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The linguistic and axiological potential of unofficial urbanonyms reflecting the realities of the urban environment as a design space is evaluated. The research tasks include identifying typical and non-standard objects and motifs of evaluative urbanonymic nomination, developing optimal methods for describing interregional nominative parallels and unique slang terms in the dictionary of unofficial urbanonyms. The material sources consist of dictionaries of youth slang, author’s archives of spoken language, and internet communications (2010—2024). The semantics of slang terms-urbanonyms were clarified using componential and contextual analysis methods. Parameters of their lexical description were developed using the method of lexicographical construction. Based on slang material from Pskov and St. Petersburg involving unofficial urbanonyms from Ufa, Volgograd, Novosibirsk, and other cities, the evaluative attitude of nominators towards design projects embodied in architectural structures, memorial objects, street sculpture, and monumental painting is demonstrated. Interpretations, comments, and contextual illustrations in the presented fragments of the projected dictionary reveal the specificity of the nominator’s imagery associations when implementing various ways of slang formation: playful transformations of official names, references to precedent phenomena, metonymic and metaphorical transfers and their combinations.

The genus Paeonia L. includes both popular ornamental and medicinal plants with a rich history of cultivation and breeding. Breeding is an important process of increasing the diversity of the assortment and creating new cultivars of peonies with various economically important characteristics, such as the shape and color of flowers, different flowering periods and resistance to diseases and abiotic stressors. The main methods used in the breeding of peonies are traditional methods, including intraspecific, interspecific and intersectional hybridization, however, such factors as a long reproduction cycle and the complexity of the breeding process limit the possibilities for good progress in this work. The application of methods of biotechnology and molecular genetics make the breeding process more efficient. The use of germplasm resources and hybridization will accelerate the process of creating new cultivars not only with various decorative features, but also those with high adaptability to biotic and abiotic factors and resistance to phytopathogens and diseases. This review highlights the history of domestic and foreign breeding, modern trends and methodology of peony breeding. Information is provided on the achievements and limitations that exist in the field of molecular biological study of peonies.

Aim. To evaluate the relationship between leukocyte telomere length (LTL) and cardiovascular risk factors in young and middle-aged patients without cardiovascular disease (CVD).Material and methods. This cross-sectional study involved 450 patients aged 30 [21;42] years. Risk factors and possible exclusion criteria was assessed through questionnaires and anthropometric examination. In all subjects, glucose concentration and lipid profile were assessed using the CardioChekPA express analyzer (USA, 2017), followed by calculation of integral metabolic indices: visceral adiposity index (VAI), body fat percentage, body adiposity index (BAI), lipid accumulation product (LAP). LTL was measured in whole blood samples using fluorimetry (Qubit 4 Singapore 2020) and reverse transcription polymerase chain reaction (QIAamp Blood Mini Kit, German 2022). Statistical analysis was carried out using the Statistica 10 program.Results. The prevalence of the studied risk factors in the main group corresponded to the general population. According to the correlation analysis, LTL was associated with age (r=-0,26; p0,05), neck circumference (NC) (r=-0,53; p

An epizootological inspection of the liberated territories of the Donetsk and Lugansk People's Republics, Zaporozhye and Kherson regions was carried out. It was established that the faunal complex of small mammals, hare-like and ectoparasites, as well as their number, make it possible to ensure the circulation of natural focal infections identified by the results of laboratory studies: tularemia, Crimean hemorrhagic fever (CHF), West Nile fever (WNF), ixodic tick-borne borreliosis (ITB), rickettsiosis, human granulocytic anaplasmosis (HGA), leptospirosis, hemorrhagic fever with renal syndrome (HFRS), Q fever, intestinal yersiniosis, Batai, Inco, Sindbis, Tyaginya fevers. For the first time, the PCR method in field material from the Zaporozhye region (Berdyansk and Melitopol regions) detected the Crimean-Congo hemorrhagic fever virus, on the territory of the Donetsk and Lugansk People's Republics in the populations of small mammals (rodents and insectivores), the circulation of viruses Inco, Sindbis, Tyagin, Batai was established. In the territories of Kherson and Zaporozhye regions, the presence of combined and conjugated natural foci of ixodic tick-borne borreliosis, rickettsiosis and human granulocytic anaplasmosis is determined. According to the results of molecular genetic analysis, it was shown that the causative agents of natural focal infections (Crimean hemorrhagic fever, West Nile fever, ixodic tick-borne borreliosis, rickettsiosis) identified in 2023 are genetically close to strains circulating in the regions of the south European part of Russia.

Aim. To assess the efficacy and safety of lenvatinib and pembrolizumab for the treatment of mismatch repair-proficient endometrial cancer (EC) in routine clinical practice in Russia.Materials and methods. This multicenter, retrospective, cohort study included patients with recurrent and metastatic EC from 37 cancer centers in Russia treated between May 2020 and April 2023. Patients with histologically verified EC without microsatellite instability who received ≥1 course of pembrolizumab/lenvatinib therapy were included in the study. The primary endpoint was progression-free survival; the clinical characteristics of the patients were additionally analyzed, the objective response rate and the toxicity profile of therapy were assessed.Results. The study included 100 patients. Median age was 65 (30–83) years. The most common histologic tumor subtype was endometrioid adenocarcinoma (68 %); serous adenocarcinoma was diagnosed in 22 % of cases, other types of tumor – 10 % of cases. All patients had pMMR/microsatellite-stable tumors. The median progression-free survival was 7.75 months (95 % confidence interval 0.7–33.8), and a partial response to therapy was observed in 24 % of patients. Almost half of the patients (44 %) required dose reduction due to adverse events. The most common adverse events included fatigue (n = 26; 26 %), hypertension (n = 20; 20 %), and hypothyroidism (n = 14; 14 %).Conclusion. This study confirms the clinical efficacy of lenvatinib and pembrolizumab in patients with recurrent and metastatic EC without mismatch repair system deficiency (pMMR-tumors) in routine clinical practice.

