Patients with post-traumatic changes of the musculoskeletal system should be allocated to a separate risk group. Such pregnant women should be subject to a thorough examination in the early stages of pregnancy by a traumatologist and a neurologist, as well as, if indicated, by other specialists. The management tactics of this category of women during pregnancy and childbirth should be strictly individualized.

Conflict of interest: the author declares no conflict of interest.