Eight years have passed since the update of the European Guidelines for the management of pericarditis, almost 3 years of which the pandemic of the new coronavirus has been continuing. COVID-19 has changed the structure and the course of all cardiac diseases. At present there is no doubt that the dominant cause of pericarditis is the new coronavirus SARS-CоV-2. However, such non-infectious causes as systemic inflammatory diseases, paraneoplastic and postpericardiotomy syndromes that require a differentiated therapeutic strategy, remain relevant. This part of the systematic review addresses the treatment of incessant, recurrent, and chronic viral/idiopathic pericarditis. Particular attention is paid to publications on the effectiveness of the therapy with colchicine and interleukin-1 antagonists. The review of the medical resources such as PubMed, Google Scholar, UpToDate (publications from 01.1990 to 10.2022) was conducted, the issues of differentiated pericarditis therapy with various anti-inflammatory drugs were studied thoroughly.

The article presents a review of current scientific articles related to a few particular questions of molecular-genetic and epigenetic pathogenesis of some cardiomyopathy types that can be the object of interest assuming potential associations with pathophysiological mechanisms of pollutants and industrial toxins impaction. The possible benefits may arise from that kind of approach due to the fact that toxic agents in question are generally recognized at the moment as one of the cardiovascular disease onset and progression factors. The need for multidirectional theoretical developments targeting potential pharmacology methods aimed to at least partially eliminate such a challenge becomes more and more apparent. We focused on mTOR function chains, translation factor eIF4E and splicing regulator RBM20 interconnected with RAAS and T3 regulatory cascades. A part of our attention was also concentrated on cardiomyocytes methylome profiling in connection with pollutant toxicodynamics and cardiomyopathies pathogenesis.

Background. The SARS-CoV-2 virus caused the COVID-19 pandemic. Arterial hypertension in COVID-19 plays an important role in the prognosis of morbidity and mortality. Objective. A brief report on the effect of COVID-19 on arterial hypertension. Discussion. COVID-19 is often accompanied by changes in the cardiovascular system. Arterial hypertension is one of the most common comorbid conditions. A lot of studies have proved the connection of hypertension with COVID-19. The main mechanisms for increasing blood pressure indicators may be: an increase in the concentration of angiotensin II in the blood, the interaction of SARS-CoV-2 with the APF2 receptors of the infected cell membrane, direct and indirect effects on the endothelium, a decrease in the level of vasodilating factors (nitric oxide (NO) and prostacyclin), psychological pressure by the COVID-19 pandemic. Conclusions. Physicians and general practitioners should be aware of hypertension in the management of patients with COVID-19, and the prophylactic medical examination of the population.

Goal: to evaluate the results of the use of preventive endovascular hemostasis in patients with a high risk of recurrent bleeding from the upper gastrointestinal tract. Material and methods. The work is based on the study of the results of 158 patients with ulcerative gastroduodenal bleeding and a high risk of its recurrence treatment (17 points or more on the scale of the recurrence of bleeding prediction), Forrest 1–2 A/B and fatal cases (30 points or more on SAPS II). To prevent recurrent bleeding, endovascular embolization of the left gastric or gastroduodenal arteries was performed. Results. The technical success of endovascular hemostasis was achieved in 94.4% of cases (153 patients). In 5 patients, embolization could not be performed due to technical reasons. A complication after transcatheter angiography and embolization was noted in one case (retroperitoneal hematoma that required surgical intervention). Relapse of bleeding after technically successful embolization was noted in 11 (7%) patients. PVA microemboli were used for embolization of the left gastric artery (LVA). Spirals and, in some cases, additional PVA microemboli were used for embolization of the gastroduodenal artery (GDA). The fatal outcome occurred in 26 cases (16.5% of all cases). Conclusion. According to our data, 7% of patients with severe somatic diseases (30 points or more according to SAPS II) and a high risk of bleeding recurrence (17 points or more according to SRBP) occurred in 7% (11 out of all 158 cases).

