The article provides a review of scientifi c publications dedicated to the study of the hemostatic system in patients with chronic heart failure (CHF). Russian and foreign authors evaluated the risks of bleeding and thrombosis in patients with CHF, as well as changes in the content of individual markers and factors of the coagulation system. The review suggests that the results obtained are quite contradictory. On the one hand, data is presented on an increased risk of thrombosis, changes in the content of some endothelial markers that promote endothelial thrombogenicity, an increase in the content of platelet aggregation markers, and elevated levels of fi brinogen and thrombin. On the other hand, there is data on an increased risk of bleeding in patients with CHF, an increase in some endothelial markers that enhance the anticoagulant properties of the endothelium. From the analysis conducted, it can be concluded that this topic is not suffi  ciently studied, and it is diffi  cult to judge the hemostatic potential in patients with CHF at present. The use of integrated methods such as thromboelastography (TEG) and low-frequency piezothromboelastography (LF-PTEG) are a promising direction for studying this problem. The results obtained using these methods will likely allow for a more precise understanding of the features of the coagulation system functioning in patients with CHF.

Type 2 diabetes mellitus (DM2) is a multifactorial disease, and obesity plays the key role in the development thereof. It is believed that the global rise in vast proliferation of DM2 and obesity, recently viewed as an epidemic, is caused by urbanization, reduced physical activity and widely available high-calorie food. Recently, another “player” in the pathophysiology of type 2 diabetes mellitus has been discovered — the intestinal microbiota (IM). Numerous studies have shown the connection between the development of type 2 diabetes mellitus and IM. The review discusses the mechanisms, through which IM contributes to the development of DM2. The results of experimental and clinical studies on the eff ectiveness of the use of probiotics, prebiotics and fecal microbiota transplantation as a method of prevention and treatment of type 2 diabetes mellitus are given.

The article presents a systematic analysis of scientifi c publications concerning the eff ect of combined hormonal contraceptives on the risk of the development of cervical cancer. The following databases were used for literary search: PubMed, Cochrane, Google Scholar, elibrary.ru. Key words and their combinations were: “cervical cancer”, “cervical intraepithelial neoplasia”, “human papillomavirus”, “contraception”, “combined oral contraceptives”, “hormonal contraceptives”. 147 scientifi c publications have been analyzed, and 10 of them have been selected with the use of I/E criteria. Based on the analyzed literature, a conclusion was made. Long-term use of combined oral contraceptives against the background of persistence of the human papillomavirus increases the risk of developing cervical cancer.

Sarcopenia is a progressive generalized skeletal muscle disease characterized by loss of muscle mass and decreased muscle function with an increased risk of adverse events. For a long time, loss of muscle mass and function has been studied as a clinical symptom in severe diseases and conditions in oncology, endocrinology, rheumatology, and a number of other systemic diseases. However, with the increase in life expectancy and aging of the population, sarcopenia, as an independent age-associated disease, comes into general medical practice and makes a significant contribution to the rates of disability and mortality. To date, several definitions of sarcopenia, screening methods and diagnostic criteria for this disease have been proposed by various international research groups. This review presents evolution of definitions and diagnostic criteria for sarcopenia and severe sarcopenia. Changes in the algorithm for sarcopenia diagnostics according to the latest recommendations of the European Working Group on Sarcopenia for Older People (EWGSOP) second revision, published in 2018 (EWGSOP2), as well as the results of the consensus of the American Geriatric Society and the International Group on study of sarcopenia. This review summarizes practical issues regarding methods for assessing muscle mass, muscle strength and skeletal muscle function, diagnostics threshold for sarcopenia from leading international research groups, as well as the results of researchers’ work on adapting tests for assessing sarcopenia in Russia.

Relevance. Total hip joint arthroplasty with a wide range of both classical and modifi ed approaches is a successful method of treating joint diseases in the fi nal stages. It should be noted that in recent years, there has been an increased interest among scientists — specialists in this fi eld — in developing and implementing new, more optimal approaches for primary and revision arthroplasty.

Research objective: to determine the advantages and disadvantages of surgical approaches in arthroplasty of the hip joint in patients with dysplastic coxarthrosis.

Material and methods. For this study, we observed 80 patients (18 men, 16 women) aged 45 to 60 years with dysplastic coxarthrosis of the hip joint who were undergoing treatment in the trauma and orthopedics department of the therapeutic surgical clinic of the Azerbaijan Medical University. The comparison group included 25 patients who underwent total hip joint arthroplasty from a posterior-lateral approach; 25 control group patients underwent surgery with a Harding approach, and 30 main group patients underwent surgery from the proposed modifi ed approach. All approaches were performed as indicated. Before and 6 and 12 months after arthroplasty, the WOMAC index, C-reactive protein level, and ESR in the blood were studied in patients.

Results. In the control group, some positive dynamics of clinical and biochemical indicators were noted at 6 and 12 months, but their values did not diff er signifi cantly from those of the comparison group (p > 0.05), but were signifi cantly higher than those of the main group (p < 0.001). Analysis of arthroplasty outcomes revealed a higher percentage of positive clinical outcomes with a signifi cant reduction in WOMAC index values and a decrease in C-reactive protein and ESR levels when using minimally invasive surgical techniques. Thus, the anterior approach with low intraoperative trauma is more optimal for patients with dysplastic coxarthrosis, as it promotes faster functional recovery and causes fewer infl ammatory complications. The posterior-lateral approach, like the anterior one, is optimal, since the above indicators did not diff er signifi cantly from those of the anterior approach. With the lateral approach, due to a higher risk of wound infection, the recovery time and reduction of the infl ammatory reaction are longer.

Objective. To identify the features of hematological and immune reactions in patients with autoimmune thyroiditis, living in the Arctic region of the Russian Federation.

