Background. The study aims to evaluate the efficacy of combination hepatoprotective therapy for alcoholic liver damage. Given the difference in the mechanism of action and the experimentally demonstrated cytoprotective efficacy of ademetionine and lipoic acid, these drugs could be expected to potentiate each other’s effects. Objective. To determine the effect of the combined use of ademetionine and lipoic acid on the cytolytic syndrome and oxidative metabolism in the blood of patients with alcoholic hepatitis. Methods. A randomized prospective study was conducted examining 30 patients diagnosed with alcoholic liver disease and 15 healthy individuals. The patients were treated at the Drug Abuse Clinic of the Krasnodar Krai Ministry of Health, whereas healthy volunteers were monitored at the Clinic of the Kuban State Medical University (2022–2024). The study included male patients aged 20 to 40 years with a diagnosis of alcoholic liver disease in the form of alcoholic hepatitis. Patients with other decompensated somatic and psychiatric disorders were excluded from the study. Via simple randomization with the use of random number tables, the patients were distributed into three groups. Group 2 patients received ademetionine (400 mg intravenously per day, Hepcifol). Group 3 patients were administered lipoic acid (600 mg intravenously per day, Octolipen). Group 4 patients received combination therapy with the administration of ademetionine and lipoic acid in the specified dosages and forms. The inpatient treatment lasted 15–18 days; on admission and prior to discharge, the patients had their blood samples taken. Blood serum was assayed for the activity of hepatocyte cytolysis markers and the concentrations of total protein, albumin, and bilirubin, as well as total antioxidant activity and thiol group content. The concentrations of glutathione and thiobarbituric acid reactive substances were determined in erythrocytes. The data were statistically processed using Statistica 10 (StatSoft, Inc., 2011). The differences between the parameters of the groups were considered statistically significant at p < 0.05. Results. Following a three-week course of treatment, the combination therapy with two sulfur-containing hepatoprotectors helped to achieve 1.7–2.1 times lower activity of alanine aminotransferase and gamma-glutamyltransferase in blood plasma as compared to the corresponding markers in the groups of patients receiving only one of the drugs. The therapy with sulfur-containing drugs was accompanied by tendencies toward normalization of free radical homeostasis. The maximum effects were achieved when lipoic acid was used alone or together with ademetionine. In this case, a 52–64% increase in the antioxidant activity of blood plasma was observed, with the concentration of thiobarbituric acid reactive substances decreasing by 28–36%. Conclusion. The combination therapy with the use of sulfur-containing hepatoprotectors helped to achieve the lowest possible enzyme activity (cytolytic syndrome markers) in patients with alcoholic hepatitis

Background. Numerous studies indicate the multifactorial genesis of allergic diseases, which development and manifestation are underpinned by both endogenous and exogenous factors. Genetic predisposition is considered significant among the endogenous factors. The existing genetic research often presents contradictory findings and population-specific characteristics, thereby prompting further investigation into the role of polymorphism in the genes of body defense and adaptation systems in the pathogenesis of allergic diseases with pollinosis among them. Objective. To study the distribution characteristics of certain polymorphic loci of genes involved in the antioxidant defense system and biotransformation of xenobiotics (superoxide dismutase, glutathione transferase), pro-/anti-inflammatory cytokines as genetic risk factors influencing the onset and characteristics of pollinosis. Methods. An observational prospective case-control study involved patients from regional allergy centers (Ochapovsky Regional Clinical Hospital No. 1 and the Outpatient Department of the Regional Clinical Hospital No. 2, Krasnodar Krai, Russia). Additionally, the study enrolled 1st to 6th-year students of the Kuban State Medical University, who suffer from seasonal allergies. The study was carried out during the acute period of the disease, from February 20, 2023 to May 31, 2024. Based on clinical and anamnestic data, laboratory analysis results, and questionnaires considering the aforementioned compliance criteria, two study groups were formed depending on the disease course and its severity. Group 1 comprised patients diagnosed with allergic rhinitis (n = 55), group 2 included patients with a diagnosis of allergic rhinitis in combination with bronchial asthma (n = 35). In addition, a control group (n = 61) was formed from individuals undergoing preventive