Background: Exercise-induced muscle damage is expected to cause delayed onset muscle soreness, inflammation, and decreased muscle function. Tart cherry juice supplementation has been explored for its anti-inflammatory and antioxidant effects, which are believed to assist in recovery as well as enhance muscle function.

Objective. Integrate the evidence from published research to ascertain the effects of tart cherry juice supplementation on muscle function, recovery, and reduction of muscle damage, with specific reference to the key outcomes such as delayed onset muscle soreness, muscle strength, range of motion, and inflammatory and oxidative stress biomarkers.

Methods. This was a systematic review and meta-analysis of the effectiveness of tart cherry juice supplementation on muscle soreness and recovery based on studies employing varied exercise protocols. A random-effects model was used to estimate MD with 95% CI between various outcomes, such as delayed onset muscle soreness, maximal voluntary isometric contraction, range of motion, inflammation (IL-6), and creatine kinase levels.

Results. Tart cherry juice supplementation improved range of motion significantly (MD = 0.33, 95% CI [0.02, 0.65], p = 0.04) and decreased IL-6 levels significantly (MD = -0.34, 95% CI [-0.56, -0.12], p = 0.003) without heterogeneity (I² = 0%). The impact on delayed onset muscle soreness was non-significant (MD = -0.47, 95% CI [-1.12, 0.18], p = 0.16) with minimal heterogeneity (I² = 0%). Maximal voluntary isometric contraction and creatine kinase also had no significant improvements (MD = 0.64, p = 0.33; MD = -33.40, p = 0.38, respectively). Heterogeneity of outcomes was observed in subgroup analyses based on intervention protocols and recovery measures.

Conclusion. Tart cherry juice improvement was moderate in enhancing range of motion and decreasing IL-6 levels, but its effectiveness on delayed onset muscle soreness, maximal voluntary isometric contraction, and creatine kinase was uncertain. Standardized dosing and extended follow-up durations are required in future research to revalidate these outcomes.

Background. The shortage of qualified specialists undermines the availability and quality of public healthcare and negatively influences national health and economy. A detailed causal analysis of the current situation, an assessment of the urgency of solving the problem, and the significance of training professionals are essential for eliminating the shortage. This article provides a comparative analysis of various approaches to upgrading the educational process to attract young people to the medical field.

Objective. To evaluate the efficiency of modern methods of training medical specialists and their impact on solving the shortage of qualified professionals in the field.

Methods. A systematic scoping review of Russian- and English-language literature in RSCI, Scopus, Pubmed, and eLIBRARY was conducted using content analysis, analytical generalization, analogies, and formalization methods.

Results. The analysis enabled the evaluation of modern methods of training specialists and their impact on solving the problem of shortages in healthcare.

Conclusion. To attract young specialists into healthcare, a comprehensive strategy is needed, including career guidance, modernization of medical education, continuous professional development of practicing physicians, and the development of medical lifelong education, and preceptorship for novice practitioners.

Background. Interleukin-1β plays an important role in the pathogenesis of coronavirus disease (COVID-19) and may also be informative as a prognostic marker of infection. Other widely used diagnostic and prognostic markers include C-reactive protein and ferritin.

Objective. To evaluate the effect of transcranial electrical stimulation on the serum levels of interleukin-1β, C-reactive protein, and ferritin in moderate to severe COVID-19 patients who do not receive targeted anti-cytokine therapy.

Methods. The conducted randomized prospective study included patients treated at the Regional Clinical Hospital No. 2 (Ministry of Health of the Krasnodar Krai) in the period from June 24, 2021 to February 23, 2022. The patients diagnosed with moderate to severe COVID-19 were divided into two groups: comparison group (n = 20) receiving standard treatment as per the current guidelines and a group (n = 15) in which, in addition to standard therapy, the patients received transcranial electrical stimulation (one session per day until day 7 of stay in the COVID ward). The study excluded patients receiving specific anti-cytokine therapy (monoclonal antibodies, kinase inhibitors, and recombinant cytokine receptor antagonists). The levels of interleukin-1β, C-reactive protein, and ferritin were assessed prior to treatment and at the end of the first week of therapy. Statistical analysis and data visualization were performed in the R environment (The R Foundation, Austria). Differences were considered statistically significant at p < 0.05.

