2025, volume 21

Objective: to establish changes in the ultrastructure of osteoapatite of the mandibular ramus in white rats during the readaptation period after 60-day administration of sodium benzoate or tartrazine and to substantiate the possibility of correcting the identified changes with Mexidol or Thiotriazolin. Material and methods. The study involved 245 male rats distributed into intact animals, animals with sodium benzoate or tartrazine administration within 60 days before the beginning of observations and animals administered Mexidol or Thiotriazolin against the background of previous 60-day exposure to sodium benzoate or Mexidol (7 groups in total). Results. Exposure to sodium benzoate and tartrazine led to disturbances of crystal lattice formation expressed throughout all observation periods. Administration of Mexidol against the background of sodium benzoate or tartrazine exposure was accompanied by signs of osteoapatite lattice restoration on 15 and 24 days — microtexture coefficient increased by 4.26 and 3.65% respectively (p<0,05). When using Thiotriazolin under the same conditions the signs of lattice restoration were observed during all observation periods that is by 5.97, 6.25, 5.74, 5.97 and 5.87% (p<0,05). Conclusion. In the study derangement of ultrastructure of biomineral of the mandibular ramus were found. Mexidol and Thiotriazolin have a positive effect on the formation of the crystal lattice, expressed in the restoration of its main parameters when prescribed against the background of chronic exposure to sodium benzoate or tartrazine.

Objective: to determine the indicators of atrial volume in men and women with overweight mesomorphic body type in the first and second periods of adulthood with echocardiography and to identify their correlation with the gender and age of the subject. Material and methods. The analysis of heart ultrasound protocols was carried out in 122 conditionally healthy overweight individuals (body mass index — 29-31), divided into two age groups: group I — 39 men aged 22-35 years and 25 women aged 21-35 years, group II — 26 men aged 36-60 years and 32 women aged 36-55 years. Atrial volumes were measured. Results. The volume of the atria in the first period of adulthood on the right/left in men and women, respectively, is: 46,6±6,4/28,3±2,5 cm; 37,6±5,3/24,6±3,0 cm. The same parameter in the second period of adulthood was: 47,7±5,1/27,8±3,8 cm; 42,5±5,8/23,9±2,0 cm. In all cases, the atria are statistically significantly larger in men (p=0,001). A relationship was established between the volume of the left atrium and the gender of the subject (K/-0.436; p=0,008). During the analysis of the relationship between the atrial volume and age, the following results were obtained: in the group of men —the volume of the right atrium (A=0,032; p=0,846), the volume of the left atrium (A=0,014; p=0,514); in the group of women —the volume of the right atrium (r=0,32; p=0,024), the volume of the left atrium (A=0,088; p=0,539). Conclusion. Mean atrial volume in men in both the first and second periods of adulthood are greater than in women. Gender affects the volume of the left atrium. In men, the left atrium volume is greater than in women. Age does not affect the atrial volumes in men, but it does affect the right atrium volume in women.

Objective: identify the most significant bioengineering and bioinformatics technologies aimed at preserving and strengthening the health of the population. Methodology for writing a review. The systematic review was performed on the PRISMA methodology applying the PubMed, eLibrary, Google Scholar, CyberLeninka databases. The search period was from 2006 to 2025. 50 sources were used to write the review. Conclusion. A review of scientific works suggests a significant potential of the development of bioengineering and bioinformatics technologies to improve population health. Analysis of studies focused on genome editing revealed the emergence of new technologies (CRISPR/Cas9, CAR-T) in the treatment of previously incurable and orphan diseases. Bioinformatics researches, related to the genome/clinic database (TCGA, GWAS), focus on the identifying of risk factors and predictors of human diseases. The modern tendency in regenerative medicine is aimed at the creating of the individual products for tissues and organs recovering (3D-printed models). They help to reduce the rehabilitation periods and return the patients to the working life. At the present, there are pressing issues of assessment the medical, economic and social effectiveness of presented here technologies. They can be integrated into healthcare system after justification of the organizational technologies.