Aim: to analyze the first neurological manifestation in patient with thrombotic thrombocytopenic purpura (TTP). Material and methods. The appeals from physicians who suspected TTP were included in the study. The neurological symptoms in 40 patients with TTP were also analyzed. Results. Among 208 physician appeals about the suspicion of TTP and the referral of plasma samples for testing of ADAMTS13 activity, there were 2% of neurologists. The diagnosis of TTP was confirmed in 40 patients. 9 (22.5%) had no neurological symptoms, and 31 (77.5%) had neurological disorders. Patients with neurological symptoms were older than patients without neurological symptoms (median 37 years and 31 years, p = 0.006). Neurological symptoms were less frequently observed in pregnancy-associated TTP (p = 0.008). Among neurological symptoms there were speech disorders (40%), headache (30%), cognitive deficits (32.5%), depression of consciousness (22.5%), paresis (25%), sensation disorders (20.5%), seizures (10%). Magnetic resonance imaging/computed tomography (MRI/CT) revealed ischemic stroke in 47.5%, hemorrhagic stroke in 15%. In 6 patients, despite neurological symptoms, no pathology was detected with MRI/CT. In 4 patients, in the absence of neurological symptoms, MRI/CT revealed ischemic foci in the brain. 8 patients died: 2 patients died from sepsis, 6 - from ischemic stroke. In surviving patients, neurological symptoms regressed after remission. Conclusion. Neurological symptoms are detected in most patients with TTP. Brain MRI/CT should be performed in all patients with TTP

A new method for fixing a synthetic graft in preperitoneal plastic surgery of median ventral hernias has been developed. The suggested method was used by us in 32 patients aged 29–75 (the main group). The size of the hernial orifice did not exceed 3 cm in diameter, the size of the hernial sac — 4–5 cm. 28 patients aged 31–74 (the control group) were operated on with the imposition of transaponeurotic sutures in the standard way. According to the main clinical characteristics, both groups were comparable. Among the evaluated indicators, the most significant were the absence of recurrence of hernias in the period from 1 to 5 years in both groups; the absence of postoperative complications in the main group; 2 cases (7.1%) of the postoperative wound hematoma in the control group (the differences are statistically significant); the reduction of the average length of hospital stay after surgery in the main group to 7.0 ± 0.2 days, and in the control group — 8.0 ± 0.1 days (the differences are statistically significant).

Aim. To assess the dynamics of functional changes in the left atrium (LA) in patients with lymphoproliferative diseases (LPD) before polychemotherapy (PCT), during treatment, after 6 courses of treatment, and the frequency of supraventricular arrhythmias (SVA) as well as the level of C-reactive protein. Material and methods. This is a prospective observational study of patients with confirmed diagnosis of lymphoma (n = 30; 57% men; median age 52 [34; 65] years old), who had no prior polychemotherapy. The comparison group included persons without lymphoma (n = 30; 49% men; median age 49 [36; 65] years old) comparable to the main group in terms of sex, age and risk factors for cardiovascular diseases. Patients with lymphoma underwent 24h-ECG monitoring and advanced transthoracic echocardiography with 2D speckle-tracking at baseline, and after 3 and 6 cycles (within 3 and 6 months) of anticancer treatment. Biomarkers of inflammation were measured. The results were compared to the data of the comparison group. Results. In lymphoma patients GLS LA, LA strain reservoir, LA strain conduit, and LA strain booster pump were found to be impaired at baseline but were comparable with these in matched controls. There was a significant decrease in GLS LA (LA strain reservoir 30% [26–41] vs 17% [15–31], p = 0.015) after 6 courses of PCT. In lymphoma patients before PCT, supraventricular tachycardia (SVT) was recorded significantly more often than in patients of the comparison group: 53% (n = 16) versus 20% (n = 6), (p = 0.02). The frequency of SVT was comparable in patients with LPD before and after 6 courses of chemotherapy: 53% (n = 16) vs 47% (n = 14) (p = 0 .7). Associations between the parameters of structural and functional changes in the LA and the incidence of SVA were not identified. A close correlation was found between the level of ESR, CRP and the parameters of the functional state of the LA. There was a significant relationship of the average strength between the ESR and the number of SVE in the analysis at all control points (r_xy = 0.44, p < 0.05). Conclusions. In lymphoma patients LA dysfunction occurs, which progressively worsens against the background of antitumor therapy, and is associated with the severity of systemic inflammation that may be a manifestation of the cardiotoxic effect of PCT, but additional studies are required.