Results. Prior to treatment, no statistically significant differences were observed in the levels of interleukin-1β, C-reactive protein, and ferritin between the groups. By the end of the first week, the level of interleukin-1β decreased by 11.8% (p = 0.7) in the comparison group, which was not statistically significant. In the group receiving transcranial electrical stimulation, interleukin-1β levels exhibited a significant decrease (by 71%) from the baseline (p = 0.007). In addition, interleukin-1β levels in this group were 52% lower than in the comparison group (p = 0.005). Also, C-reactive protein levels decreased significantly in both groups, while ferritin levels did not exhibit any statistically significant changes.

Conclusion. The use of transcranial electrical stimulation in combination therapy for moderate to severe COVID-19 patients results in a more pronounced decrease in serum interleukin-1β levels as compared to standard therapy, which may indicate the anti-inflammatory potential of this method.

Background. Post-pancreatectomy acute pancreatitis is a serious, procedure-specific complication that occurs after pancreatoduodenectomy. However, only in 2022 did the International Study Group of Pancreatic Surgery formulate a clear definition and diagnostic criteria for post-pancreatectomy pancreatitis.

Objective. To determine the incidence of post-pancreatectomy acute pancreatitis according to the current ISGPS definition and classification, to assess risk factors for this complication, and to evaluate its association with other procedure-specific postoperative complications following pancreatoduodenectomy.

Methods. A single-center retrospective cohort study was conducted based on review of medical record of 451 patients who underwent pancreatic resections at the Department of Abdominal Surgery of the National Medical Research Center of Surgery named after A.V. Vishnevsky between January 2021 and May 2025. A total of 147 patients who underwent pancreatoduodenectomy were included in the analysis. All patients were divided into two groups: those who developed post-pancreatectomy acute pancreatitis (per ISGPS criteria) and those without this complication. Primary endpoints included: incidence and severity score of post-pancreatectomy acute pancreatitis; its impact on overall postoperative morbidity; overall frequency of procedure-specific postoperative complications and each complication separately (pancreatic fistula, postoperative hemorrhage, delayed gastric emptying); frequency of reoperations; postoperative length of stay; length of stay in the intensive care unit; and in-hospital mortality. Potential risk factors for post-pancreatectomy acute pancreatitis were assessed.

Results. Persistent elevation of serum amylase for at least the first two postoperative days occurred in 29/147 patients (19.7%). According to ISGPS criteria, 7/147 patients (4.8%) were classified as having postoperative hyperamylasemia rather than a complication. Post-pancreatectomy acute pancreatitis developed in 22/147 patients (14.9%): grade B in 14 cases (9.5%) and grade C in 8 cases (5.4%). Post-pancreatectomy acute pancreatitis had a significant impact on postoperative course. These patients had a significantly longer postoperative hospital stay (p < 0.001), longer ICU stay (p < 0.001), a higher overall rate of postoperative complications (p < 0.001), and a higher rate of severe complications (Clavien–Dindo ≥ 3) (p = 0.002), including procedure-specific complications (p < 0.001). Clinically relevant pancreatic fistulas (p < 0.001), postoperative hemorrhage (p = 0.003), and delayed gastric emptying (p = 0.016) occurred more frequently; reoperations were more common (p = 0.001); and mortality was significantly higher (18.2% vs. 3.2%; p = 0.018). Comparative analysis showed that post-pancreatectomy acute pancreatitis developed significantly more often in patients with diagnoses other than pancreatic ductal adenocarcinoma or chronic pancreatitis (p = 0.011), in those with a “soft” pancreatic texture (p = 0.008), a narrow main pancreatic duct (p = 0.007), and with a high abundance of acinar structures in the pancreatic section (p = 0.001). Multivariate analysis demonstrated statistical significance only for the high proportion of acinar structures in the pancreatic specimen and intraoperative blood loss.