medical check-ups in specified organizations, as well as from allergy-free 1st to 6th-year students of the Kuban State Medical University. The distribution of genotypes of polymorphic variants of the following genes: -58 T>C SOD2, -313 A>G GSTP1, -308 G>А TNF-α, -592 C>A IL-10 among the study groups was considered a primary outcome measure of the study. Additional study parameters included indicators of the antioxidant system and lipid peroxidation, which were determined in order to evaluate the pathogenetic role of polymorphic variants of the studied genes in the patients (activity of the enzymes superoxide dismutase, glutathione transferase, and the level of malondialdehyde). Statistical analysis was performed using the Jamovi 2.3 (2022) software (Jamovi Project, Australia). Differences were considered statistically significant at p < 0.05. Results. The study established the metabolic shifts in the pro-/antioxidant system, leading to a condition characterized as oxidative stress in the study group of patients. An analysis of the distribution of genotypes for the -58 T>C SOD2 polymorphism gene revealed that the heterozygous TC genotype was more frequently observed in the allergic rhinitis group (p < 0.001, odds ratio = 8.636; 95% confidence interval: 2.99–24.91) and in the group of patients with allergic rhinitis combined with bronchial asthma (p < 0.05, odds ratio = 3.75; 95% confidence interval: 1.30–10.86). The mutant genotype polymorphism -313A>G GSTP1 gene was characteristic of patients in the allergic rhinitis group (p < 0.05, odds ratio = 5.25; 95% confidence interval: 1.26–21.86). The predominance of the GA genotype of the -308 G>А TNF-α gene polymorphism was characteristic of patients in all study groups (p < 0.001, odds ratio = 22.53; 95% confidence interval: 8.34–60.83 for allergic rhinitis; odds ratio = 15.88; 95% confidence interval: 5.48–45.99 for allergic rhinitis combined with bronchial asthma). Conclusion. The identification of gene polymorphisms related to body defense and adaptation systems, namely, -58 T>C SOD2, -313A>G GSTP1, -308 G>А TNF-α in individuals suffering from pollinosis obtains high predictive potential for disease development, its course, and guiding treatment strategies.

Background. To date, no unified approach exists to assessing the typological characteristics of peripheral microcirculation parameters, including those obtained through laser Doppler flowmetry, which diminishes the diagnostic value of the method but opens up prospects for experimental studies using laboratory animals. Objective. To identify and analyze the typological features of the cutaneous microhemodynamics of rats using laser Doppler flowmetry. Methods. A selective experimental study was conducted on 42 sexually mature male Wistar rats of mean age (192.21 ± 11.73 days) and weight (377.57 ± 21.93 g). Indices of cutaneous blood microcirculation were assessed using laser Doppler flowmetry with the laser blood flow analyzer “LAZMA-MC-1” (wavelength 0.8 μm) using the LDF 2.20.0.507WL software program (NPP Lazma, Russia). A comprehensive set of indices was recorded in the rats, allowing for the evaluation of individual-typological characteristics of cutaneous microhemodynamics: microcirculation index (average blood perfusion in microvessels per unit volume of tissue over the study period); flux (standard deviation from the arithmetic mean value of perfusion); coefficient of variation (ratio of flux to the mean value of perfusion); amplitudes of blood flow velocity fluctuations in endothelial, neurogenic, myogenic, respiratory, and cardiac frequency ranges; values of neurogenic, myogenic, and endothelium-dependent components of microvascular tone; ratio of blood inflow to venous outflow; value of nutritive and shunt perfusion; and microcirculation efficiency index. The significance of differences between index values in animals with different typological characteristics of cutaneous microhemodynamics (3 groups) was evaluated using the Kruskal-Wallis test, with the level of significance of differences between groups assessed by Dunn’s test. Results. Based on the assessment of baseline blood flow indicators in rats, three types of microcirculation were identified: aperiodic (41% of the sample), monotonic with low perfusion (33% of the sample), and monotonic with high perfusion (26% of the sample). These types, as demonstrated by wavelet analysis of the amplitude-frequency spectrum of dopplerograms, differ in their functional states concerning the main regulatory factors associated with endothelial, neurogenic, myogenic, and metabolic mechanisms and correspond to normo-, hypo-, and hyperemic hemodynamic types of microcirculation. Conclusion. The conducted study has revealed the typological features of cutaneous microhemodynamics and is instrumental in understanding the mechanisms of its functioning as well as in more effective applying laser Doppler flowmetry.