Objective: to evaluate the outcomes of comprehensive treatment in patients who underwent surgery for pulmonary tuberculosis with multidrug resistance, with the inclusion of linezolid and bedaquiline in chemotherapy regimens. Material and methods. A non-randomized, continuous, single-center retrospective study was conducted involving 114 patients who underwent surgery at the National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of Russia between 2018 and 2022. A comparative analysis of the effectiveness of chemotherapy regimens was carried out in patients with localized and extensive tuberkulosis forms. Results. In 41.6% (n=32/77) of patients with tuberculosis and in 18.9% (n=7/37) with fibrous-cavernous tuberculosis, a statistically significantly higher spectrum of МВТ was detected in the study of resection samples compared with inspiratory materials (p=0.03). The inclusion of linezolid and bedaquiline in the chemotherapy regimen in MDR-TB patients led to a reduction in the duration of postoperative treatment by an average of 14.0±1.3 and 11.1±4.5 weeks in limited forms and by 14.8±3.2 and 14.9±3.7 weeks in common forms of ТВ, compared with chemotherapy regimens that do not include these drugs. Conclusion. The addition of novel anti-tuberculosis drugs such as linezolid and bedaquiline to the chemotherapy regimen for patients with multidrug-resistant tuberculosis can reduce the duration of treatment for both localized and extensive forms of the disease.

Objective: to identify the biological mechanisms that most significantly influence the aggressive progression of tuberculosis, including the relationship between metabolic disorders, immune response, and the resistance of Mycobacterium tuberculosis to drugs, considering current scientific understanding of the disease's pathogenesis. Methodology for writing a review. The study is based on materials from both Russian and international databases, including PubMed, Scopus, eLibrary and others. From an initial selection of 213 publications covering the period from 2019 to 2024, 43 of the most relevant works were chosen. Conclusion. The results of the study show that the progression of aggressive forms of tuberculosis depends on the complex interaction between metabolic disorders, immune response abnormalities, and the development of M. tuberculosis resistance to therapeutic drugs. These interconnected processes play a central role in the worsening of the disease, emphasizing the need for the implementation of comprehensive strategies for more effective treatment and prevention.

Objective: to analyze postural balance parameters in the quiet standing position in patients with chronic cerebral ischemia (CCI) using stabilometric assessment and to evaluate the impact of moderate to severe obstructive sleep apnea syndrome on postural control regulation. Material and methods. Ninety-four patients diagnosed with CCI stage 1-2 were examined. All participants underwent stabilometric testing and cardiorespiratory monitoring with calculation of the apnea — hypopnea index (AHI). Patients were divided into two groups: Group 1 — CCI with AHK15 (n=44); Group 2 — CCI with AHI>15 (n=50). Balance assessment in quiet standing was performed using the MBN-Stabilo system (MBN, Russia). Results. In patients with CCI, the quiet standing posture was characterized by asymmetry in the frontal plane and an anterior shift of the center of pressure (CoP). In Group 2, this forward displacement was more pronounced (p=0.004) and accompanied by significantly greater CoP sway area (p=0.03), amplitude (p=0.001), and velocity (p<0.001). A positive correlation was observed between AHI and anterior CoP displacement (rs=0.44; p=0.02). Conclusion. Patients with CCI exhibit postural instability in quiet standing, including anterior CoP displacement and instability in the sagittal plane. The presence of obstructive sleep apnea syndrome with AHI>15 is associated with more pronounced forward CoP shift and increased amplitude, velocity, and area of postural sway.