Conclusion. Post-pancreatectomy acute pancreatitis now has a well-established definition and clear diagnostic criteria, including severity score. It substantially affects the postoperative course, often necessitating additional conservative or interventional treatment and, at times, reoperation. Accounting for risk factors for post-pancreatectomy acute pancreatitis may help improve short-term outcomes following pancreatoduodenectomy.

Introduction. Tuberculosis represents a long-standing biological challenge, and its impact on public health can be examined through epidemiological evaluation. Alongside traditional analysis of key disease indicators, molecular-genetic monitoring is a crucial component of epidemiological assessment. It enables identifying and tracking specific Mycobacterium tuberculosis strains circulating in a population. The aim of this study was to examine the epidemiology of tuberculosis as a long-standing biological challenge together with the genetic characterization of contemporary M. tuberculosis strains circulating in the Republic of North Ossetia–Alania. Methods. This mixed-design study (cohort and cross-sectional) consisted of two parts and employed epidemiological and microbiological (molecular-genetic) methods. A cohort analysis of all tuberculosis cases registered in the Republic of North Ossetia–Alania was conducted from 2014 to 2024. The epidemiological method evaluated the prevalence of pulmonary tuberculosis and served as the background for the bacteriological (molecular-genetic) cross-sectional study of the genotypes of M. tuberculosis strains circulating in the region, conducted from January to August 2024. Epidemiological indicators were obtained from federal statistical reporting forms and Rosstat. For genotyping, the total cohort of patients with active pulmonary tuberculosis under follow-up in the Republican Clinical Center for Phthisiopulmonology from January to August 2024 was considered (n = 230). Among them, 82 patients had newly diagnosed pulmonary tuberculosis; of these, 40 excreted the bacteria. Strain affiliation to the Beijing genotype and its subtypes B0/W148 and Central-Asian/Russian in culture-positive cases was determined using PCR detection of specific markers. All strains underwent spoligotyping, followed by comparative analysis with published datasets from neighboring territories and entries in the international SITVIT2 database. Results. Between 2014 and 2024, the Republic of North Ossetia–Alania demonstrated a marked decline in tuberculosis incidence and mortality — from 49.7 to 20.4 and from 9.1 to 1.5 per 100,000 population, respectively. From January to August 2024, 82 newly diagnosed cases of pulmonary tuberculosis were registered, and 40 M. tuberculosis cultures were isolated from bacteria-excreting patients. Of the genotyped strains, 41.7% (15/36) belonged to the Beijing genotype, with characteristic spoligotypes SIT 1 and SIT 265. The remaining strains belonged to the LAM (19.4%), T (22.2%), Haarlem (8.3%), and Ural (5.6%) families. Drug sensitivity was retained in 73.9% (17/23) of non-Beijing strains; 85.7% (7/8) of multidrug-resistant (MDR) isolates were of the Beijing genotype. Within the Beijing lineage, the dominant subtypes were Central-Asian/Russian (60.0%; 9/15) and B0/W148 (33.3%; 5/15), with all B0/W148 isolates demonstrating MDR. Rifampicin and isoniazid resistance was associated with rpoB Ser531Leu and katG Ser315Thr mutations. Conclusion. In the Republic of North Ossetia — Alania, the tuberculosis situation has stabilized with a trend toward improvement; however, the proportion of primary multidrug-resistant tuberculosis has significantly increased. Molecular-genetic analysis of M. tuberculosis isolates from newly diagnosed patients in 2024 revealed a heterogeneous pathogen population dominated by Beijing-genotype strains (42%). Although the proportion of the Russian epidemic Beijing subtype B0/W148 (13.9%) was relatively low, all such strains exhibited multidrug resistance. High population migration from neighboring Caucasus states with unstable socioeconomic conditions may contribute to the spread of MDR tuberculosis in North Ossetia — Alania and adjacent Russian regions, indicating the need for continued and geographically expanded study.