Introduction. Allergy to microscopic fungi (micromycetes), which can colonize the respiratory tract, is associated with an eosinophilic endotype of inflammation and severe disease course. Among the hallmarks of fungal allergy, experts identify fixed airways obstruction, bronchiectasis, and fibrosis. Currently, there has been proposed the term “allergic fungal airways disease” (AFAD), which combines various clinical phenotypes, which pathogenesis is based on IgE-mediated allergic reaction against fungal spores colonizing the respiratory tract. According to this approach, the AFAD group includes severe asthma with fungal sensitization and allergic bronchopulmonary aspergillosis (ABPA). A promising direction in AFAD treatment implies the use of genetically engineered biological drugs against T-2 inflammation. The aim of the study was to evaluate the prevalence ofAspergillusspp. sensitization and allergic bronchopulmonaryAspergillosis in patients with asthma. Materials and methods. A retrospective single-center registry study was conducted in the I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russian Federation. The study included 523 patients with asthma of varying severity. The level of total and specific blood serum IgE against aeroallergens, includingAspergillusspp., was analyzed by enzyme immunoassay. The diagnosis of asthma was established in accordance with the recommendations of the GINA working group and the Clinical recommendations of the Ministry of Health of the Russian Federation, fungal sensitization and ABPA — in accordance with the recommendations of the ISHAM working group.Results. During the examination of patients with asthma, sensitization toAspergillusspp. recorded in 16.6% cases, severe asthma with sensitization toAspergillusspp. — in 7.4%, ABPA — in 6.1%. In patients with allergic asthma, the prevalence of sensitization toAspergillusspp. was 22%, severe asthma with sensitization toAspergillusspp. — 10.1%, ABLA — 8.1%. Among patients with ABPA, females (64%) aged 40 years and older prevailed. The major clinical manifestations of ABPA were presented as cough (96%) and shortness of breath (76%), CT scan radiological changes were in a form of bronchiectasis (72%). Conclusion. A high prevalence of sensitization toAspergillusspp. in patients with asthma was found. It is necessary to includeAspergillusspp. into the list of tested allergens while examining patients with chronic lung diseases for timely detection of AFAD and prescription of proper anti-inflammatory or antimycotic therapy.

This review article is focused on the progress made in the synthesis of 5′-α-P-modified nucleoside triphosphates (α-phosphate mimetics). A variety of α-P-modified nucleoside triphosphates (NTPαXYs, Y = O, S; X = S, Se, BH3, alkyl, amine, N-alkyl, imido, or others) have been developed. There is a unique class of nucleoside triphosphate analogs with different properties. The main chemical approaches to the synthesis of NTPαXYs are analyzed and systematized here. Using the data presented here on the diversity of NTPαXYs and their synthesis protocols, it is possible to select an appropriate method for obtaining a desired α-phosphate mimetic. Triphosphates’ substrate properties toward nucleic acid metabolism enzymes are highlighted too. We reviewed some of the most prominent applications of NTPαXYs including the use of modified dNTPs in studies on mechanisms of action of polymerases or in systematic evolution of ligands by exponential enrichment (SELEX). The presence of heteroatoms such as sulfur, selenium, or boron in α-phosphate makes modified triphosphates nuclease resistant. The most distinctive feature of NTPαXYs is that they can be recognized by polymerases. As a result, S-, Se-, or BH3-modified phosphate residues can be incorporated into DNA or RNA. This property has made NTPαXYs a multifunctional tool in molecular biology. This review will be of interest to synthetic chemists, biochemists, biotechnologists, or biologists engaged in basic or applied research.

abstractPurpose: is to develop a methodology for zoning and socio-economic forecasting of the state of the northern and arctic territories in order to produce a conceptual framework to ensure their sustainability.Methods: the work is based on the statistical indicators and rating scores of the spatial development of the territories of the Republic of Karelia, indicators of financial statements of companies operating in the region, and other public information about them for 2010-2021. A number of methods of multivariate statistics, in particular, cluster and regression analysis, mapping method and scenario approach were used to analyze the data.Results: the study shows the importance of zoning and forecasting in the design and implementation of sustainable spatial development policy, as well as the need to update and adapt existing tools to new challenges and characteristics of the regions. The methodology of zoning of territories, based on the existing economic relations between actors and the role of human capital in sustainable development was developed. The methodology of mediumand long-term forecasting of socio-economic space, taking into account the mutual influence of adjacent territorial units, was proposed. The methods have been tested for the Karelian Arctic and economically connected territories of the North; a dynamic zoning model has been built. The forecast of mediumand long-term development of this space was carried out with the use of institutional innovations and overcoming of "bottlenecks" by the subjects of management.Conclusions and Relevance: the results obtained can become the basis for the policy of regional development. The paper proposes a conceptual framework of sustainable development strategy for the territories of the Republic of Karelia under consideration. It is shown that one of the fundamental problems of the majority of the northern territories is low human capital characteristics; in this connection a number of institutional changes, in particular, affecting the methodology of calculating social deductions for personal income tax and issuing referrals for targeted training, is proposed. This determines the practical signifi e of the study. The continuation of the work will be the detailing of the policy of sustainable development of Karelia.

Relevance. Molecular surveillance, aimed at obtaining up-to-date information on the genetic variants of pathogens circulating in the studied region, is an important element of the surveillance of natural focal infections (NFIs). The Stavropol Territory is one of the main recreational regions in the Russian Federation; it is endemic for a number of NFIs, including: Crimean-Congo hemorrhagic fever (CCHF), Q fever, tularemia, Lime disease, etc.The aim of the work is is genomic profiling of NFIs causative agents circulating in the Stavropol Territory in 2016-2021.Materials and methods. Microbial strains and samples of field and clinical material containing genomic DNA/RNA of pathogens were used as material for the study. Genetic typing of strains and isolates of DNA/RNA NFIs causative agents was performed by MLVA (Francisella tularensis and Coxiella burnetii) and genome fragment sequencing (Crimean-Congo hemorrhagic fever virus, West Nile virus, orthohantaviruses, Borrelia burgdorferii s.l., Ricckettsia sp.).Results. As a result of molecular genetic typing in the ST in 2016-2021 confirmed circulation of strains of F. tularensis of genetic subgroups B.I, B.III, B.VI, genetically identical strains of C. burnetii (VNTR-профиль 4-6-6-4-7-6-3-12-3-11), rickettsia belonging to 5 species: R. raoultii, R. aeschlimannii, R. slovaca, R. massiliae, R. helvetica , Borrelia belonging to the species: B. afzelii, B. garinii, B. miyamotoi, B. bavariensis, B. lusitaniae, B. valaisiana, RNA isolates of the CCHF virus of the Europe-1 and Europe-3 genetic lines, Tula orthohantaviruses, West Nile virus genotype 2. For the first time on the territory of the CT, in insectivore lung samples, RNA isolates of orthohantavirus genetically close to Camp Ripley virus (RLPV) were detected.Conclusions. New data have been obtained on the distribution of genetic variants of NFIs causative agents in the S, also in the recreation areas. Genetic structure of the population of NFIs causative agents in the ST in 2016-2021 did not change significantly, which indicates the relative stability of the natural foci of NFIs in the region.

