Changing dietary patterns plays a leading role, especially as a means against obesity and related metabolic diseases. Over the past decades, intermittent fasting regimens have gained popularity as an alternative to traditional weight loss strategies such as fasting-diet therapy and hypocaloric diets. Available literature suggests that intermittent fasting, taking into account the specifi c characteristics and needs of a person, can be recommended both as part of an individual program for weight loss and treatment of metabolic diseases, and after long cycles of fasting-dietary therapy in order to maintain positive treatment results in the long term. This review shows that the methods of complete fasting, low-calorie nutrition and intermittent fasting are eff ective non-pharmacological interventions for the correction of cardiometabolic disorders that contribute to an increase in life expectancy and suppression of oncogenesis and it is advisable to consider them within the framework of a unifi ed treatment and preventive strategy for age-associated human pathology

Depression is a significant medical problem that affects quality of life and social productivity. Investigating the biological basis of depression is essential for developing effective treatment methods. The aim of this work is to analyze the biological mechanisms of depression and modern treatment methods, including the use of new antidepressants. Material and methods. A review of scientific literature on the genetic, neurochemical, and neuroanatomical aspects of depression. An assessment of the effectiveness of various antidepressants and psychotherapeutic methods. Results. Key biological factors infl uencing the development of depression were identified, including monoamine imbalance, neuroendocrine, and immunological changes. Modern antidepressants such as SSRIs, SNRIs, and new drugs including ketamine and its derivatives were discussed. The advantages and disadvantages of various treatment methods were highlighted. Conclusion. Effective treatment of depression requires an individualized approach that includes a combination of pharmacotherapy and psychotherapy. New antidepressants and multimodal approaches represent promising directions for future research and clinical practice

Fibrin sealants in surgery has been used for a long time as a tool for hemostasis and perioperative bleeding preventing. The appropriateness of fi brin glue to diff erent surgical strategies infl uences the clinical outcome. Numerous studies on biological and synthetic adhesive compositions show that there is still limited data on how diff erences in fi brin sealant formulations relate to their clinical eff ectiveness and safety. The review is an attempt to summarize information on biological adhesives including the history of implementation of fi brin glue in surgery, gelation and adhesion mechanisms that determine the bioadhesive properties and sealing functions, the development of adhesive composition formulations, and the reasons prompting researchers to new solutions are also discussed. Alternative technologies, their advantages and disadvantages taking into account surgical strategies, are considered

In patients with cerebral infarction (CI) and sleep apnea syndrome (SAS), neurocognitive disorders are a common symptom, which underscores the relevance of improving their early diagnosis and treatment. A prospective dynamic study was conducted on disorders of visual-constructive and executive skills (VCES) in 74 patients with SAS (main group) and 36 patients without SAS (comparison group) during the acute period of CI using route-building tests (RBT), cube copying tests (CCT), and clock drawing tests (CDT). It was found that patients with SAS exhibited more severe VCES disorders within the fi rst 72 hours of CI, primarily due to impaired performance on the CDT, and worse recovery after one month compared to patients without SAS (p < 0.05). The CDT showed good indicators for the early diagnosis of VCES disorders in patients with SAS and CI (AUC — 0.926 (95% CI 0.86–0.97; p < 0.0001), sensitivity — 100.0% (95% CI 84.6–100.0), specifi city — 85.23% (95% CI 76.1–91.90). In patients with severe SAS, the lowest scores for VCES, RBT, and CDT were established (p < 0.05), and moderate negative correlations were identifi ed between the CDT scores and the apnea-hypopnea index and desaturation index (p < 0.001). Among 20 patients receiving CPAP therapy, a positive dynamics in VCES scores was noted (p < 0.05), which was not observed in the subgroup without similar treatment, suggesting a positive eff ect of CPAP therapy on recovery in this cognitive domain

The aim of this study was to investigate the nature and frequency of functional disorders in patients with non-tuberculous mycobacteriosis (NTM). Material and methods. A total of 178 patients with NTM caused by slowly growing species of NTM (M. avium, M. intracellulare, M. kansasii, M. xenopi, M. lentifl avum) were examined, including 145 women and 33 men aged 25 to 80 years. All patients underwent spirometry. Results. Ventilatory function disorders were identifi ed in 97 (54.5%) of the patients with NTM; among them, the majority—70 (39.3%) patients—exhibited obstructive disorders, while restrictive disorders were observed in 27 (15.2%) patients, which is half as frequent. The frequency and severity of lung function disorders were highest in patients with cavitary forms and lower in those with focal and bronchiectatic forms according to computed tomography (CT) of the lungs. The types of slowly growing mycobacteria did not have a signifi cant impact on the impairment of lung ventilatory function. Conclusion. Ventilatory function disorders were identifi ed in half of the patients with mycobacteriosis. Most frequently, ventilatory function impairment was observed in patients with cavitary forms. The high prevalence of functional disorders indicates the necessity of performing spirometry for all patients with NTM