Currently, the problems of the mechanisms of immune and inflammatory response aging, which determine the mechanisms of the development of the inflammatory process in the elderly, are being actively studied. A sectional observation of senile tuberculosis in a patient K., 78 years old, who had been treated for 4 months in the University Clinical Hospital No. 4 of the First Sechenov Moscow State Medical University in 2018 is presented. After autopsy, histological, histochemical and PCR examination, the following pathoanatomical diagnosis was made: primary (senile) tuberculosis with hematogenous and lympho-vascular generalization, with a focus of caseous pneumonia in the III segment of the right lung; caseous lymphadenitis of bifurcation, thoracic and abdominal paraaortic lymph nodes; miliary and large-focal generalization in the lungs, parietal and visceral pleura on the left, spleen and liver (acid fast stain; PCR study No. 18-5935 dated 08/13/2018 (Central Research Institute of Tuberculosis) detected DNA of mycobacterium tuberculosis complex). A feature of senile tuberculosis is the course of primary tuberculosis with hematogenic generalization and predominantly exudative-necrotic tissue reaction. Its pathogenesis is mainly due to the phenomenon of "aging immune system" (immunosenescence), as well as inflammaging — features of the inflammatory response in old age. Their main characteristics are the preactivated status of the immune system even before the recognition of the antigen, characterized by a basal level of circulating cytokines, as well as a sharp weakening of the adaptive immune response in the presence of an antigen associated with impaired functioning of the immune system with a large number of memory T cells lacking naive T-cells.

One of the most common variants of malignant neoplasms of the female reproductive system is endometrial cancer. At the same time, cases of this disease in patients with genital abnormalities are extremely rare in the general structure of female oncopathology. The article presents clinical cases of endometrioid carcinoma in a 75-year-old woman with doubling of uterus. According to the clinical picture, the results of ultrasound, magnetic resonance imaging and histological examination of endometrial scraping, the following diagnosis was made: cancer of the doubled uterus IB (cT1bNxM0) G2 (morphological type — endometrioid carcinoma). The surgery was performed: laparotomy, modified extended extirpation of the uterus with appendages of level B2 with pelvic lymph node dissection C3, omentectomy. The result of postoperative histological examination confirmed the preoperative diagnosis. The postoperative period was uneventful. The presented rare clinical case demonstrates the need to increase clinical suspicion in relation to patients with abnormalities of the uterus structure. Timely diagnosis and verification of the diagnosis will allow to provide adequate treatment, which will affect the prognosis of survival.

The article presents the results of the selflfl ess, sometimes heroic labour of dozens of thousands of medical workers — doctors, paramedics, nurses, combat medics, orderlies, during the Great Patriotic War

The article presents the facts concerning the career and creative development of an outstanding Russian teacher, a well-known public figure, academician of the USSR Academy of Medical Sciences, Honored Scientist of the RSFSR, one of the founders of the Siberian Surgical School, Professor Vladimir Mikhailovich Mysh.

The article presents data on military doctors of the Russian Imperial Army who stayed in Russia after the revolution. After going through several wars, they continued to carry out their professional duty during the Great Patriotic War. Many of them did not survive the most difficult blockade winter of 1941–1942. They were buried in the "blockade cemeteries" of Leningrad.