Material and methods. The study involved 84 people aged 21–55, including 35 patients with AIT and 49 practically healthy ones at the time of examination. The study included estimating of erythrocyte aggregation, platelets, neutrophil granulocytes, lymphocytes, hemogram, neutrophil phagocytic activity, immunoperoxidase reaction, fl ow cytometry, enzyme immunoassay (EIA).

Results. In patients with AIT living in the Arctic, an increase in the aggregation of erythrocytes (82.86% vs. 65.31%) and platelets (11.43% vs. 2.04%), an increase in the number of monocytes with vacuolization of cytoplasm and nucleus (5.71% vs. 2.04%) and neutrophils with azurophilic granularity (14.28 vs. 10.20%) was found. Pathological processes in AIT are combined with a high frequency of neutropenia incidence (34.28% vs. 18.37%) and a defi ciency of phagocytic protection (34.28% vs. 4.08%). The compensatory reaction in neutropenia is manifested in a high level of monocytosis registration (48.57%) and eosinophilia (17.14%). In patients with AIT, a decrease in the total content of lymphocytes was revealed mainly with CD3+, CD3–CD16+CD56+, CD71+, CD25+, CD54+ receptors, as well as the level of sCD25, sCD54 against the background of an increase in the concentration of IFN-γ, IL-6, IgA, M, G.

Conclusion. The pathogenetic mechanism of tissue damage and infl ammation exacerbation in patients with autoimmune thyroiditis (AIT) living in the Arctic is a combination of increased levels of erythrocyte and platelet aggregation, degranulation of neutrophil granulocytes with the release of azurophilic granules, and vacuolization of monocyte cytoplasm and nucleus. Reduction in cell-mediated cytotoxicity alongside an increase in humoral reactions refl ects the risk of autoimmune processes formation. 

Rationale. Currently, there is a growing number of mental disorders, which are infl uenced by various external and internal factors, including the presence of alexithymia. Most studies focus on the prevalence of somatic diseases among patients with alexithymia, while the prevalence of mental disorders in these patients remains insuffi  ciently studied. Presumably, alexithymia can serve as a background for the development of mental disorders such as anxiety, depressive, and mixed anxiety-depressive disorders. The aim of the study is to investigate the correlation between alexithymia and mental disorders, somatic diseases, and suicidal thoughts in patients.

Material and methods. A total of 184 outpatients (107 women and 77 men) with various illnesses were examined. Clinical rating was conducted using the TAS, HADS, and MADRS scales. Additionally, medical history was collected.

Results. A higher incidence of mental disorders was detected in patients with alexithymia (correlation coeffi  cient 0.71). Depression was most frequently observed in these patients (73.5%), followed by anxiety disorder and mixed anxietydepressive disorder (13.2%). Patients with alexithymia also had a higher incidence of psychosomatic disorders (correlation coeffi  cient 0.68), with multiple psychosomatic diseases usually occurring in the same person. Moreover, a higher incidence of hypertension (47%), ischemic heart disease (25%), skin diseases such as neurodermatitis, psoriasis, atopic dermatitis, and others (59.6%), gastrointestinal diseases such as peptic ulcer and irritable bowel syndrome (28.7%), bronchial asthma (8.8%), thyrotoxicosis (0.7%), and rheumatoid arthritis (0.7%) was detected in patients with alexithymia. As the degree of alexithymia increased, suicidal thoughts were more frequent and severe (correlation coeffi  cient 0.74).

Conclusion. The hypothesis of the correlation between alexithymia and the development of mental and psychosomatic disorders and the appearance of suicidal thoughts has been confi rmed.

The article discusses the statements of the section of the consensus meeting “Maastricht-VI” (2021), dedicated to the role of H.pylori infection eradication in prevention of the development of gastric cancer. Experts have confi rmed that this infection is currently the main etiological factor of gastric cancer. Its eradication leads to regression of atrophic changes in the gastric mucosa and reduces the risk of development of gastric cancer. This makes it necessary to implement the population program “test and treat” for the purpose of cancer prevention and to include it among the priorities of healthcare. 

This article provides an analysis of the data of magnetic resonance spectroscopy in dermoid tumor of the postcranial fossa, the features of metabolites in the focus and along the periphery of the tumor process. Information about the surgical treatment of cholesteatoma by suboccipital paramedian access in the early and late postoperative period is given.

The information about the participation of the Russian Red Cross Society sanitary detachment in Abyssinia during the First Abyssinian War in 1895–1896 is presented. Biographical information of military doctors of the Russian Red Cross Society detachment and the fi rst Russian diplomatic mission in Ethiopia is given. Military doctors conducted geographical and ethnographic studies, studied the fl ora of Ethiopia, its soils, the  features of local agriculture and tools.

The diversity and low specifi city of clinical manifestations of COVID-19, as well as its widespread prevalence, present diffi  culties for diff erential diagnosis, including  conditions caused by drug overdose. The challenging experience of providing medical care during the coronavirus pandemic draws attention to the importance and necessity of further improving its diagnosis, especially in comorbid conditions. A clinical case of diff erential diagnosis of non- iatrogenic overdose of methotrexate in a patient with a preliminary diagnosis (virus unknown) is described: U07.2 (ICD-10) COVID-19.

Hereditary inclusion body myopathy (IBM) is a variant of multisystem proteinopathy. It is a generalized progressive disease with autosomal recessive or autosomal dominant inheritance, characterized by the development of a degenerative process in muscle fi bers due to the accumulation of rimmed vacuoles and nuclear intermediate fi laments. This article presents a clinical observation of a rare variant of IBM — HNRNPA2B1-associated myopathy with a phenotypically diverse picture in representatives of one family from diff erent generations.