Brain and atrial natriuretic peptides play a key role in the pathogenesis of chronic heart failure (CHF), therefore molecular genetic studies on the association of polymorphic variants of the genes of these hormones are of particular importance.

Objective - to study the associations of rs632793 polymorphisms of the NPPB gene and rs5065 of the NPPA gene with CHF in conditions of comorbidity.

Materials and methods. The study was carried out on the basis of the State Budgetary Healthcare Institution of the Novosibirsk Region "NOKGVV№3" in the period from 01.11.2022 to 01.12.2024 with the participation of 260 patients with a history of myocardial infarction (MI) and CHF with preserved ejection fraction. All participants underwent an assessment of clinical, anamnestic, laboratory and instrumental data at the beginning of the study and after 12 months. Within the framework of molecular genetic analysis, two single nucleotide polymorphisms (SNPs) were studied: rs632793 of the NPPB gene; rs5065 of the NPPA gene. Statistical analysis was performed in SPSS Statistics 28.0.1.0. Assessment of the significance of genetic factors included calculation of genotype and allele frequencies, testing of the distribution compliance with the Hardy-Weinberg equilibrium. Associations of polymorphisms were analyzed using the χ² (Pearson) criterion, odds ratio (OR) with 95% CI. Intergroup differences (≥3 groups) were assessed by the Kruskal-Wallis H-test. The significance level is p≤0.05.

Results. A significant association of the G/G rs5065 genotype with the development of recurrent MI (OR 5.139, 95% CI 1.593-16.583, p=0.003) and poor prognosis (OR 3.357; 95% CI 1.025-10.999; p=0.035) was revealed, as well as an association of the G allele (OR 1.805; 95% CI 1.159-2.813; p=0.009) with the risk of a negative outcome in patients of the study group. The presence of the G/G rs5065 genotype, T/C or C/C rs632793 genotype demonstrates an association with a higher concentration of NT-proBNP (p<0.001).

Conclusion. Integration of molecular genetic studies into clinical practice will improve the prognostic assessment of the course of CHF and develop personalized approaches to therapy, which in the long term will improve the quality of medical care.

One of the directions of clinical medicine is to study the effect of concomitant diseases of the bronchopulmonary system on the prognosis of diseases of the cardiovascular system.

Objective - to evaluate the state of a number of morphofunctional parameters of the cardiovascular system and endothelial dysfunction in patients with hypertension in combination with COPD on the background of cytoprotective therapy.

Materials and methods. The study included a group of patients (80 people) with hypertension, some patients (40 people) had moderate or severe chronic obstructive pulmonary disease in combination with hypertension (FEV1/FVC <0.7 (70%), FEV1<80% of the required). The age of the patients participating in the study, he ranged from 35 to 67 years old. The average age was 48.3±1.1 years. The hypertensive history of the persons under observation ranged from 4 to 17 years, the average duration of the disease was 8.3±1.2 years.

Results. The article analyzes changes in a number of morphofunctional parameters of the cardiovascular system and endothelial dysfunction in patients with hypertension in combination with chronic obstructive pulmonary disease on the background of cytoprotective therapy. In patients with hypertension in combination with COPD, a more pronounced deviation from the norm of indicators characterizing the morphofunctional state of the cardiovascular system and endothelial function was revealed.

Conclusion. The use of mildronate in combination with traditional therapy in patients with hypertension has a positive effect on the condition of the heart and blood vessels. In the presence of chronic obstructive pulmonary disease in combination with arterial hypertension, the positive effect of mildronate is more pronounced.

This literature review encompasses both domestic and international studies on the characteristics of urinary tract infections (UTIs) in children of various age groups, taking into account contemporary knowledge of uropathogens. Approaches to understanding the pathogenetic mechanisms of the inflammatory process have evolved due to advances in microbial diversity research using 16S rRNA amplicon sequencing. Consequently, our understanding of clinical features and therapeutic approaches also requires revision.

