Prerequisites for the survival of residents of besieged Leningrad: genetically determined human resilience, physiological psycho-emotional stress, nonspecifi c stress adaptation. A description of the trophological and energy status of the body is given in conditions of a significant decrease in the functions of all organs and systems due to atrophy of internal organs during starvation under blockade conditions. 

Preeclampsia (PE) is a relevant healthcare problem and represents a high risk for the development of various diseases in both the mother and fetus. In domestic and foreign literature, the number of works on the influence of PE on the cardiovascular and nervous systems of the fetus is constantly increasing. Thus, PE is associated with an increased risk of congenital heart defects, high blood pressure (BP), increased body mass index (BMI), and systemic vascular dysfunction in off spring. In addition, PE leads to disorders of the development of the nervous system, such as attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). PE is one of the main causes of adverse perinatal outcomes and neonatal mortality. This review also presents the correlation between PE and the risk of developing cardiovascular diseases (CVDs), stroke, and chronic kidney disease (CKD). In recent decades, there has been increasing evidence that manifestations of PE are not limited to pregnancy but also increase the risk of long-term complications. Thus, PE is a common disease that can lead to severe consequences for the mother and fetus in later life.

One of the links in the pathogenesis of cardiovascular diseases is chronic low-intensity systemic inflammation. In 2004, a previously unknown process was discovered — the formation of extracellular neutrophil traps (NETs) — NETosis (n eutrophil extracellular traps). NETs play a role in antimicrobial immunity though in certain cases they become a factor in the development of pathology. This review presents data on the effect of extracellular neutrophil traps on individual pathologies of the cardiovascular system (atherosclerosis, atrial fibrillation, thrombosis). The authors describe the mechanisms of NET formation (vital NETosis, suicidal NETosis) and their role in thrombus formation (as a framework for thrombus formation, initiation of coagulation), in the development of endothelial dysfunction, and electrical heterogeneity of the atrial myocardium. Data are presented indicating the connection between atherosclerosis, thrombosis, and atrial fibrillation with the activity of NETosis. Most studies demonstrate existing correlations on laboratory models, while the determination of NETs in patients with cardiovascular pathology in real clinical practice is almost absent. At the same time, understanding the processes associated with NETosis can help to identify specific markers and further strategies for the therapy of cardiovascular diseases.

Cardiac amyloidosis is considered a rare disease, but as diagnostic capabilities increase, so does the assessment of its prevalence. Cardiac amyloidosis manifests itself with symptoms of restrictive cardiomyopathy, leading to progressive heart failure. However, the underlying pathogenetic mechanisms of the disease differ. This literature review provides an overview of cardiac amyloidosis, from classification to molecular mechanisms and modern treatment options.

To date, treatment of cicatricial post-burn strictures of the esophagus remains one of the main challenges of thoracic surgery. Despite the signifi cant number of diff erent treatment methods, the number of patients requiring it,  does not decrease. Conservative methods are mostly ineff ective. Bougienage of the esophagus remains the main method of treating scar strictures after burns.

Research objective: to evaluate arterial stiff ness indicators and its correlation with parameters of 24-hour ambulatory blood pressure monitoring (ABPM) in women with newly diagnosed breast cancer (BC).

Material and methods: a prospective cohort study in 158 women aged 27 to 64 years with a median age of 45.4 years and newly diagnosed BC at stage IIA–IIIB before chemotherapy was conducted. The first group included 109 patients with normal or high-normal office blood pressure (BP), and the second group included 49 women with previously diagnosed stage 1– 2 essential hypertension (EH) with low or moderate cardiovascular risk. All patients underwent indirect arteriography and ABPM.

 Results. According to ABPM data, “masked” arterial hypertension (MAH) was diagnosed in 54 (49.5%) women in the fi rst group. In patients with MAH, the mean daily level and diastolic BP time index exceeded the corresponding indicators in EH, and the magnitude of the morning rise in systolic BP was significantly lower. In 35.4% of the examined patients with EH, the pulse wave velocity (PWV) was increased, and in 17.4% it was pathological. With MAH, these changes were recorded in 28.5% and 14.1% of cases, respectively. The odds ratio showed that in women with normal BP, the probability of an increase in PWV >10 m/s increased by 1.6 times, and in the presence of comorbidity with MAH and EH, it increased by 2.2 and 2.4 times, respectively. The risk of an increase in central systolic BP >125 mm Hg and pulse BP >60 mm Hg was highest in patients with EH.