Background. Selecting therapy for temporomandibular myofascial pain syndrome must be carefully justified, since functional impairments may be compensated and acceptable for the patient. Treatment for patients with temporomandibular myofascial pain syndrome is primarily aimed at improving the psychological and physical state of the patient, as well as restoring lost functions, which is defined by the rehabilitation potential. Along with eliminating the chronic pain, the treatment is required to activate the compensatory mechanisms of the body responsible for restoring lost functions. Objective. To assess the rehabilitation potential of the masticatory musculature in patients with temporomandibular myofascial pain syndrome over the course of treatment. Methods. 74 patients diagnosed with temporomandibular myofascial pain syndrome participated in a randomized prospective controlled study conducted from 2021 to 2024. The patients were divided into two groups based on the therapeutic regimen applied. Group I comprised 37 patients who received standard therapy, including the administration of non-steroidal anti-inflammatory drugs and blocking the motor fiber of the third branch of the trigeminal nerve. Group II included 37 patients who additionally participated in a device-assisted facial and mandibular gymnastics. The study was supervised by the Advisory Council of the Department of Dentistry of the Institute for Continuous Medical and Pharmaceutical Education and the Department of Surgical Dentistry and Maxillofacial Surgery, Volgograd State Medical University, Russian Federation. The study was conducted at the Volgograd Regional Clinical Dental Polyclinic and the Dental Clinical Diagnostic Center, Volgograd State Medical University, Russian Federation. The duration of follow-up for each patient comprised 6 months. The data analysis was carried out prior to treatment, as well as in 14 days, 1 month, 3 months, and 6 months after treatment. The masticatory muscles rehabilitation potential was assessed using various methodologies, including psychological evaluations (assessment of psycho-emotional state via the Perceived Stress Scale), clinical measures (palpatory algometry, evaluation of muscle functional activity according to the Modified Ashworth Scale, maximum mouth opening, 3D dental scanning, and radiological examination), as well as functional assessments (myotonometrical and electromyographic tests). The applied methodology allowed for evaluating pain management, restoring masticatory muscle functionality, a decrease in the mean amplitude of the temporalis and masseter muscles, and an increase in maximal mouth opening. Statistical analysis was performed using Microsoft Excel 2017 (Microsoft, USA), with a significance level at p ≤ 0.05. Results. According to the analysis of psychological stress, all patients exhibited disturbances in their psycho-emotional state, with an average stress score of 39.4 ± 4.1, indicating its high intensity. Based on these findings, the patients were referred for consultation with a psychotherapist. During the treatment, all groups demonstrated positive outcomes within a short observation period (within 14 days after the start of treatment). However, pain relief occurred more intensively with the administration of a 2% lidocaine solution (3–4 ml) for nerve block. In the long term, the dynamics of functional activity changes varied among the compared groups. Notably, Group II (patients received a device-based complex of facial and mandibular gymnastics) revealed a statistically significant difference in both pre-treatment measurements and the control group indications. A persistent reduction in the mean amplitude of the temporal and masseter muscles, as well as their symmetry index, torsional index, and masseteric index, was observed. Clinically, this correlated with an improvement, implying a decrease in the severity of pain. In contrast, Group I showed changes in values that were close to the initial parameters, marked by a decrease in rehabilitation potential. Improvements in clinical and functional assessment indicators suggest the activation of compensatory mechanisms and enhanced functionality of the masticatory muscles underpinned by alleviating the temporomandibular myofascial pain through facial and mandibular gymnastics. Conclusion. The study results justified the use of device-assisted facial and mandibular gymnastics in the treatment of temporomandibular myofascial pain syndrome to be safe and effective in terms of rehabilitation potential. The standard treatment was established to be most effective within the short-term period (up to 14 days from the start of treatment), while the suggested regimen activates the compensatory mechanisms of the body. Consequently, the management strategy for patients with this pathology should consider the individual resources and rehabilitation potential, as well as social activity and compliance of the patients.

