The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), alarmed the global community due to the significant loss of human lives during the pandemic. However, as the saying goes, every cloud has a silver lining. A positive aspect of this recent pandemic has been that it stimulated scientists to create vaccines against SARS-CoV-2, accelerating the emergence of new therapeutic agents based on messenger ribonucleic acid (mRNA). Numerous mRNA therapeutic products are currently in development, with dozens at various clinical trial stages. These products have facilitated significant changes in the paradigm of medical therapy, including the treatment of cardiovascular diseases (CVD). Although most of these cardiovascular mRNA therapeutics are still in preclinical development, phase IIa trials for myocardial ischemia therapy have already been completed with encouraging results. The scope of mRNA therapy for CVD is extremely broad, potentially even limitless, with ongoing research including conditions like myocardial ischemia, heart failure, arrhythmias, hypercholesterolemia, and occlusive arterial diseases. Moreover, mRNA can be used to enhance the effectiveness of cell therapies. In the future, researchers predict that mRNA therapies will not only replace some existing biopharmaceuticals and pharmacotherapy methods but also be applied to treat previously considered untreatable cardiovascular diseases.

One of the current issues in tuberculosis treatment is the intolerance to anti-tuberculosis drugs, which drives the search for the most effective method of delivering medications to the site of inflammation. A review of literature sources from the databases RSCI, Google Scholar, PubMed, and Scopus, covering the period from 1984 to 2020, was conducted, focusing on the use of endolymphatic therapy in patients with tuberculosis of various localizations. The analysis showed that the effectiveness of endolymphatic administration of anti-tuberculosis agents improves treatment outcomes for patients with progressive tuberculosis.

Chitosan is widely used in all areas of human activity. It is obtained from animals, insects, and plants containing chitin through chemical purification. Animal-derived raw materials are most in demand, while insect-derived sources are the most promising. Main Provisions. Chitosan is extensively used in medicine: in nutrition, surgery, hematology, dentistry, and oncology. It exhibits biocompatibility, bioresorbability, non-toxicity, hemostatic properties, plasticity, adhesive qualities, and has antibacterial properties. By altering the chemical formula of chitosan, its molecular weight and charge, and combining it with various substances, new application areas and more economical extraction methods can be found. Detoxifying, sorptive, and hypolipidemic properties are sought after in nutrition and gastroenterology. The effects of chitosan on various phases of regeneration, as well as its anticoagulant properties, are utilized in surgery. Chitosan’s osteoinductive efects are applied in dentistry and traumatology, while its hemostatic, antibacterial, antitumor, and radioprotective properties are key research directions in emergency surgery and oncology, respectively. Conclusion. The widespread application of chitosan in all areas of human activity, especially in medicine, makes it a sought-after and promising substance. To expand the production of various chitosan-based substances, it is essential to find new, cheaper methods for extracting chitosan from chitin, streamline the routes from raw materials to final products, and develop independent Russian equivalents of chitosan drug forms.

For many decades, heart transplantation has been the “gold standard” for terminal chronic heart failure resistant to medical therapy treatment. However, there is a significant number of patients with contraindications to orthotopic heart transplantation. The only effective treatment method for these patients may be the implantation of long-term mechanical circulatory support systems. This article provides information for practicing physicians on the evolution of long-term mechanical circulatory support systems, the main criteria for selecting patients for implantation, and the specifics of their subsequent outpatient monitoring.

This article analyzes the potential for enhancing the effectiveness of cultural bacteriological testing in patients with infectious endocarditis through the cultivation of arterial and venous blood. Experimental data are presented, based on which the concept of the phenomenon of arterial bacteremia surpassing venous bacteremia is formulated, alongside the results of its clinical application. 