Conclusion: Among young and middle-aged women with newly diagnosed BC, a significant number of cases of MAH and EH are detected, which determines the need to evaluate arterial stiff ness and daily BP profiles before starting antitumor therapy.

Research objective. To evaluate the levels of CRP, cardio-specific markers, lipids, structural-functional (SF) state of vessels, and their interrelations in patients with lymphoproliterative diseases (LPD) before polychemotherapy (PCT).

Materials and methods. The study included patients with newly diagnosed LPD (n = 30), including 16 men (53.3%) and 14 women (46.7%). All patients were divided into two groups: group 1 (n = 15) — patients with low/intermediate cardiovascular toxicity (CVT) risk; group 2 (n = 15) — patients with high/very high CVT risk. CVT risk stratification was performed with the use of specialized scales according to the current European clinical guidelines for cardio-oncology 2022. All patients included in the study underwent standard laboratory and instrumental examinations. Specific laboratory research involved assessing the levels of C-reactive protein (CRP), troponin I (TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), and lipid profile. The SF state of vessels was evaluated non-invasively using photoplethysmography (PPG) (Angioscan-01 device, Russia) and computerized videocapillaroscopy (CVC) of the periungual area (Capillaroscan-01 device, Russia).

Results. According to the results of PPG and CVC, the occlusion index (OI) in group 2 was significantly lower and amounted to 1.2 [1; 1.3] compared to 1.7 [1.45; 2.1] in group 1 (p < 0.001); capillary density after reactive hyperemia (CDRH) was also significantly lower in group 2 compared to group 1 — 43 [35.5; 45] and 54 [43; 58] cap/mm², respectively (p = 0.033). According to the obtained results, there were no statistically significant diff erences in the levels of CRP, TnI, and NT-proBNP between patients in both groups; the indicators were within the reference values. A moderate inverse statistically signifi cant correlation was found between the level of CRP and the percentage of perfused capillaries (PPC) (rs = –0.545; p =  0.02) and the percentage of capillary recovery (PCR) (r = –0.446; p = 0.013).

Conclusion. Patients with LPD have endothelial dysfunction before PCT, primarily due to the presence of cardiovascular risk factors (age, body mass index), and concomitant cardiovascular diseases. At the same time, the SF state of vessels initially does not depend on the stage and course of LPD, lipid levels, and TnI.

The presented article discusses the risk of side eff ects when using proton pump inhibitors (PPI): infectious complications (small intestinal bacterial overgrowth, Clostridium difficile-associated disease, community-acquired pneumonia, spontaneous bacterial peritonitis), stomach cancer, myocardial infarction, hypomagnesemia, iron and vitamin B₁₂ deficiency, kidney damage, bone fractures, dementia, Alzheimer’s disease. An analysis of the literature indicates a weak causal relationship between the occurrence of these diseases and the use of PPI. Nevertheless, it is necessary to strive for the appointment of these drugs in the minimum effective dose and for as short a time as possible.

Pneumococcal infection is a serious problem for practical healthcare. After the COVID-19 pandemic, there has been a significant increase in bacterial infections incidence, with pneumococcus remaining the main causative agent in all age groups. Among military personnel, pneumococcal pneumonia is the most common severe pathology requiring significant efforts in patient treatment. Vaccination remains an important factor in reducing the incidence of disease, and most importantly, in significant reduction of cases of invasive pneumococcal infection, which is characterized by high mortality. Currently, modern approaches to vaccination regimens in adults have been developed, which are reflected in this publication.

The emergence of effective therapy for AL amyloidosis with cardiac involvement raises the challenge of a comprehensive assessment of the risk of SCD and its prevention. This problem should be approached individually and the possibility of ICD implantation should be considered in patients with ventricular arrhythmias: frequent extrasystoles and unstable ventricular tachycardia. With the development of rhythm and conduction disturbances in patients with amyloidosis, one should keep in mind the possibility of myocarditis, and in patients who have suffered a new coronavirus infection, its possible role in the induction of both post-Covid myocarditis and amyloidosis itself.

Data on the first military aeronautical schools in Gatchina and in Kacha are presented. Information is given about the first military doctors of aeronautical schools and the first studies of the effect of flights on the human body.

The article presents some data on maternity care in Ancient Russia. The connection of myths and legends of Ancient Russia, Ancient Greece and Rome with modern elements of medical care for women in labor and newborns is traced.