Background. Lung cancer has long been the most common type of cancer in the male population (16.4%). The incidence of lung cancer among women is increasing worldwide. In Russia, as of 2022 (compared to 2013), lung cancer shifted to the second place in the structure of cancer incidence among males, following prostate cancer. However, the anticipated rise in new cases of this pathology requires an analysis for evaluating and adjusting the current anti-cancer programs. Objective. To analyze the incidence rates and quality of oncological care provided for malignant neoplasms of the lung in the Siberian Federal District within 2013–2022. Methods. A retrospective observational study was conducted utilizing depersonalized data on the prevalence and structure of malignant neoplasms derived from the reports of the Siberian Federal District subjects, the Russian Federation (form No. 7 “Information on Malignant Neoplasms” and form No. 35 “Information on Patients with Malignant Neoplasms”), as well as from the Russian Federal State Statistics Service. The primary indicators of the study included the proportion of lung cancer within the structure of cancer incidence in men and women (C33.0, 34.0–C34.9 according to the ICD-10 classification), standardized incidence rates of lung cancer in men and women, age-specific incidence rates of lung cancer in men and women, by-stage distribution of the lung cancer tumor process, morphological verification, active case finding, one-year mortality, and the proportion of patients with malignant lung neoplasms who were registered for five years or more, uptake ratio of lung cancer population, ratio of one-year mortality to stage IV cases of the previous year. The calculations of standardized and age-specific incidence rates were performed using ONCOSTAT, while the quality indicators of oncological care were assessed using the Cancer Care Indicators software. Standardized incidence rates were calculated according to SEGI age standardization. Statistical analysis of qualitative indicators of medical care provided to patients with malignant neoplasms of the lung over time was conducted using linear regression analysis methods; statistical significance was evaluated at p ≤ 0.05. Results. A decrease in lung cancer incidence among men was observed in the Siberian Federal District, whereas the level of this indicator among women remained unchanged. The comparison of oncological care indicators for lung cancer patients in 2013 and in 2022 revealed several notable changes. The proportion of morphologically verified malignant neoplasms increased from 72.9% to 87.9%. The percentage of cases diagnosed at stages I-II grew from 24.2% to 29.1%, while the proportion of patients registered for five years or more increased from 37.3% to 43.4%. The uptake ratio of lung cancer population extended from 2.2 to 2.7. Conversely, the one-year mortality rate decreased from 55.2% to 47.8%, and ratio of one-year mortality to stage IV cases of the previous year diminished from 1.3 to 1.0. However, a number of advanced cases grew from 39.4% to 40.6%. Conclusion. The conducted epidemiological analysis revealed a decrease in the incidence of lung malignancies among men (from 63.9 to 57.5 cases per 100,000 population) and stagnation of the incidence rate among women (approximately 10.1 cases per 100,000 population) in the Siberian Federal District during the study period. The proportion of lung cancer within the structure of cancer incidence in men reduced from 21.5% to 17.6%. Key indicators of the quality of medical care provided to patients with lung malignancies demonstrate a positive trend; however, the proportion of cases diagnosed at stage IV appears pessimistic (40.6%). The obtained data necessitates the development and implementation of preventive measures for early diagnosis, including screening programs, as well as educational activities aimed at healthcare professionals and the general population, to promote healthy lifestyles and enhance oncological awareness.