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, with over 30% of these patients dying from cardiovascular diseases. Objective: to study the pathophysiological links between echocardiography, spirometry indicators, and inflammatory biomarkers in patients with various clinical phenotypes of occupational COPD with cardiovascular comorbidity. Material and methods. The study included 111 patients with occupational COPD and cardiovascular comorbidity. Based on spirometry results, patients were divided into 4 groups (clinical phenotypes). Clinical examinations, echocardiography, and serum concentrations of troponin I, endothelin-1 (E-1), endothelial synthase (ES), hyaluronic acid (HA), and myoglobin were performed. Results. The concentrations of troponin I, myoglobin, and E-1 were normal in all groups. HA concentration was highest among phenotype “E” patients (p = 0.0008). ES concentration in phenotype “E” was more than 2.5 times higher compared to other groups (p = 0.0022). Myoglobin concentration positively correlated with left ventricular myocardium thickness, ES, eosinophil levels, and coronary heart disease (p < 0.05), while ES concentration correlated positively with hypertension. HA concentration negatively correlated with spirometry and echocardiography indicators and positively correlated with eosinophil levels and exacerbations (p < 0.05). Conclusion. Further research is needed to identify biomarkers reflecting the risk of exacerbations in cardiovascular comorbidities in patients with occupational COPD

Currently, there is insufficient research on the optimal sleep surface to improve sleep quality and reduce lower back pain. Studying orthopedic mattresses in this context could be a promising direction. Objective: To assess the impact of orthopedic mattresses on pain severity and sleep quality. Materials and Methods: From September to December 2023, we conducted a randomized controlled trial involving volunteers with chronic lower back pain. Participants were randomized into 4 groups: 3 using orthopedic mattresses of varying firmness (firm, medium, and soft) and 1 control group (with a non-orthopedic mattress). Observations were made over 4 weeks, assessing pain intensity and sleep quality through a visual analog scale and sleep quality questionnaire. Results: Out of 117 screened volunteers, 86 were included, and 5 withdrew, leaving 81 participants: 21 in the firm group, 20 in the medium, 20 in the soft, and 20 in the control group. No differences were found in participant characteristics. Significant pain reduction was noted in all groups (p < 0.001), with considerable sleep quality improvement in the 3 experimental groups (p < 0.001) but not in the control (p = 0.101). Conclusion: Using orthopedic mattresses for 4 weeks significantly reduced lower back pain and improved sleep quality.

Objective. Тo study the impact of standard hypolipidemic therapy and stent type on the progression of atherosclerosis in coronary arteries in patients with familial hypercholesterolemia and acute coronary syndrome. Material and methods. Analyzed treatment results of 100 patients with familial hypercholesterolemia and acute coronary syndrome, divided into two equal groups. Group 1 received bare-metal stents, while Group 2 received drug-eluting stents. All patients were prescribed standard hypolipidemic therapy to reduce restenosis risk and normalize lipid profiles. Immediate postoperative outcomes included coronary flow restoration and adverse event rates, with long-term assessments focused on lipid profile dynamics and restenosis rates. Results. Coronary flow was restored in 98%, with adverse events occurring in 8% equally across both groups. Hypolipidemic therapy normalized lipid profiles in one-third of patients after 1 month, half after 3 months, and two-thirds after 6 months. Restenosis rates at 6 months were 45.2% in Group 1 and 21.2% in Group 2, escalating to 84.6% and 48% at 12 months. Repeat stent implantation occurred in 14% of Group 1 and 8% of Group 2. Conclusion. Standard hypolipidemic therapy is insufficient for rapid lipid normalization, while drug-eluting stents significantly reduce restenosis risk.