Objective - to analyze and summarize the literature on the etiological, clinical, and laboratory characteristics of urinary tract infections in childhood.

Materials and methods. The analysis of scientific literature was conducted using databases such as PubMed, Scopus, and Free Medical Journal, covering publications from the last 10 years.

Results. The article presents the latest data on the etiological and epidemiological features of UTIs, considering age and gender characteristics. It is shown that molecular laboratory diagnostic methods continue to improve, encompassing not only technologies for the precise identification of uropathogen species and genera but also their contribution to the clinical course of UTIs. The determination of microbial diversity using 16S rRNA amplicon sequencing will further address questions regarding the composition of the urobiome, quantitative characteristics in children of different age groups, and, consequently, the determination of optimal approaches to treatment and prevention. The issues of prescribing and duration of antibiotic therapy remain debatable, with alternative therapeutic approaches, such as the use of D-mannose-based dietary supplements in patients with uncomplicated UTIs caused by uropathogenic strains of Escherichia coli, being considered.

Conclusion. The implementation of modern molecular diagnostic methods for uropathogens in children with UTIs will help address questions regarding the clinical course, indications for antibiotic therapy, and the consideration of etiological factors.

Objective - to analyze and systematize the results of fundamental and clinical studies in recent years devoted to the study of the role of compliance and other psychosocial factors in the development of cerebral vascular catastrophe and other neurological disorders in adults.

Materials and methods. This thematic review includes available full-text publications obtained as a result of a literary search in the domestic (E-Library) Russian Science Citation Index (RSCI), as well as foreign databases (PubMed, Google Scholar, Semantic Scholar). In addition, studies conducted on the basis of the Smolensk State Medical University were analyzed.

Results. The role of compliance and other psychosocial factors in the occurrence and further progression of stroke, other neurological diseases, as well as some pathologies associated with other medical fields is significant and can be used for further study.

Conclusion. Based on the literature review, it can be concluded that the medical compliance of patients with neurological disorders is at a low level, which varies among different types of disorders. Most often, neurological patients do not follow the medication regimen due to forgetfulness, skipping doses outside the home and difficulties with taking medications. Patients who do not follow the medication regimen have low quality of life indicators, which requires further research and development of strategies to improve compliance, taking into account the specifics of neurological diseases.

Objective - to determine the microbial landscape and evaluate the sensitivity and resistance of isolated microorganisms to antibacterial drugs in patients of a multidisciplinary somatic hospital.

Materials and methods. The paper presents the results of 1203 crops of biological material (bronchial aspirate, sputum, pleural fluid and bronchial flushes) in patients of the somatic departments of the Kursk Regional Multidisciplinary Clinical Hospital for 2022-2023, as well as the results of a study of crops for antibiotic sensitivity and antibiotic resistance to antimicrobials.

Results. The largest number of positive microbiological examination results were obtained in sputum (88.0%) and bronchial aspirate (80.1%), while there were significantly fewer positive results in pleural fluid and bronchial flushes - 42.6% and 47.8%, respectively. The leading representatives in the biological materials of patients in somatic departments were Streptococcus pyogenes (18%), Klebsiella pneumoniae (15.6%), Acinetobacter baumannii (14.9%), Pseudomonas aeruginosa (11.1%), Candida albicans (6.7%), while Staphylococcus aureus was observed only in 4.2% of samples. Streptococcus pyogenes, detected in patients with somatic departments, was sensitive to chloramphenicol in 90% and clindamycin in 89% and resistant to erythromycin in 53% and azithromycin in 45%, while in 71% of cases intermediate, i.e. partial, sensitivity (resistance) to levofloxacin was noted.

Conclusion. The results obtained allow the attending physician to choose the most effective and consistent with approved clinical recommendations regimens for empirical antimicrobial pharmacotherapy in patients with somatic departments of a multidisciplinary hospital.