There is a signifi cant amount of scientifi c data on the clinical course, molecular biology, treatment options for plasma cell tumors and other disorders connected with the secretion of paraproteins. However, the analysis of the infl uence of specifi c clinical and laboratory signs and their combinations on disease progression and prognosis is less represented. The search for other indicators of disease progression is relevant, particularly the determination of the relationship between the type and level of monoclonal immunoglobulin secretion and the severity of the anemic syndrome, which is the focus of our work. Purpose. To determine the correlation between the type of secretion and the amount of monoclonal immunoglobulin in serum and urine with the severity of anemic syndrome in patients with paraproteinemic hemoblastoses (PН). To evaluate the secretion of pathological protein as a possible prognosis factor for the development of anemia in this category of patients. Material and methods. A retrospective analysis was conducted on data from 116 patients with plasma cell neoplasms and Waldenström’s macroglobulinemia. Of these, 104 (87.8%) were diagnosed with multiple myeloma. Eight (6.9%) patients were diagnosed with Waldenström’s macroglobulinemia, two (1.7%) with plasma cell leukemia, and one case each (0.8%) of solitary plasmacytoma and monoclonal gammopathy of undetermined signifi cance. Patients were divided into four groups based on hemoglobin levels: the fi rst group included patients with hemoglobin above 120 g/L, the second group consisted of patients with mild anemia (hemoglobin level from 119 to 100 g/L), the third included patients with moderate anemia (hemoglobin level 99– 80 g/L), and the fourth group comprised patients with severe anemia (hemoglobin level below 79 g/L). Paraproteins were determined in serum in all four groups: Gκ, Gλ, Aκ, Aλ, Mκ, Mλ, Dλ, BJκ, and BJλ proteins, as well as the excretion of BJκ and BJλ proteins in urine. Results. In most patients, paraproteins were detected in blood: Gκ (35.1%), Gλ (24.6%), and BJλ protein (14.9%); in urine: BJλ protein (14.9%) and BJκ (28.1%). The secretion of other types of paraproteins in blood was less frequent: Aκ (9.6%), Aλ (7%), Mκ (3.5%), Mλ (3.5%), Dλ (2.6%), BJκ (4.4%). The absolute majority consisted of patients with paraprotein in blood (Gκ and Gλ), BJλ protein in serum, and excretion of BJλ and BJκ proteins in urine. At the same time, the secretion of other types of paraproteins—Aκ, Aλ, Mκ, Mλ, Dλ, BJκ—was signifi cantly less frequently detected. Anemia of grade I was more frequently diagnosed—in the group with hemoglobin levels of 119–100 g/L, there were more patients (40; 35%). Grade II anemia (hemoglobin 99–80 g/L) was diagnosed in 33 (28%) patients, grade III in 13 (11%) patients. Hemoglobin levels above 120 g/L were found in 30 (26%) patients. No statistically signifi cant relationship was found between the type of paraprotein, its quantitative value in serum and urine, and the severity of anemia in any group. There was a certain correlation between the excretion of BJκ in urine and hemoglobin levels (χ2 = 10.94, p = 0.01 (< 0.05)). This is likely related to a higher number of patients with renal failure among those excreting BJκ in urine. Kidney damage was diagnosed in 18 (54%) out of 33 patients with BJκ excretion in urine. A statistically signifi cant relationship was identifi ed between the number of tumor cells in bone marrow and the severity of anemia, as well as between the level of β-2 microglobulin and the severity of anemia. Conclusions. It has been established that the type and quantitative level of secretion cannot be a prognostic factor for the severity of anemic syndrome in patients with PH. The study revealed a relationship between the severity of anemia and the amount of BJκ protein determined in urine. Since 54% of pati ents in t his group have renal insuffi ciency, we suggest that there is anemia of chronic disease caused by impaired erythropoietin production due to kidney damage. A correlation has also been identifi ed between the severity of anemia and the infi ltration of tumor cells in the bone marrow, which confi rms that the leading cause of anemia in patients with plasma cell disorders is the infi ltration of the bone marrow by tumor cells and their negative impact on erythropoiesis