The article presents a clinical observation of acute disseminated encephalomyelitis in a 45-year-old female patient. The onset of the disease began with speech disturbances, changes in voice, weakness in the right leg, and periodic twitching in the right arm. Magnetic resonance imaging revealed lesions in the white matter of the brain. A complication of the disease was occlusive thrombosis of the left internal jugular vein, the lower jugular vein, and the subclavian vein. This case highlights the importance of physicians’ awareness—specifically general practitioners and neurologists—about rare diseases such as acute disseminated encephalomyelitis, its early manifestations, potential long-term complications, and modern treatment approaches

Objective: To evaluate the effectiveness of comprehensive treatment for tubo-peritoneal infertility using immunomodulators and to compare the results obtained with literature data presenting classical therapy schemes for this type of infertility. Material and Methods: A retrospective study using a targeted sampling method. A total of 97 protocols for laparoscopic surgeries on patients with a clinical diagnosis of “Female infertility of tube-peritoneal origin. Chronic salpingitis and oophoritis” were examined. Results: Pregnancy occurred in 77.3% of patients, with 69.4% conceiving within the first year after surgery, and among these, 44.2% within the first 6 months (p < 0.05). Conclusions: As a result of comprehensive treatment using active immunomodulatory therapy, pregnancy occurred in 77.3% of cases, which is a statistically significant indicator for this sample (p < 0.05) and reflects the high effectiveness of the therapy conducted. Based on the results obtained, it is possible to state a significant impact of active immunotherapy on the outcomes of treatment for female infertility associated with the tubal factor. This is most clearly visible when compared with literature data, where in classical treatment schemes, the pregnancy rate within one year varied from 38 to 44% (whereas in the first year after therapy, pregnancy occurred in only 13–15% of cases).

Fibrinogen (FG), factor I of the blood coagulation system, is a critical component of the hemostatic cascade. Its primary physiological function involves the final stage of blood coagulation, where soluble fibrinogen is converted into insoluble fibrin by thrombin and factor XII. Increasing data highlight congenital disorders of fibrinogen synthesis and/or structure, with deficiencies found in 9.3% of rare blood coagulation disorders. The variety of phenotypes in congenital FG structural disorders, characterized by a tendency for bleeding and/or thrombosis, primarily in the arterial system (infarcts, strokes), complicates modern diagnosis. Therefore, a detailed study of FG defects in patients is required. This article reviews current literature on the role of fibrinogen in the pathogenesis of cardiovascular diseases. A clinical case is presented involving a 36-year-old woman who experienced a myocardial infarction without obstructive coronary artery disease, linked to a homozygous mutation in fibrinogen (FGB −455 G/A).

Currently, one of the primary methods of reperfusion in ischemic stroke is systemic thrombolytic therapy (TLT) using recombinant tissue plasminogen activators (rtPA). Despite TLT’s effectiveness demonstrated in several large multicenter randomized placebo-controlled clinical trials, the use of rtPA at standard dosages carries a high risk of hemorrhagic complications, especially in patients with certain aggravating factors. This article presents a clinical case of early thrombolysis in a patient with ischemic stroke, utilizing an individualized dosage of rtPA despite the presence of relative contraindications for reperfusion therapy.

The article presents biographical and statistical data about doctors and nurses of the White Army during key battles of the Civil War. It includes information on the Northwestern Army, Northern Army, participants of the 1st Kuban (“Ice”) Campaign, the “Siberian Ice Campaign,” and the evacuation from Crimea and Primorsky Krai. 

The article presents the life and work of the outstanding world-renowned surgeon, Professor Theodor Billroth. It includes lesser-known yet significant facts about the life of this innovative scientist. His contributions to abdominal surgery and practical medicine as a whole cannot be overstated. One of Billroth’s contributions was the development of annual reports in the surgical clinics he led, which he and his colleagues compiled over 17 years and published in 1879. He performed the first laryngectomy for malignancy, the first prostatectomy, and the extirpation of the pancreas, among other pioneering operations. Billroth also developed surgical procedures for the tongue, a closed method for treating echinococcosis, and the first esophagectomy, leading to advancements in gastrointestinal surgery. Initially, gastric resection was developed by him and his assistants in animals before being applied to a living human in 1881. On January 29, 1881, he performed the world’s first successful “pyloric resection” on a patient with stenosis due to stomach cancer. Billroth is recognized as a respected leader in global abdominal surgery and as the founder and head of a prestigious German scientific school, which produced notable surgeons who established their own schools, trained worthy students, and made significant contributions to European practical medicine.