Purpose of the study: to determine the individual psychological characteristics and features of coping with the disease in patients with the first psychotic episode and post-psychotic depression in order to identify targets for subsequent psychosocial interventions. We examined 1112 patients who underwent the first psychotic episode, of which, after the introduction of inclusion/exclusion criteria, two groups were formed in the final design: 243 patients with postpsychotic depression and 119 patients without depression in partial remission. Clinical and psychopathological method with objectification by PANSS, CDSS scales, clinical and psychological method with diagnostics of coping, psychological defense mechanisms, perfectionism and self-stigmatization by standardized questionnaires were used, regression analysis was carried out using the method of multiple linear regression with stepwise inclusion. From the numerical characteristics of the samples, the arithmetic mean was determined with the calculation of the standard error of the mean, standard deviation. Statistically significant results were accepted at the p

Recently, more attention has been paid to the role of indolamine-2,3-dioxygenase and aryl hydrocarbon receptor in maintaining a balance between immune reactivity and tolerance in various infectious diseases. It is known that the hallmark of COVID-19 is the activation of immuno-inflammatory pathways that induce indoleamine-2,3-dioxygenase, a key enzyme that catalyzes the metabolism of tryptophan along the kynurenine pathway, thereby changing the ratio of kynurenine/tryptophan in the blood serum of patients. An important property of SARS-CoV-2 is its ability to bind to aryl hydrocarbon receptor, which leads to an increase in intracellular expression of indolamine-2,3-dioxygenase and production of kynurenine at the initial stage of infection. Long-term activation of the aryl hydrocarbon receptor increases the production of interleukin-6, enhancing the inflammatory state and counteracting immune tolerance in the later stages of COVID-19. In aggregate, these data point to an important role of indolamine 2,3-dioxygenase and the aryl hydrocarbon receptor in controlling inflammation in patients with COVID-19. Dysregulation of the immune response not only threaten the host’s ability to cope with SARS-CoV-2, but can also predispose a person to secondary bacterial and fungal infections. Among the secondary infections that occur in patients with new coronavirus infection, COVID-19-associated invasive pulmonary aspergillosis is an important cause of death, although many aspects of the disease still remain unresolved. This review presents the current understanding of the importance of tryptophan metabolites and immunological factors in the pathogenesis of COVID-19 and invasive pulmonary aspergillosis.

The need for adaptation of existing cardiac rehabilitation programs for elderly myocardial infarction patients is dictated both by theprogressive aging of the Russian population and by the higher prevalence of cardiovascular diseases among them, including coronaryheart disease in the form of a previous myocardial infarction. The necessary condition for successful realization of the set task is to takeinto account the identified features of myocardial infarction patients of older age group, who are admitted for cardiac rehabilitation.Aim. To give a comparative characteristic of patients with myocardial infarction of older and middle age groups admitting to the thirdstage of cardiac rehabilitation in the Ivanovo State Medical Academy clinic (ISMA).Material and methods. 85 patients with myocardial infarction were examined, they were admitted from primary vascular centers fora three-week course of cardiac rehabilitation at the ISMA clinic. According to the WHO age periodization, 2 groups were identified: 40middle-aged patients (Group 1); 45 elderly patients (Group 2). An individual cardiac rehabilitation program was developed for eachpatient, which included daily controlled physical training, dosed walking, staircase walking at individually calculated pace, correctionof the revealed cardiovascular risk factors, information support, adequate drug therapy, correction of psychological disorders if needed.Clinical features of the disease course, tolerance to physical activity were analyzed in both groups.Results. The characteristic features of MI patients of the older age group in comparison with the middle-aged patients admitted to thethird stage of cardiac rehabilitation in the ISMA clinic are: dominance of non-working pensioners; high polymorbidity; higher frequencyof development of repeated MI without ST-segment elevation on ECG; predominance of complicated formation of left ventricularaneurysms and heart rhythm disturbances forms of MI; low frequency coronary revascularization in the acute period of the courseof the disease; prevalence of persons with signs of diastolic heart failure with preserved or slightly reduced left ventricular ejectionfraction; lower exercise tolerance. After completion of cardiac rehabilitation course in patients of older age group the increase in 6MWTdistance covered was 18%, while in middle-aged group it was only 8.3%. The implementation of the three–week rehabilitation programled to an increase in the number of patients with 1 FC of coronary heart disease due to a decrease in the number of patients with 3 and4 FC of coronary heart disease in the middle-aged group and 4 FC of coronary heart disease in the elderly.Conclusion. The identified features specify the necessity to include methods of concomitant pathology correction, individual approachto the choice of physical activity programs based on a thorough clinical assessment, including risk stratification of post-rehabilitationcomplications and rehospitalizations in the cardiac rehabilitation program. A three-week program of the third stage of cardiacrehabilitation of MI patients increases exercise tolerance to a greater extent in elderly patients compared with middle-aged patients.

In the conditions of the Moscow region in 2019-2022 the effectiveness of funicides of new chemical classes in the potato protection system against rhizoctoniosis, late blight and alternariosis was studied, taking into account the different resistance of varieties (Gulliver, Grant, Sante) to diseases. Potato tubers were treated with the preparation Idikum, SC before planting, its biological effectiveness in reducing the incidence of rhizoctoniosis in the full germination phase was 76.7-95.7 %. It was found that the effectiveness of the preparation depended on the degree of disease development, the stability of the variety and the phase of crop development. In addition, when etching the planting material with Idikum, SC, there was no population of rhizoctosis sclerotia and the spread of dry rot on tubers of the new yield significantly reduced (1.6-5.0 times) compared to the control. The proposed scheme of potato protection in conditions of epiphytotic development of late blight and early blight based on combined chemicals Metaxil, SP, Inside, SC with contact fungicides Raek, CE, Talent, SC, Tirada, SC showed high efficiency in reducing harmfulness of the diseases, which allowed to extend the growing season of plants, to ensure a higher yield of potatoes, its marketability and quality. The use of preparations provided an increase in yield by 36.3-47.5 %, depending on the prevailing weather conditions of the growing season and on the variety in relation to the control (without treatment). It has been established that the biological effectiveness of the protection scheme in reducing the degree of late blight and early blight increased from susceptible to relatively stable varieties and, accordingly, this trend continued with an increase in yield. Higher increases were obtained on unstable varieties Gulliver and Sante (10.6-13.5 t /ha, or 45.7-56.0 %), lower – on the relatively stable variety Grand (7.8 t/ha, or 36.0 %). The contribution of the application of the protection scheme to the overall variation of gross and marketable potato yields was 76.5-81.0 %, gene-type - 7.9-12.5 %, the interaction of these factors – 3.7-4.7 %.