Objective - to examine the impact of transcranial electrical stimulation on the dynamics of adiponectin concentration in blood in a rat model of metabolic syndrome and sedentary lifestyle.

Materials and methods. In the present study, experimental animals (n=180) comprised outbred male Wistar rats (age 10-12 weeks). These rats were divided into three groups. The control group (n=60) received a standard diet and were housed in cages with a seating density of at least 350 cm² per rat. The comparison group (n = 60) and the transcranial electrical stimulation group (n=60) were provided a high-fat and high-fructose diet, and cage density did not exceed 270 cm² per rat. In the transcranial electrical stimulation group, this procedure was performed daily for 30 minutes (current 0,6 mA). The adiponectin concentration in the blood of the animals was evaluated at 30, 60, and 90 days into the study.

Results. On the thirtieth day of the study, the estimated concentration was not statistically significantly different (p=0,5) between the groups. However, by day 60, the concentration in the transcranial electrical stimulation group exhibited a significant increase of 38.2% over the comparison group (p=0,008; effect size: ε2=0.2 (95% CI 0,04-0,5)). At the 90-day mark, the adiponectin concentration remained non-significantly different (p=0,5) between the groups.

Conclusion. This finding suggests that transcranial electrical stimulation may have an impact on adiponectin concentration in animals model of the discussed pathology. To provide a more comprehensive interpretation of the observed results, it is essential to consider the impact of transcranial electrostimulation on various parameters, including but not limited to: carbohydrate and lipid metabolism, the concentration of other adipokines, parainflammation, activation of anti-inflammatory systems (e.g. opioidergic) within the model of the aforementioned pathology.

Objective - to determine the efficiency of correction of hemodynamic parameters in bevacizumab-induced arterial hypertension in laboratory Wistar rats with monovariant administration of antihypertensive drugs.

Materials and methods. Modeling of bevacizumab-induced arterial hypertension in Wistar rats was carried out by intraperitoneal administration of a monoclonal antibody drug. Hemodynamic parameters were recorded in male Wistar rats using the hardware and software complex for electrophysiological studies MP150 manufactured by Biopac Systems, Inc., USA, with data processing converted by the AcqKnowledge 4.4 program. 6 groups of rats (age - 8 months, weight - 400±40 g), 10 male rats in each group. The control group received Bevacizumab at a dose of 15 mg/kg per week for a 4-week period and 5 groups in addition to monotherapy with antihypertensive drugs after achieving stable bevacizumab-induced arterial hypertension: doxazosin, telmisartan, amlodipine, lisinopril, moxonidine at doses of 0.08; 3.1; 0.4; 0.8; 0.016 mg/kg/day for 3 weeks, respectively.

Results. Correction of bevacizumab-induced hypertension using monovariants of antihypertensive drugs showed efficacy by the 20th day of their intragastric administration, while blood pressure remained elevated in control animals, and in groups where hypertension was corrected with monotherapy, hemodynamic parameters did not reach the values recorded in Wistar rats before intraperitoneal administration of bevacizumab.

Conclusion. Intraperitoneal administration of bevacizumab to Wistar rats at a total dose of 60 mg/kg leads to a persistent increase in arterial pressure. Monovariant therapy with antihypertensive drugs in bevacizumab-induced arterial hypertension is irrational, in this regard, the possibility of using combination therapy with antihypertensive drugs should be considered for the purpose of effective correction of arterial hypertension induced by the administration of a monoclonal antibody drug.

Objective - to establish functional (conducting, draining, pillar) properties of different types of structural components (biunites) of splenic venous vasculature by their numerical modelling based on the results of morphometry.

