Despite extensive research aimed at studying the causes of peripartal cardiomyopathy, it is currently accepted to consider this disease as a cardiac pathology of unknown etiology. 
Objective: to conduct a literature review to study the pathogenetic features of the development of peripartal cardiomyopathy and to analyze a series of clinical cases. 
Research methodology. As part of the assessment of the pathogenetic mechanisms of PPCM development, a multi-stage approach to data collection and analysis was implemented, including both domestic and foreign sources. Information was searched in international databases such as PubMed, Scopus, Web of Science and Cochrane Library, as well as in Russian databases, including eLibrary, to account for all relevant and significant publications. The search used keywords and combinations such as peripartal cardiomyopathy, prolactin, STAT3, sFlt-1, VEGF, matrix metalloproteinases, in English and Russian. Special attention was paid to papers published over the past 15 years, with an emphasis on research conducted over the past 5 years to reflect all pathogenetic aspects of the development of PPCM. Both primary and secondary clinical studies and data from real clinical practice were included. Additionally, an analysis of domestic and foreign regulatory documents and recommendations was carried out in order to assess the possibilities of solving the clinical problem of PPCM. 
Results. Current data indicate the need to integrate pathogenetic mechanisms, such as the effects of prolactin, STAT3, MMP and other molecules, into clinical practice for more effective diagnosis and treatment of PPCM. The analyzed studies show that PPCM requires an integrated approach to examination and treatment, as it can have various manifestations, and can also have serious consequences for the health of the mother and child. Due to the growing awareness of PPCM, its etiopathogenetic mechanisms should be further investigated.; Further clinical studies are needed to develop clear treatment protocols and recommendations that will help improve outcomes for this category of individuals.

Despite the successes of modern medicine, retains one of the leading positions in the causes of disability and mortality. In order to improve the prognosis of patients with acute myocardial infarction, reduce the focus of necrosis, and reduce mortality, modern reperfusion therapy has been developed. This review examines the possible timing of thrombolysis, assessment of the relevance and features of the pharmacoinvasive approach in the treatment of acute myocardial infarction. Large randomized medical trials aimed at studying the effectiveness and safety of thrombolytic therapy were analyzed. We compared properties of thrombolytic drugs, their mechanism of action. The properties of an “ideal” thrombolytic were assessed. The advantages of the non-immunogenic staphylokinase drug- forteplase, are shown for use both stages — prehospital stage and in-hospital.

The article discusses the issue of the use of combined titanium-containing drugs in practical medicine using the example of an aquacomplex of titanium glycerosolvate (AGT). The purpose of this work was to analyze the effectiveness of the use of titanium-containing drugs in various fields of medicine. The materials for the study were the official information base of Roszdravnadzor “State Register of Medicines”, legal information bases “Consultant”, “Garant” (accessed 11/25/2024), scientific journal articles from the database Elibrary, PubMed and RusMed. Articles containing isolated observations and having poor statistical processing were excluded from the review. The unique properties of the AGT are described in detail, allowing it to be widely used in surgery, dentistry, dermatology, rheumatology, traumatology, pediatrics and other fields. Its safety is emphasized. The nosological units of its application in various fields of medical practice are given. Combinations of AGT with various medicines used in practical healthcare are described in detail. The study demonstrated the advantages of using an AGT with different drugs compared with its isolated use due to potentiation and prolongation of their action. It is emphasized that this titanium preparation can serve as an ointment base for the development of combined medicines.

The work reflects the toxicological aspects of tattoos and their complications caused by an increase in the number of carriers, as well as the area of application and the number of tattoos, the expansion of their color range, etc. Inks, the composition and potential toxicity of which are not always known, contain complexes of pigments and auxiliaries, which, like the products of their transformation, can provoke the development of various types of skin and systemic reactions. The main factors determining the toxic risks of tattooing are given.

Atrial fibrillation (AF) is a significant cause of chronic heart failure development. The results of randomized clinical trials focusing on interventional treatment of AF in patients with systolic left ventricular (LV) dysfunction demonstrate varying effectiveness and safety of catheter interventions. 
Objective. The main aim of this study is to evaluate the efficacy and safety of catheter ablation of AF in patients with systolic LV dysfunction compared to patients without systolic LV dysfunction. 
Material and methods. Following “pseudo-randomization” 395 patients who underwent pulmonary vein isolation were divided into 2 groups: the main group (LV ejection fraction < 50%, n = 42) and the comparison group (LV ejection fraction ≥ 50%, n = 81).
Results. There was no statistically significant difference between the main group and the comparison group in the frequency of postoperative AF recurrence during hospitalization (7.1% (3) vs. 14.8% (12), p = 0.218), the frequency of intraoperative complications (2.4% vs. 9.9%, p = 0.130), and their structure (p = 0.442). The main group showed an increase in LV ejection fraction by +6.6 ± 7.9% on the 2nd day post-operation (p < 0.001), primarily due to the control of tachysystole and restoration of sinus rhythm in the presence of viable LV myocardium. 
Conclusion. Interventional treatment of AF in patients with systolic LV dysfunction is comparable in safety and efficacy to outcomes in cases with preserved LV ejection fraction.