Background. There is insufficient data on the antifungal activity of activated zinc pyrithione, which is widely used in practice. Taking into account the reports about a significant role of Malassezia in the pathogenesis of a number of dermatoses, the study of this issue is of scientific, practical interest. Aims. To evaluate the antifungal activity of external forms of activated zinc pyrithione in the treatment of psoriasis, seborrheic dermatitis, pityriasis versicolor. Materials and methods. An open prospective study was conducted between March and July 2022. Patients with psoriasis, seborrheic dermatitis, pityriasis were treated with external forms of activated zinc pyrithione for 21 days. Skin scales and circular prints from lesion foci, as well as from skin areas without clinical manifestations before and after therapy were studied. A quantitative assessment of skin colonization by micromycetes of Malassezia was performed using microscopic, cultural methods of examination. Clinical efficacy and drug safety of the therapy was assessed using the Dermatological Symptom Scale Index, by recording adverse events at weeks 0, 1, 2, 3. Results. 64 patients aged 18 to 65 years with diagnoses of psoriasis, seborrheic dermatitis, and pityriasis versicolor were included. 60 patients completed the study, 4 were excluded due to failure to adhere to the schedule. In patients with seborrheic dermatitis and pityriasis versicolor in the lesion foci after therapy, a significant decrease colonization level according to the results of microscopic, cultural studies was observed. In psoriasis patients, a significant decrease in the colonization level was obtained only based on the results of microscopic examination. In all groups, significant differences in comparison to the initial level were registered already at the 1st week of treatment. No adverse events were registered. Conclusion. Activated zinc pyrithione in the form of cream and aerosol showed moderate antifungal activity against micromycetes of the genus Malassezia.

Aim. To study the relationship of biomarkers of collagen metabolism and systemic inflammation with left ventricular (LV) remodeling in patients with stable coronary artery disease (CAD) and obstructive sleep apnea (OSA).Material and methods. The study included 195 patients with stable CAD, of which 63 without OSA and 132 patients with combination of CAD and OSA. The mean age of patients was 63,4±3,7 years. Biomarkers of collagen metabolism and systemic inflammation were assessed by determining the concentration of matrix metalloproteinase (MMP)-9, tissue inhibitor of matrix metalloproteinase-1, monocyte chemoattractant protein-1 (MCP-1) and calculating the neutrophil-to-lymphocyte (NLR) and platelet-tolymphocyte ratio (PLR). Echocardiography was performed according to a standard protocol.Results. There were no significant differences in systemic inflammation parameters (MCP-1, NLR, PLR) between the group of patients with CAD and CAD with mild OSA and a significantly higher level of MCP-1, NLR, PLR in more severe OSA. In patients with CAD and severe OSA, the eccentric LV remodeling was diagnosed in 75% of individuals, while the concentric type was diagnosed in only 25%.Conclusion. In patients with stable CAD, the more severe the OSA, the more pronounced systemic inflammation (MCP-1, NLR, PLR), and there are higher proportion of eccentric LV hypertrophy, which may be associated with an imbalance of fibrosis markers (high concentration of MMP-9 with an almost unchanged level of tissue inhibitor of MMP-1).

Aim. To assess the association of hypertension with the severe forms and fatal outcomes of Coronavirus disease 2019 (COVID-19).Material and Methods. This retrospective cohort study involved adult patients (≥18 years old), admitted to the University hospital №4 of Sechenov University (Moscow, Russia) between 08 April 2020 and 19 November 2020 with clinically diagnosed or laboratory-confirmed COVID-19. The cohort included 1637 patients. The primary outcome was all-cause in-hospital mortality. The secondary outcomes included intensive care unit admission (ICU) and invasive ventilation. Multiple logistic regression was performed to assess the independent association between risk factors and endpoints.Results. A total of 1637 patients were included in the study. 51.80% (n=848) of the subjects were males. The median age was 59.0 (48.0; 70.0) years and 55.90% (n=915) had pre-existing diagnosis of hypertension. Patients with hypertension had significantly more severe lung injury based on chest CT scan findings as well as lower oxygen saturation (SрO2). More of them were admitted to ICU and placed on invasive ventilation. The hypertension group also had higher mortality. Age, hypertension, glucose, C-reactive protein and decreased platelet count were independently associated with mortality, hypertension having the strongest association (OR 1.827, 95% CI 1.174-2.846, p=0.008). Age, hypertension, neutrophil count, platelet count, glucose, and CRP were independently associated with ICU admission, with hypertension having the strongest association (OR 1.595, 95% CI 1.178-2.158, p=0.002). Age, hypertension, glucose, CRP and decreased platelet count were independently associated with invasive ventilation, with hypertension having the strongest association (OR 1.703, 95% CI 1.151-2.519, p=0.008).Based on the multiple logistic regression models, odds of death, ICU admission, and invasive ventilation were higher in the hypertension group as compared to the group without hypertension.Conclusion. Hypertension can be an independent predictor of severe COVID-19 and adverse outcomes, namely death, ICU admission, and invasive ventilation in hospitalized patients.

Abstract Coding sequences of BRCA1, BRCA2, ATM, TP53, and PALB2 genes were analyzed in 68 consecutive Chechen patients with high‐grade serous ovarian cancer (HGSOC). Pathogenic BRCA1/2 variants were identified in 15 (22%) out of 68 HGSOC cases. Nine out of ten patients with BRCA1 pathogenic alleles carried the same deletion (c.3629_3630delAG), and three out of five BRCA2 heterozygotes had Q3299X allele. The analysis of 49 consecutive patients with triple‐negative breast cancer (TNBC) revealed 3 (6%) additional BRCA1 heterozygotes. All women with BRCA1 c.3629_3630delAG allele also carried linked c.1067G>A (Q356R) single nucleotide polymorphism, indicating that this is a genuine founder variant but not a mutational hotspot. An ATM truncating allele was detected in one HGSOC patient. There were no women with TP53 or PALB2 germline alterations. Genetic analysis of non‐selected HGSOC patients is an efficient tool for the identification of ethnicity‐specific BRCA1/2 pathogenic variants.