Background. The enzyme-linked immunosorbent assay based on recombinant analogues of Treponema pallidum immunogenic proteins enables the diagnosis of syphilis by determining immunoglobulin G and immunoglobulin M. The detection of specific immunoglobulin M is considered an important criterion in diagnostics of syphilis at early stages. The efficiency of the assay depends on the antigens used to detect antitreponemal antibodies and the clinical stage of the infection. No consensus exists on which antigens exhibit the best characteristics for serodiagnosis of syphilis, and no test systems can differentiate between various forms of the infection or assess treatment efficacy. This highlights the need for new antigens or combinations thereof that can identify antibodies characteristic of specific clinical forms of the disease. Objective. To evaluate the diagnostic potential of recombinant Treponema pallidum proteins TР0163 and TР0971 as candidate antigens for detecting immunoglobulin M in serum samples from patients with primary, secondary, early latent, and late latent syphilis using the enzyme-linked immunosorbent assay. Methods. A pilot observational study was carried out with a control group of blood serum samples from 10 healthy donors and 45 blood serum samples from patients with a confirmed diagnosis of the following forms of syphilis: primary (n = 12), secondary (n = 6), early latent (n = 13), and late latent (n = 14). Diagnosis and classification of the disease were determined by a dermatovenereologist according to clinical guidelines. The primary endpoint of the study was to assess the diagnostic capability of recombinant Treponema pallidum proteins TР0163 and TР0971 for detecting immunoglobulin M using enzyme-linked immunosorbent assay. Data processing was carried out by means of Microsoft Excel 2017 (Microsoft, USA). A statistical level was considered statistically significant at p < 0.05. Results. The diagnostic sensitivity of detection immunoglobulin M with recombinant antigen TР0971 accounted for 91.7%, 83.3%, 84.6%, and 7.7% for patients in the primary, secondary, early latent, and late latent syphilis groups, respectively. For recombinant antigen TР0163, statistically significant detection of immunoglobulin M was observed for secondary and early latent syphilis, with diagnostic sensitivities of 66.7% and 53.8%, respectively. In primary and late latent syphilis, immunoglobulin M to TР0163 were not revealed. Conclusion. TР0971 represents a promising antigenic marker for early stages of syphilis. Antigen TР0163 is characterized by low diagnostic sensitivity for detecting immunoglobulin M to Treponema pallidum.

Background. In the post-pandemic period, Russia is characterized by a relatively high level of infectious morbidity, combined with the “infection surveillance” of the population and fear of possible epidemics. Managing health risks associated with the spread of infections requires a comprehensive approach that addresses both the healthcare system and individual behavior. Objective. To identify the features of subjective risk perception regarding infectious diseases and to describe behavior risk-associated strategies in a sample of urban populations in the Russian Federation. Methods. An empirical study was conducted using a mixed methodology. The first phase involved a formalized survey (n = 300) aimed at measuring the subjective perception of infectious disease risk and related behaviors. The second phase included an analysis of in-depth interviews (n = 11) in order to clarify the essence of behavior strategies aimed at managing the infectious disease risk. Descriptive statistics, odds ratio calculations, as well as correlation and factor analyses were employed for processing quantitative data by means of SPSS Statistics 21.0. Qualitative data analysis involved open and axial coding. Results. The development of infectious diseases is perceived as the most significant risk among residents of Russian metropolitan areas. The majority of respondents (80%) rate the risk at 0.5 or higher (indicating alarming and high levels of risk) and implement various measures for its management. Determinants influencing strategy choice include age (Pearson’s r = (-)0.539 at p < 0.001) and parental status (Spearman’s ρ = 0.360 at p < 0.05). Subjective risk assessment is not considered a statistically significant predictor of individual activity regarding risk. Factor analysis (model explanatory capacity 53%, p < 0.001) identified groups of actions aimed at risk reduction: 1) information seeking, 2) creating a protective space, and 3) interacting with the external environment. In-depth interview analysis clarified that despite a documented inclination towards action, individual behavior can be characterized as passive adaptation to the risk. Conclusion. Risk perception is found to be not a primary or necessary factor in choosing an active risk management strategy. The reluctance to take risk-reducing actions is associated with an external locus of control, which involves a belief that risk is uncontrollable and assigning responsibility to other subjects of the risk space. The findings may be considered in the development and improvement of measures to prevent the spread of infectious diseases, including health risk communication strategies