Objective: to evaluate the features of myocardial revascularization in patients with acute coronary syndrome (ACS) in the post-COVID period. Material and methods. A total of 114 patients with ACS and a history of new coronavirus infection (NCI) (group 1). The comparison group included 111 patients with ACS without a history of NCI (group 2). All patients in both groups underwent percutaneous transluminal coronary angioplasty (PTCA) with stenting on the first day. Results. A significant difference between the groups was noted in the frequency of PTCA with stenting, taking into account the age aspect: for patients in the age group over 65 years: p=0.031, relative risk (RR) 0.717 ([95% confidence intervals — Cl 0.518-0.991]). ACS in the post-COVID period was associated with damage to the right coronary artery (p<0.001, RR 1.629 [95% Cl 1.251-2.120]) and statistically significantly increased the risk of developing reperfusion syndrome, namely the occurrence of cardiogenic shock on the operating table (p=0.023, RR 1.553 [95% Cl 1.162-2.075]), AV blocks (p=0.034, RR 1.775 [95% Cl 1.322-2.383]) and bradycardia (p=0.021, RR 1.707 [95% Cl 1.280-2.276]). Conclusion. Patients with ACS in the post-COVID period more often experience manifestations of reperfusion syndrome after revascularization compared to patients without previous NCI.

Objective: to reveal the frequency of hemostasis and folate cycle gene polymorphisms in stable coronary heart disease (CHD) patients based on the severity of COVID-19 during the acute phase. Material and methods. During the study, 416 patients with stable CHD who had previously experienced COVID-19 with documented severity were examined for hemostasis and folate cycle gene polymorphisms. The severity of COVID-19 was used to categorize patients into two groups: the first group included patients with mild cases (n=203), while the second group comprised patients with moderate severity (n=213). The evaluation included the following genetic variants: 20210 G>A of the F2 gene, 1691 G>A of the F5 gene, 807 ОТ of the ITGA2 gene, 10976 G>A of the F7 gene, 1298 A>C of the MTHFR gene, 66 A>G of the MTRR gene, 2756 A>G of the MTR gene, 677 ОТ of the MTHFR gene, 455 G>Aof the FGB gene, 103 G>T of the F13A1 gene, 6755G>4G of the SERPINE1 (PAI-1) gene, and 1565 T>C of the ITGB3 gene. These polymorphisms likely contribute to a more severe course of COVID-19 in patients with CHD. Results. The presence of the heterozygous FGB: 455 G>A polymorphism and the ITGB3: 1565 T>C CC genotype may contribute to more severe COVID-19 progression in patients with CHD. Conversely, the CC genotype of the 807 ОТ polymorphism of the ITGA2 gene was associated with protection against more severe forms of the disease in the analyzed sample. Conclusion. Polymorphisms 455 G>Aof the FGB gene and 1565 T>C of the ITGB3 gene can be considered potential markers for detecting and predicting a more severe course of COVID-19 in patients with CHD.

The article presents a clinical case of the development of a massive paradoxical embolism during the removal of a large vestibular schwannoma. The clinical case demonstrates one of the complications that occur during neurosurgical operations performed in the patient's sitting positionln this clinical case, against the background of an air embolism of cerebral vessels, multiple foci of cerebral ischemia formed, which are of interest mainly due to the cortical localization of the formed multiple foci, which determined the rapid regression of gross postoperative neurological deficit.

Objective: to compare the outcomes of surgical plasty of bone defects of various localization with block allografts or spongy bone powder for distal humerus fractures. Material and methods. The study included 56 patients with comminuted distal humerus fractures divided into 3 groups based on the bone defect location and 2 subgroups based to the replacement method used for them. The functional outcomes were evaluated based on the indicators of the Broberg and Morrey scale, pain was evaluated based on the Visual Analogue Scale. Results. The amplitude of flexion-extension movements of the elbow joint in patients with defects of the medial column reached 90±5° (p=0.04) 1.5 months after surgical plasty with a block allograft and 75±6° with the use of spongiosus allograft. 3 months after surgical block graft surgery, the strength and pain in elbow joint for defects in the central zone reached 80±2 points (p=0.01), lateral — 82±3 points (p=0.01) and medial epicondyles — 88±4 points (p=0.03). Conclusion. The plasty of the defect with a block allograft in distal humerus fractures increases the multiplane range of motion in 1.5 months after the surgery for the medial column defects, improves strength and flexion-extensional range of motion, reduces pain in 3 months after the surgery for the bone defects in the medial, lateral or central metaphyseal areas.