Introduction. Aspergillus fumigatus is able not only to sensitize patients with atopy, but also to colonize the respiratory tract, remaining a constant source of allergens due to the small spore size and thermal tolerance. Currently, the role of micromycetes in the immunopathogenesis of asthma has been poorly studied. The objective was to evaluate the features of the immune response regulation in patients with allergic bronchopulmonary aspergillosis (ABPA) or asthma with sensitization to A. fumigatus. Materials and methods. There were enrolled 15 patients with ABPA, 10 patients with asthma with sensitization to A. fumigatus, 16 patients with asthma without sensitization to A. fumigatus. The control group consisted of 16 apparently healthy volunteers. All patients underwent a clinical and functional examination. The subpopulations of blood lymphocytes were assessed by flow cytometry. The A. fumigatus allergen was added to peripheral blood samples to evaluate the production of IFN, IL-10 and IL-13. The serum cytokine levels in cell culture supernatants, as well as total IgE, A. fumigatus-specific IgE (sIgE) as well as thymus and activation-regulated chemokine (TARC) level were measured by enzyme-linked immunosorbent assay. Results. Significantly higher serum levels of total IgE, A. fumigatus-specific sIgE and TARC were found in patients with ABPA and asthma with sensitization to A. fumigatus compared to patients with asthma without sensitization to A. fumigatus. The results of lymphocyte immunophenotyping revealed significant excess of memory Th2 cells and T-regulatory cells in all patients with asthma compared to the control group. The count of Tfh2 was higher but memory Th17.1 cells were lower in patients with sensitization to A. fumigatus compared to those of apparently healthy volunteers. Patients with ABPA had significantly higher count of memory Th2 cells and TARC level compared to patients with asthma sensitized to A. fumigatus. The increased activity of memory Th2 cells is confirmed by increased secretion of IL-13 and IL-10 following along with decreased IFN production in response to specific fungal allergen stimulation of blood cells compared to the patients with asthma and the control group. A positive correlation was revealed between the count of memory Th2 cells and the levels of sIgE, IgE, TARC, a negative correlation with FEV1. Conclusion. Thus, exposure to A. fumigatus significantly enhances the activity of memory Th2 cells in patients with asthma which can lead to severe disease course and development of allergic bronchopulmonary aspergillosis. The features of the immune response identified dictate a need for a personalized approach to choose therapeutic tactics in such patients.

The purpose of the study: to study the relationship between emotional burnout and the experience of psychological stress with socio-psychological factors, anxiety-depressive and asthenic manifestations in medical workers during the pandemic of a new coronavirus infection. 227 medical workers were studied using a socio-psychological questionnaire, the Questionnaire of emotional burnout by K. Maslach, the A. Beck Depression Scale, the A. Beck Anxiety Scale, the Visual Analogue Fatigue Scale, the PSM-25 Psychological Stress Scale. The results of the study reveal conflicting attitudes of medical staff towards COVID-19. Psychological distress was revealed in more than a third of those studied in the form of a decrease in emotional tone, increased mental exhaustion, a decrease in interest and positive feelings for others, a feeling of «satiation» with work, dissatisfaction with life in general, and emotional withdrawal. Nearly a quarter of healthcare workers report signs of depression. 30% of respondents experience a fairly high level of fatigue. Doctors are the most emotionally exhausted of all the examined specialists. Doctors and medical psychologists have more pronounced depressive manifestations, depreciation of interpersonal relationships than junior staff. A more pronounced reduction in personal achievements was found in women than in men, and in men, somatic manifestations of depression and fatigue were more pronounced. A greater subjective saturation of experiences for medical workers during a pandemic is caused by the fact that they suffered COVID-19 in their relatives than in themselves. Conclusions. There is a certain similarity in the emotional response to stressful situations during the COVID-19 pandemic among doctors and clinical psychologists, in contrast to nurses and orderlies. A COVID-19 infection in loved ones is stressful for healthcare professionals. Gender is associated in different ways with manifestations of psychological stress in medical professionals with a predominance of astheno-depressive manifestations in men and a decrease in confidence in professional competence in women.

Aim. To determine lenvatinib treatment outcomes in patients with advanced unresectable hepatocellular carcinoma (uHCC) in real clinical practice.Patients and methods. A multicenter retrospective observational study included 58 patients with a confirmed uHCC diagnosis receiving lenvatinib. At baseline, ECOG, Child-Pugh and BCLC scores were assessed. The objective response rate (ORR), disease control rate (DCR), median overall survival (OS) and median progression-free survival (PFS) rates were assessed. In addition, adverse effects (AE) during treatment were monitored.Results. The median OS and PFS comprised 14.6 (95 % CI 10.6–18.6) and 11.1 months (95 % CI 8.31–13.8), respectively. The ORR amounted to 32.8 %, while DCR reached the level of 79.3 %. The levels of ORR and DCR were not statistically significantly different between the patients with stages B and C according to the BCLC staging system, with grades 0 and 1 according to ECOG, with classes A and B according to the Child-Pugh score, with viral and non-viral HCC etiology, with and without extrahepatic spread, and with and without portal vein invasion. Patients with alpha-fetoprotein (AFP) blood levels 200 ng/mL (44.4 % vs. 13.6 %, p = 0.015; and 88.9 % vs. 63.6 %, p = 0.021, respectively). The uHCC stage according to BCLC, ECOG functional status, Child-Pugh class, presence or absence of extrahepatic spread and viral etiology had no effect on the OS and PFS median levels. Patients with macroscopic portal vein invasion had a significantly lower PFS compared with those lacking this complication: 3.97 (0.00-8.07) vs. 11.1 (8.46-13.7), p = 0.053. AFP levels ≥200 ng/mL adversely affected survival rates: median OS comprised 12.0 (5.95-18.9) months in the group of patients with AFP ≥200 ng/mL vs. 16.1 (8.73-23.5) months in the group of patients having AFP

The aim of study Based on computed tomography data, to determine the most characteristic criteria for true lumen (TL) and false lumen (FL) in aortic dissection. To identify the relationship of the studied features with the stage of aortic dissection.Materials of the study Computed tomography (CT) data of 115 patients diagnosed with aortic dissection (AD) who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine were analyzed. The average age of the patients was 54.5 years (median — 56 years), men predominated in the studied group. AD types according to the De Bakey classification were distributed as follows: Type I — in 47% of patients, Type II — in 16.5%, Type III — in 36.5%. Dissection in the acute stage occurred in 62% of the patient, in the subacute — in 16%, in the chronic — 22%.Results In the studied group, FL in all cases prevailed over the TL by size, regardless of the stage and type of AD. Analysis of lumen ratio showed that in 63.55% of patients, FL occupied 75% or more of the aortic cross-sectional area. Location of FL: at the level of the ascending aorta, along the right and anterior walls of the aorta — 94.5%; in the descending thoracic aorta, along the posterior and left walls — 84%; in the abdominal aorta, along the posterior and left walls — 70%. Calcifications of the non- dissected part of the aortic wall, as a sign of a true lumen, were found in 59.1%. There was no correlation between calcification and the AD stage. Partial thrombosis of one of the lumens was detected in 59% (in FL — 85%, in TL — 13%, thrombosis of both lumens — 2%). The beak signs occurred in 85% of patients with AD, however, it was significantly more often detected in patients with acute and subacute AD stages than in the chronic stage (p