Prior to the Omicron variant of SARS-CoV-2, COVID-19 was characterized by a severe course and unfavorable prognosis, including fatal outcomes, in a significant proportion of patients with end-stage chronic kidney disease undergoing renal replacement therapy via programmed hemodialysis. Since January 2022, the Omicron variant of SARS-CoV-2 has been the dominant strain in Russia and is associated with a low incidence of viral pulmonary lesions in infected individuals.
Objective. To identify clinical and laboratory predictors of viral pulmonary lesions caused by the Omicron variant of SARSCoV-2 in patients with end-stage chronic kidney disease. 
Material and methods. A retrospective analysis was conducted on 33 medical records of patients with end-stage chronic kidney disease undergoing programmed hemodialysis who contracted COVID-19 between January 2022 and February 2024. 
Results. Laboratory markers associated with viral pulmonary lesions in patients with end-stage chronic kidney disease and COVID-19 included hemoglobin ≤ 115 g/L, neutrophil count > 65%, monocyte count < 8%, absolute and relative eosinophil counts < 0.1 × 10⁹/L and < 2%, respectively, reduced albumin values, AST > 20 U/L, CRP > 50 mg/L, prothrombin activity < 100% (according to Quick’s method), and APTT ≥ 30 seconds. It was demonstrated that a body temperature of ≥ 37.2 °C during the first three days of hospitalization, an absolute eosinophil count < 0.1 × 10⁹/L, and a relative eosinophil count < 2% increased the risk of viral pulmonary lesions by 9 times.
Conclusion. Considering that COVID-19 caused by the Omicron variant of SARS-CoV-2 remains a significant threat to patients undergoing programmed hemodialysis, it is essential to predict the development of a generalized form of SARS-CoV-2 infection with pulmonary involvement in patients with end-stage chronic kidney disease. Early prediction will facilitate timely therapeutic adjustments and the planning of additional diagnostic evaluations.

A study was conducted on the effectiveness of the program for visual identification of skin melanoma “Melanoma Check” (a computer program for a smartphone), which showed high accuracy in determining the probability of a patient having skin melanoma. The diagnostic accuracy of the program was 88%, sensitivity — 77%, specificity — 91%, the proportion of false positive results — 9.2%, the proportion of false negative results — 23.1%. Due to the widespread use of smartphones, modern artificial intelligence technology makes it possible to early detect skin melanoma during the initial examination by a general practitioner and therapist, especially in medical organizations in regions with a shortage or absence of dermatovenerologists and oncologists.

The article presents the statements of the updated Lyon 2.0 consensus, dedicated to improving the diagnosis of gastroesophageal reflux disease (GERD). The possibilities of using wireless pH-monitoring, as well as pH-impedansometry, are shown. They help to make a differential diagnosis between proven GERD and functional diseases of the esophagus, to clarify its form and the course. The practical implementation of the statements of this consensus will improve the diagnosis and treatment of GERD.

A clinically and pharmacologically sound and rational combination of various anesthetics is of increasing interest in scientific and practical activities, as it makes it possible to more effectively achieve targeted therapy within the criteria of quality and safety of anesthesia. 
The purpose of the study. To demonstrate the effective use of the inhaled anesthetic xenon and the intravenous sedative dexmedetomidine during plastic surgery. 
Material and methods. A clinical case of performing plastic surgery, reduction mammoplasty, lasting 2 hours and 40 minutes under combined anesthesia with the use of inhaled anesthetic xenon and intravenous sedative dexmedetomidine is presented. 
Results. The success and adequacy of the anesthesia performed are convincingly proved by the data of intraoperative monitoring, the quality of the patient’s post-acute awakening. 
Conclusion. Combined use of inhalation anesthetic xenon and intravenous anesthetic.

The article presents historical information about the creation and activities of the Vyatka Community of Sisters of Mercy, as well as biographical data of doctors and nurses of hospitals and infirmaries of the Vyatka province. The information about medical institutions in Vyatka, created to provide assistance during the First World war, is presented.

During his life, famous Russian surgeon N.I. Pirogov have get a personal and professional contacts with significant European scientists of the 19th century, who made a great contribution to the history of development the operative surgery. In this historical review presents brief biographical information and contributions to surgery of some European surgeons lived in 19th-century, who have get scientific and professional connections with Pirogov and who are mentioned in his autobiographical book — «Questions of Life: The Diary of an Old Doctor». From memories N.I. Pirogov, he got acquaintance with the European surgical school at Moscow University, continued scrutiny it for his studies in the professorial institute and during an internship in Germany, business trips and vacations in Europe. His scientific environment included such significant anatomists and surgeons as: J.C. Loder, I.F. Moyer, F. Schlemm, J.N. Rust, C.F. Grafe, J.F. Dieffenbach, J.P. Müller, E.H. Weber, R.F. Froriep, B. Langenbeck, A. Velpeau, J.Z. Amussat, A. Jobert, J. Lisfranc, T. Billroth. N.I. Pirogov had deep respect for the achievements of European surgeries and highly valued their contribution to science. The famous Russian surgeon combined their strengths and his own genius in a new science — topographic anatomy and created modern operative surgery. The famous scientist called on supporters — the study, improvement and implementation of advanced Western achievements in Russian medicine.