Introduction. Cerebral cavernous malformations may coexist with various disorders of the central nervous system, including brain tumors. There are few descriptions of combined cavernous malformations and meningiomas in the literature. When a cavernous malformation co-occurs with a tumor, the diseases may have various progression trajectories, and symptoms may appear in different sequences over many years. The present case describes the detection of multiple de novo cavernous malformations of the brainstem and the right subcortical region 14 years after the total resection of a meningioma arising from the posterior third of the falx cerebri.

Case description. A 55-year-old woman was transferred from the Abinsk Central District Hospital to the Research Institute — Prof. S.V. Ochapovsky Regional Hospital No. 1 with complaints of dizziness, gait instability, dysarthria, dysphagia, and nausea. According to her history, on 14 February 2008 she had undergone successful resection of a meningioma of the posterior third of the falx cerebri. For five years she was regularly followed by a neurosurgeon at the consultative and diagnostic center of Prof. S.V. Ochapovsky Regional Hospital No. 1; no evidence of tumor re-growth or other intracranial pathology was found, after which she discontinued follow-up. Fourteen years later she developed sudden-onset dizziness, gait instability, speech and swallowing disturbances, and nausea. Examination revealed cavernous malformations of the brainstem and right subcortical region. The brainstem cavernous malformation had presented with intracerebral hemorrhage. The pronounced neurological deficits were an indication for surgical intervention. A midline suboccipital craniotomy with resection of the brainstem cavernous malformation was performed. Neurological deficits regressed during postoperative management.

Conclusion. The combination of multiple cavernous malformations and meningiomas is rare. Surgical treatment should be guided by the pathology that is clinically dominant at the time. Resection of a brainstem cavernous malformation can improve functional outcomes.

Introduction. The development of gamete donation programs and the rapid increase in the number of offspring born from assisted reproductive technologies have raised questions about access to biological identity information. This ethical and legal dilemma is linked to physiological risks (consanguinity), psychological risks (self-identification and defining kinship), and social risks (perceptions by others), and requires the attention of the medical community as the primary actor.

Aim. To provide an ethical and legal examination of different approaches to reproductive donor anonymity, comparing models of open and anonymous donation. Special attention is given to the risks associated with de-anonymizing donors and to analyzing limitations and advantages of each approach.

Methods. The study included a comparative legal analysis, followed by an ethical analysis of assisted reproductive technologies, and concluded with a qualitative risk assessment.

Results. The main donation models are identified and described: anonymous donation, the use of biomaterial from a known donor (a relative or friend of the recipient), and open donation, which implies potential access to identifying information about the donor. The choice of model is determined by the political and legal framework and cultural norms within a given society. The Russian Federation features a three-tiered donor model that allows the recipient to decide on anonymity themselves. In this context, reproductive medicine clinics play a crucial role in shaping openness policies. Ethical contradictions are reflected in scholarly debates. Advocates of open donation appeal to the value of birth-related information for the child’s genetic and psychological well-being. Free access to donor information presupposes family institution transformation towards greater variability of family forms and a reinterpretation of links between genetic and social kinship. On the other hand, researchers express concern about how this transformation may affect individual families seeking to preserve their own normativity. The final section outlines the main risks of de-anonymizing donors: a decline in donor numbers, psychological pressure on donors, and intra-family conflicts. Existing legislative mechanisms to mitigate these risks are described.

Conclusion. There is no global consensus regarding the ethical and legal interpretation of donor anonymity in human reproduction, yet the growing number of donation programs suggests that their anonymity is likely to be removed. To date, the scientific community has not developed a unified position on this issue, differing primarily in two key arguments: the prioritization of interests and the impact on family institution.