We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation.The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we conducted a case-control study. The control group included 60 adult patients with COVID-19 without mucormycosis. To analyze the clinical manifestations of COVID-M, we created a control group of hematological patients with mucormycosis examined in 2011–2020.In patients with COVID-19, the risk of developing mucormycosis was significantly increased with diabetes mellitus (OR=49) and overweight (OR=4,75), as well as with the use of high (≥100 mg per day for prednisolone) doses of glucocorticosteroids (OR= 4,762), especially ≥10 days (OR=25,4). The main localization of mucormycosis in patients with COVID-19 was the paranasal sinuses (95%) and the orbit (68%). Involvement of ≥2 organs was identified in 70% of patients. The main causative agents of mucormycosis were Rhizopus arrhizus (43%) and unidentified mucormycetes (36%).90-days overall survival of patients with mucormycosis and COVID-19 – 71%. The stay in the ICU (p=0,01), the use of mechanical ventilation (p=0,0481), the presence of CVC (p=0,049), CNS damage (p=0,016) and ≥ 2 organs (p=0,048) significantly worsened the prognosis of the disease. The best prognosis was in patients who received antifungal therapy (p=0,03875) and surgical treatment (p=0,046).

The problem of timely diagnosis and proper management of patients with cystic fibrosis is crucial not only in our country, but throughout the world. Experts of the Union of Pediatricians of Russia have considered various issues of etiology, pathogenesis, epidemiology, diagnosis, and treatment of this genetic disease in a modern light. Particular attention was paid to screening methods for early diagnosis of cystic fibrosis. The principles of complex therapy were justified, including rational use of antibacterial and mucolytic drugs and enzyme replacement therapy that significantly determine the disease prognosis.

Aim. To study changes in myocardial contractile function when prescribing mineralocorticoid receptor antagonists of spironolactone in patients after coronavirus infection SARS-CoV-2 with symptoms of chronic heart failure (CHF).Materials and methods. The study included 90 hospitalized patients with a diagnosis of SARS-CoV-2 coronavirus infection. The inclusion criteria were: age from 18 to 85 years; the presence of CHF with a preserved or mildly reduced left ventricular ejection fraction (LVEF). The patients were randomized into two groups: group I (n=60) included patients who, for 6 months after discharge from the hospital, in addition to standard drug therapy for CHF, took spironolactone at a dose of 25 mg per day; group II (comparison group; n=30) included patients who received standard drug therapy without additional prescription of spironolactone. The study groups were comparable in age, gender, prevalence of hypertension, coronary heart disease, diabetes mellitus, obesity and severity of CHF; the drug therapy given to the patients had no significant differences. Assessment of LV systolic function, exercise tolerance (six-minute walk test, TSW), quality of life (questionnaire EQ-5D-5L) were performed.Results. When repeated echocardiography was performed after 6 months of treatment, there was a significant improvement in LV systolic function in group I patients. In group I, after 6 months of treatment, there was a significant decrease in the proportion of patients with moderately reduced LVEF (from 30 [50%] to 12 [20%]; p

In recent years, special attention is paid to increasing the regional role in training personnel for the economy and social sphere, to implementing the “Strategy for Scientific and Technological Development of the Russian Federation”, and to balanced development of the entire territory of Russia. The purpose of the article is to study the regional economic features of the Russian Federation members in relation with a personnel training structure with higher education. The sectoral specialisation of the Russian Federation members is assessed in the article on the example of the Siberian Federal District. The assessment is based on a comprehensive analysis of the sectoral structures of the Russian Federation members, economic activities localisation, population employment. It is emphasised that a degree of sector production concentration, which characterise the sectors importance in a national scale, must be taken into account. This will make it possible to optimise the personnel training structure with higher education. A comparison of specialists graduation in terms of specialties and areas enlarged groups with the population employment structure has shown that the regions specifics are not sufficiently taken into account by the training areas of higher education institutions. The results of the study can be useful to the top management of higher education institutions in the Russian regions.

Objective: the development and verification of a scale for identifying patients at high risk of osteoarthritis (OA).Material and methods. The results of the analysis of a sample of patients aged 35–90 years from the database of the Institute of Trace Elements (n=3440), which included information on clinical and anamnestic, diagnostic parameters and pharmacotherapy of patients, including patients with OA (n=107), are presented. To analyze information about patients, modern methods of data analysis proposed within the topological theory of pattern recognition were used.Results. Based on the analysis of the sample, a 100-point scale of 27 points was developed which allows to identify patients at high risk of OA (sensitivity 88%, specificity 100%). For patients with high scores on the scale, a kind of “preemptive” prescription of symptomatic slowacting drugs for osteoarthritis (SySADOA) based on highly purified substances of chondroitin sulfate (CS) and glucosamine sulfate (GS) is promising. The evidence for CS/GS is extensive and has been reviewed previously.Conclusion. Early adoption of preventive measures (including the usage of SySADOA – CS/GS) in patients with a high score on the developed scale may reduce the risk of OA.

Aim. To evaluate the effect of sinus tachycardia and reduced left ventricular ejection fraction (LVEF) on the prognosis of patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2.Material and methods. The study included 1,637 patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2. The average age of the patients was 58.8±16.1 years. More than half of the patients admitted to the hospital had a history of cardiovascular diseases: hypertension was diagnosed in 915 (56%) patients, coronary artery disease – in 563 (34%), chronic heart failure – in 410 (25%). 294 (17.9%) patients suffered from diabetes mellitus. The unfavorable course of new coronavirus infection was assessed by the fact of being in the intensive care unit (ICU), the use of mechanical ventilation and death.Results. An unfavorable course of coronavirus infection was observed in 160 (9.8%) patients. Statistical analysis revealed that 341 (20.8%) patients with COVID-19 were diagnosed with sinus tachycardia, which required the appointment of pulse-reducing therapy. The occurrence of sinus tachycardia in patients with COVID-19 significantly increased the risk of death (odds ratio [OR] 1.248, confidence interval [CI] 1.038-1.499, p=0.018), increased the likelihood of mechanical ventilation use (OR 1.451, CI 1.168-1.803, p