Materials and methods. Virtual (digital) models of different types of splenic venous biunites based on their morphometric characteristics obtained earlier were used as objects for the study. We distinguished 4 types of splenic venous biunites: 1 type - complete asymmetry, the diameter of the proximal segment (D) is not equal to the diameters of the larger (dmax) and smaller (dmin) distal segment D≠dmax≠dmin, 2 type - lateral asymmetry, D=dmax, D≠dmin, 3 type - unilateral symmetry, D≠dmax, dmin=dmax, 4 type - complete symmetry, D=dmax=dmin. ANSYS Student computer program was used to analyse the conductive function (haemodynamic resistance) and pillar function (structural rigidity) of virtual models of different types of splenic venous biunites. The drainage function of virtual models of different types of splenic venous biunites was analysed using the Vasculograph computer program.

Results. It was found that in the direction of increasing the value of the index characterising 1) hemodynamic resistance biunites of different types of splenic venous vasculature were arranged as follows: 1st type, 2nd type, 3rd type, and 4th type; 2) draining function: 4th type, 2nd type, 3rd type and 1st type; 3) pillar function: 4th type, 3rd type, 2nd type and 1st type.

Conclusion. Different types of splenic venous biunites take part in fulfilment of conducting, draining and pillar functions to an unequal extent. The main role in fulfilment of the functions of blood conduction, drainage of the spleen tissue and creation of the "soft skeleton" of the organ belongs to type 1 splenic venous biunites. The morphometric characteristics of type 1 biunites can be used as a morphometric standard of the splenic venous norm.

Objective - to investigate changes in the fatty tissue of the bone marrow of the proximal halves of the femur and tibia in experimental postmenopausal osteoporosis and its therapy with resveratrol.

Materials and methods. The study was performed on 15 female Wistar rats. A model of postmenopausal osteoporosis was created by bilateral ovariectomy with a follow-up period of 56 days. Resveratrol therapy in the experimental group was performed by daily intraperitoneal administration at a dose of 2 mg/ kg during the same follow-up period. Histological examination with computer analysis of images and morphometry, absorption X-ray densitometry were performed.

Results. Bilateral ovariectomy in experimental Wistar rat animals 8 weeks after ovariectomy, together with osteoporotic lesion, leads to an increase in the volume of bone marrow adipose tissue with hyperplastic type of obesity in the femur and mixed in tibia. Resveratrol at a dose of 2 mg / kg, without affecting the diameter of adipocytes, significantly reduces their number, reducing the degree of bone marrow obesity.

Conclusion. Resveratrol at a dose of 2 mg/kg has a pronounced pharmacological effect on the fatty component of the femoral and tibial bone marrow in the Wistar rat model of postmenopausal osteoporosis, reducing the degree of bone marrow obesity. This may reflect its effect on the fixation of bone marrow stromal precursors with a switch mainly to the osteoblastic direction of differentiation, which explains its osteoprotective and regenerative effects.

A detailed study of the variant anatomy of the internal base in the area of the middle cranial fossa is of interest to practitioners of various specialties. The paper provides data on the morphometric and topographic-anatomical characteristics of the formations of the middle cranial fossa associated with the intracranial part of the trigeminal nerve (trigeminal depression, superior orbital fissure, round and oval openings).

Objective - to study the craniometric and topographic-anatomical characteristics of the depression of the trigeminal nerve node (DTNN), round and oval openings, and the superior orbital fissure in various forms of the cerebral skull.

Materials and methods. The study was conducted on male Caucasian turtles, which were divided into 3 groups according to the transverse-longitudinal cranial index: dolicho-, meso- and brachycranes.

Results. It was found that the morphometric characteristics of the depression of the trigeminal nerve node correlated with the transverse-longitudinal dimensions of the skull, its width (transverse size) changed in the groups of mesocrans and brachycranes and the distance from the top of the pyramid to the medial edge of the depression in the groups of lobes-hawkranes and mesocrans. The sizes of the holes in which the branches of the trigeminal nerve pass (the upper orbital fissure, round and oval holes) also differed. Attention is drawn to the differences in some characteristics of the contralateral sides of the study.