The objective of the study is to develop, implement, and evaluate the eff ectiveness of a method for distal hybrid reconstruction using a shunt with a port system for performing endovascular revascularization. Material and methods. In a prospective controlled non-randomized study, 24 individuals suff ering from femoral-popliteal occlusion and stenotic-occlusive lesions of the lower leg arteries participated. The fi rst group (n = 12) consisted of patients who underwent femoral-popliteal bypass surgery above or below the knee joint gap in combination with balloon angioplasty of the lower leg arteries according to our proposed method, which involved modeling a special port system on the shunt for the installation of an introducer. The second control group (n = 12) included patients in whom the described interventions were performed using classical methods. The groups were comparable in terms of age, sex, and spectrum of comorbidities. For statistical data processing in comparing the study groups, SPSS Statistics 17.0 software was used. Results. No early postoperative complications were noted in the fi rst group. In the second group, two patients experienced postoperative bleeding associated with the dissection of synthetic graft tissue at the site of defect closure. The revascularization indicators of the limb at the time of discharge from the hospital were comparable between the groups. Additionally, there were no signifi cant diff erences in the healing rate of ulcerative defects on the foot or in the need for necrosectomies prior to discharge. Within one month after surgery, one patient from the second group was readmitted with a clinical and instrumental picture of thrombosis of the femoral-popliteal shunt, which was due to intraoperative compression of the atheroscleroticly aff ected popliteal artery after control angiography. No complications were noted in the fi rst group during this period. In terms of key parameters of the late postoperative period (number of reoperations, recurrence of critical ischemia, amputations, mortality), both groups were comparable during the six-month follow-up. Conclusion. Performing femoral-popliteal bypass surgery using a port system for conducting the endovascular stage of revascularization on the lower leg arteries as part of a hybrid operation helps minimize early postoperative complications, and therefore can be used in distal hybrid reconstructions.

The present article discusses the risk factors for acute and chronic multiple gastric ulcers. Acute multiple ulcers are often stress ulcers that occur in critically ill patients, as well as ulcers that occur when taking medications (fi rst of all nonsteroidal anti-infl ammatory drugs). Acute multiple ulcers are often manifested by gastrointestinal bleeding (hematemesis, melena). Prevention of acute multiple gastric ulcers involves the timely appointment of proton pump inhibitors in the presence of risk factors for their occurrence. In cases of chronic multiple gastric ulcers, the exclusion infi ltrative ulcerative gastric cancer, MALT-lymphoma, B-cell lymphoma, stenosis of the abdominal trunk and other diseases is of great importance

A doctor of any specialty has to deal with lymphadenopathy (LAP), which is a symptom of various diseases. The diff erential diagnosis of LAP in lymphoproliferative diseases is important due to the high mortality rate in this pathology. The article presents a clinical case describing the diffi culties of diff erential diagnosis of LAP and verifi cation of T-cell lymphoma

This article presents data on the stages and episodes of the fi rst (White) wave of emigration. The main focus is on the most signifi cant episode—the Crimean evacuation (“Russian Exodus”) of 1920—and the subsequent placement of refugees in temporary camps in Constantinople, Gallipoli, and on Lemnos Island. Information is provided about the work of medical institutions of the evacuated units and the Russian Red Cross Society in the temporary settlement areas, including the names and some biographical details of military doctors and nurses

In the mid-20th century, radiation therapy was successfully used as an independent treatment method for early stages of certain tumors (skin cancer, lower lip, nasopharynx, larynx, breast, cervix). Radiation therapy was signifi cantly more often utilized in the form of preoperative and postoperative irradiation alongside surgical treatment. This article examines the scientifi c contributions of the outstanding domestic radiologist, Academician of the USSR Academy of Medical Sciences G.A. Zedgenidze. It presents little-known facts about the scientist’s life, his scientifi c achievements, and his merits in organizing the radiological service in the USSR. It is noted that the depth and clinical focus of Georgy Artemyevich’s scientifi c research, along with his originality of thought, always attracted followers and students to him. Under his guidance, more than 70 candidate and over 50 doctoral dissertations were completed. Many of his students headed departments and research teams in various cities across the Soviet Union