Aim. The aim of the work was to study the possibility of using an environmentally friendly strain of yeast of the genus Rhodotorula for the bioconversion into fodder carotenoid‐containing biomass of the secondary product of processing pea flour into a protein concentrate (whey).Material and Methods. We used a new strain of Rhodotorula mucilaginosa 111 and by‐products of processing pea and chickpea flour into protein concentrates and potatoes into starch (whey). We used standard and special methods for the analysis of serum and microbial‐vegetable concentrate (FMVC) namely: chemical; biochemical; microbiological; and the determination of toxicity with ciliates.Results. Optimal conditions for growing R. mucilaginosa 111 on pea whey were determined (temperature 16.9°C, pH 7.8, amount of inoculum 1.85%). More biomass was synthesized on pea whey than on chickpea and potato whey – 81 g/dm3. The mass fraction of protein in the biomass is 58.90±3.03% on dry matter and the rate of essential amino acids is 119– 243%. Lipids included 20% saturated and 78% unsaturated fatty acids, linoleic acid – 45.26±0.70%, oleic – 24.04±0.76%, palmitoleic – 6.46±0.31%, palmitic – 13.70±0.81%. The yeast produced phytoin derivatives, torulene, β‐carotene, torularodin and phytoin. FMVC from pea whey stimulated the growth of ciliates Tetrahymena pyriformis by 29.1%, from chickpea whey (by 18.6% more intensively than distilled water), while potato whey reduced its growth rate.Conclusion. The dry biomass of the ecologically safe new yeast strain R. mucilaginosa 111 contained complete proteins, lipids, minerals, and carotenoids necessary for feeding animals. Thus liquid pea whey can be used for its biokonversions, while avoiding environmental pollution.

Aim. To compare the effectiveness of telmisartan and perindopril in the treatment of elderly patients with arterial hypertension (AH) and metabolic syndrome (MS) who have suffered ischemic stroke (IS).Material and methods. 92 elderly patients with AH and MS who underwent IS (mean 68±4 years) were examined. Patients were randomly divided into pharmacotherapy groups: 47 patients took telmisartan (80 mg/day) and 45 — perindopril (10 mg/day). Fasting plasma glucose levels, insulin, leptin, total cholesterol, triglycerides, highand lowdensity lipoprotein cholesterol were determined, the HOMA-IR index was calculated, and daily monitoring was performed. Statistical processing was carried out using STATISTICA 10,0. The indicators are presented in the form of the median, interquartile ranges of Me (Q25%; Q75%), and mean ±SD. The comparison was carried out using the Wilcoxon rank criterion. The differences are significant at p

Abstract Background At present, no agents are known to be effective at preventing COVID-19. Based on current knowledge of the pathogenesis of this disease, we suggest that SARS-CoV-2 infection might be attenuated by directly maintaining innate pulmonary redox, metabolic and dilation functions using well-tolerated medications that are known to serve these functions, specifically, a low-dose aerosolized combination of glutathione, inosine and potassium. Methods From June 1 to July 10, 2020, we conducted a pilot, prospective, open-label, single-arm, single-center study to evaluate the safety and efficacy of preexposure prophylaxis (PrEP) with aerosolized combination medication (ACM) on the incidence of SARS-CoV-2 positivity in 99 healthcare workers (HCWs) at a hospital designated for treating COVID-19 patients. We compared SARS-CoV-2 positivity in ACM users to retrospective data collected from 268 untreated HCWs at the same hospital. Eligible participants received an aerosolized combination of 21.3 mg/ml glutathione and 8.7 mg/ml inosine in 107 mM potassium solution for 14 days. The main outcome was the frequency of laboratory-confirmed SARS-CoV-2 cases, defined as individuals with positive genetic or immunological tests within 28 days of the study period. Results SARS-CoV-2 was detected in 2 ACM users (2, 95% CI: 0.3 to 7.1%), which was significantly less than the incidence in nonusers, at 24 (9, 95% CI: 5.8 to 13.0%; P = 0.02). During the PrEP period, solicited adverse events occurred in five participants; all were mild and transient reactions. Conclusions Our findings might be used either to prevent SARS-CoV-2 infection or to support ongoing and new research into more effective treatments for COVID-19. Trial registration ISRCTN, ISRCTN34160010 . Registered 14 September 2020 - Retrospectively registered.

Radial charts were commonly used in the industry to allow retrospective assessment of technological parameters. Today it is relevant to digitize the obtained data in order to simplify the automation of technological processes. Digitization of radial charts by means of standard methods is carried out with the help of human labor at significant time costs. The article proposes an automated method for digitizing radial charts using software, developed in the LabVIEW programming environment. The results of processing radial charts are displayed on the screen in numerical and graphical form, and can also be exported to a file (for example, to Notepad or MS Excel). The presented technique can be applied to images obtained on a color or black-and-white scanner, which minimizes geometric distortions, associated with the conversion of a paper document into electronic form, and ensures recognition quality of the clear plot line with an average relative error of up to 3 %. In case of ink fading or perspective photos of the diagram, the value of relative error can reach 8 %, as a result of which additional manual correction of the data will be required.

Objective: the development and approbation of the method for comparative analysis of the lists of medicines in different countries and systems of healthcare.Material and methods. Based on the open-access data on the lists of medicines published on official websites of the authorized regulators, the authors selected the national lists of medicines of Russia, England, and Italy for the development and approbation of the method. It was proposed to use three parameters: the absolute number of medicines by international nonproprietary name (INN); the structure of the lists based on anatomical therapeutic chemical (ATC) classification; and the coverage of the indications based on the International Classification of Diseases, 10th edition (ICD-10). The results of the analysis provided grounds for the review of the approaches to the formation of the lists of medicines required for medical help in Russia, England, and Italy and reimbursed from the state budget.Results. The number of medicines by INN in the national lists of England and Italy exceeds the total number of drugs included in the list of vital essential and desirable (VED) in Russia. All the analyzed lists were characterized by an uneven distribution of medicines within the lists by the ATC groups. The lists of medicines in England and Italy significantly exceed the list of VED by the number of the included medicines by all ATC groups excluding groups J and H in comparison with Italy, and groups J and V in comparison with England. At the same time, the list of VED significantly exceeds the list in England by the number of covered indications from the ATC L group. During the approbation, the method showed to be effective and can be used for further comparative studies of the national lists of medicines.Conclusion. Non-uniform lists of medicines by ATC-codes show that each country has priority areas in their healthcare systems. The list of VED can be shorter by the absolute number of the included medicines in England and Italy but it can exceed them by the coverage of indications due to peculiarities of the procedure of the list formation (reimbursement of medicines by all the registered indications). The results of the study with the proposed method can serve for the optimization of the VED list and the analysis of therapeutic areas that are undercovered.

The article considers the application of method for identifying the significance and importance of linear correlation between indicators of the population life quality in regions of the Russian Federation and indicators of fire fatalities/injuries among children. The statistically significant presence of these correlations is shown.