Conclusion. The analysis of the formation parameters for the DTNN and branches of the trigeminal nerve should be carried out taking into account the shape of the cerebral skull and for each side separately. It can be assumed that the morphometric differences of the studied formations are due to the functional asymmetry of the brain (right-handed, left-handed), however, this requires special research.

Age-related changes and multimorbidity affect the organs and tissues of the oral cavity. Dry mouth syndrome is painful for the elderly patient and difficult to treat, which is most often associated with endocrinopathies, chronic reactive-dystrophic diseases of salivary glands, consequences of combined treatment of head and oral cavity tumors.

Objective - to characterize the functioning of taste buds in the "dry mouth" syndrome.

Materials and methods. We used methods of determining the thresholds of taste sensitivity of the tongue to sweet, salty, sour and bitter stimuli, as well as assessing the functional mobility of taste receptors of the tongue in 66 (19 men and 47 women) elderly patients (61-73 years old). Group 1 included 20 patients who had partial or complete tooth loss and did not have hyposialia or any dentures or diseases in which xerostomia may occur. Group 2 also included 20 elderly patients who did not suffer from hyposialia but had various designs of fixed and/or removable dentures in their mouths. Group 3 consisted of 26 elderly people who suffered from dry mouth syndrome.

Results. It was found that the elderly people suffering from the syndrome of "dry mouth" showed an increase in the indicators of the thresholds of taste sensitivity of the tongue for all types of stimuli, which were higher than the reference and age values, that together with the existing in them violation of the indicators of functional mobility of taste receptors of the tongue, which is characterized by a weak mobilization of taste receptors of the tongue on an empty stomach, and after eating - almost complete absence of demobilization of the studied receptors of the tongue.

Conclusion. The data obtained in the study may indicate that patients with "dry mouth" syndrome have problems with regulating the number of meals and the quality of the food consumed, which may cause certain difficulties in regulating the dietary therapy necessary for them.

Objective - to find optimal combinations of biopolymer and mineral enterosorbents capable of the most effective and selective removal of excess metals from the body of residents of large cities. The article is devoted to the development of a method for combining, with an assessment of the effectiveness of the most common biopolymer and mineral enterosorbents. One of the objectives of the experiment was to model the conditions of the internal environment of the human body, under which enterosorption occurs, for a more adequate assessment of the sorption capacity of the obtained combinations of enterosorbents in relation to a number of the most common essential and toxic metals.

Materials and methods. To model the complex composition of the internal environment of the body, whey was used, which is a multicomponent matrix consisting of water with minerals dissolved in it and an organic fraction (proteins, carbohydrates, fats and vitamins). Dioctahedral smectite (Smecta), finely dispersed silicon dioxide (Polysorb MP), granulated zeolite (Zeo Detox), and activated carbon were used as mineral enterosorbents to create combinations. Chitosan and Mikoton were used from biopolymer enterosorbents to create combinations. Model solutions of salts of the most common metals (Fe, Cu, Cd, Zn) were prepared by appropriate dilution of standard samples of metals in whey.

Results. The possibility of using whey to simulate the liquid phase in which sorption processes occur in the body is shown. The results of assessing the sorption capacity and sorption efficiency of various combinations of enterosorbents are presented. The most effective combinations are proposed that promote the selective removal of excess metals from the body. Thus, the combination of "Zeolite + activated carbon" is more suitable for long-term regular use for the purpose of selective removal of metals from the body during their chronic oral intake. In acute poisoning, combinations of enterosorbents are more effective - "Smecta + Mikoton + Chitosan" or "Polysorb + Mikoton + Chitosan".

Conclusion. The composite sorbent based on zeolite and activated carbon showed a relatively high absolute efficiency compared to other composites based on mineral enterosorbents - Smecta and Polysorb. At the same time, it has high selectivity, which, in combination with low hydrophilicity, is optimal for regular use in conditions of polymetallic pollution in large cities.