Osteoporosis is a progressive multifactorial systemic disease of the skeletal system characterized by the damage of the microarchitectonics of the bone tissue, which leads to the occurrence of low-energy fractures and impairment of the quality of life of individuals. The risk factors for the development of osteoporosis include smoking, which inhibits calcium absorption in the intestine and not only contributes to the reduction of bone density but also acts as a predictor of bronchopulmonary pathology. The systemic inflammation that develops in patients with chronic obstructive pulmonary disease, associated with the production of interleukins (IL)-6, IL-1, IL-8, and tumor necrosis factor – α, stimulates osteoclast-mediated bone resorption and a low level of osteoprotegerin closes the circle. In clinical practice, the determination of markers of bone resorption is required. This is a tartrate-resistant acid phosphatase, the 5β fraction of which signals the end of the resorption process; these are hydroxypyridine crosslinks – pyridoline (PYD) and deoxypyridoline, that stabilize the bone collagen molecule. Genetic factors also play an important role in the development of osteoporosis. The presence of the GG genotype or the G allele of the 283 A> G polymorphism (Bsml) of the VDR gene is a predictor of osteoporosis of the lumbar vertebrae L1-L4. The substitution of cytosine for thymine (C> T) in exon 17 of the calcitonin gene (CALCR) at position 1340 leads to the substitution of the amino acid proline (CCG) for leucine (CTG) at position 463 of the receptor protein molecule and affects bone density. But the most phylogenetically ancient mechanism for regulating the development and maintenance of tissue homeostasis by controlling cell proliferation, differentiation, migration, and apoptosis is the Wnt signaling pathway (SP-Wnt). Alterations in Wnt signaling observed in cases of genetic mutations cause various diseases of the human skeleton. A systematic literature search was carried out using the Scopus, PubMed, Web of Science databases.

The article focuses on the review of a pharmacotherapeutic approach to the therapy of hand osteoarthritis (HO). Apart from non-steroid antiinflammatory drugs (NSAID), promising therapeutic means of HO therapy include steroid drugs, chondroitin sulfate (CS), glucosamine sulfate (GS), and vitamin D. Transdermal application of NSAID and steroid drugs reduces the side effects without a decrease in the effectiveness of the therapy. Reconstructive therapy of cartilaginous and connective tissue of hands includes a long-term application of CS/GS, and in the acute period, injections of CS/GS.

A number of negative characters in Yakut mythology, as well as individual images of folklore, are considered. The point of view, according to which the basis for the emergence of certain mythological ideas among the Yakuts was the real world, the features of the landscape and climate, to the extent that they influenced a person, is proved. It is noted that the culture of the Sakha people is based on rich mythological concepts that have developed during the development of the vast expanses of the Arctic space. The authors analyze ethnographic notes of the XIX—XX centuries and modern scientific publications, which examine the mythology and folklore of the Sakha people (Yakuts). An attempt has been made to clarify the question of the influence of knowledge about the fossil remains of the mammoth fauna on the formation of mythological ideas related to the peculiarities of the climate of the region being developed. The image of a mammoth is analyzed in the broad context of the mythological views of the Yakuts. It is concluded that secondary esoteric ideas about mammoths, caused by the discovery of their remains, could form the basis of a prototypical image for a number of characters in Yakut mythology, for example, a water bull and a cold bull. It is proved that the idea of mammoths could be reflected in the external appearance of the abaasy heroes in the epic folklore of the Sakha.

In this article, we review the basic principles of brief psychotherapeutic intervention in patients with urolithiasis. The brief psychotherapeutic intervention has proven successful in the treatment of addictive behaviour. Currently, this method is also used in the treatment of many chronic diseases, such as hypertension, diabetes mellitus, and ischemic heart disease. Adaptation of this method can be a successful tool to increase the level of adherence to therapy for patients with urolithiasis since adherence to medical recommendations can significantly reduce the frequency of recurrent stone formation.

Purpose: to study the structural and microcirculatory changes in the optic nerve and retina in patients with primary open-angle glaucoma (POAG) in diabetes using OCT and OCT-A.Material and methods. The study involved 156 eyes of 104 patients, divided into 4 groups: group 1 — 47 eyes (26 patients aged 66.96 ± 6.05) with stage I POAG and diabetes, group 2 — 36 eyes (24 patients aged 64.64 ± 7.91) with stage I POAG; group 3 — 36 eyes (28 patients aged 63.03 ± 7.10) with stage III POAG and diabetes; group 4 — 37 eyes (26 patients, aged 69.70 ± 7.44) with stage III POAG. All patients underwent a complete ophthalmologic examination, spectral OCT, OCT-A of the optic disc and the macula.Results. In groups 1 and 3 (with POAG and diabetes), a decrease in the parameters of best corrected visual acuity and MD was revealed, which became worse as glaucoma progressed. A thinning of retinal nerve fiber layer (RNFL), neuroretinal rim, ganglion cells and inner plexiform layer (GCL + IPL) was noted, with the lowest values in patients with stage III POAG and diabetes. The analysis of hemodynamics showed a pronounced decrease in perfusion (39.04 ± 3.42 %) as well as vascular density of the optic disc (0.35 ± 0.04 / mm) and the macular area (22.96 ± 5.82 % and 12.19 ± 4.04 / mm) in stage III of POAG and diabetes. This decrease is strongly correlated with functional and structural changes, the stage of glaucoma and the presence of diabetes.Conclusion. A comparative analysis of structural, functional and vascular changes between groups of patients with stage I and III POAG, both accompanied and unaccompanied by diabetes, revealed signs of significant deterioration in perfusion of the optic nerve and retina in patients with diabetes. In combined glaucoma and diabetes, early diagnosis, monitoring and adequate timely therapy require careful attention of specialists.

Objective: to evaluate the efficiency and the safety of treatment with injectable chondroitin sulfate (ICS) in combination with dosed physical exercise (exercise therapy (ET)) for hand osteoarthritis (HOA).Patients and methods. A study group consisted of 68 patients with HOA; the diagnosis of which was established in accordance with the 1991 American College of Rheumatology (ACR) criteria. The investigators identified two groups: 1) 36 women and 4 men; mean age, 62.2±3.4 years (a study group); 2) 20 women and 8 men; mean age, 61.7±6.5 years (a control group). Group 1 patients received treatment with 25 intramuscular ICS (Chondroguard) injections per cycle and underwent ET under the guidance of a trainer. In the first 3–5 days, the patients could take nonsteroidal anti-inflammatory drugs (NSAIDs). Group 2 patients were prescribed a magnetic therapy cycle (alternating pulsed magnetic field, 15–20-minute hand exposure, a total of 10 sessions). They could also take NSAIDs within the first 3–5 days. A visual analogue scale (VAS, mm) was used to analyze hand pain severity over time: at baseline, at 3 weeks, and at 3 months after the start of treatment.Results and discussion. The dynamics of VAS joint pain was statistically more significant in Group 1 than in Group 2: 69.1±2.83 and 71.1±2.15 mm at baseline; 42.6±1.16 and 57.14±1.96 mm at 3 weeks (p