Neurosarcoidosis is a rare manifestation of systemic sarcoidosis characterized by involvement of both the central and peripheral nervous systems. The clinical presentation is highly variable and depends on the localization of granulomatous inflammation, which complicates the diagnostic process. This article reviews current understanding of the pathogenesis, clinical phenotypes, and differential diagnosis of neurosarcoidosis. It also describes methods of neuroimaging, laboratory diagnostics, and histological verification of the disease. Special attention is given to therapeutic strategies, including glucocorticoid and immunosuppressive therapy. Prognostic considerations and potential directions for future research are discussed.

In clinical practice, situations often develop that are accompanied by clinical death. Effective resuscitation is only one of the steps in the management of such patients. In the period after successful resuscitation, along with the processes of recovery and compensation, a new set of pathological conditions, called post-resuscitation disease, arises. As a result of effective resuscitation measures, various clinical manifestations may develop in the long term, resulting from cardiac or cerebral damage. Doctors of any specialty may encounter such a clinical situation, but not every specialist has information about this pathology, which can lead to mismanagement of these patients.

CLIP is a chronic, systemic and smoldering inflammatory condition clearly indicated by a 2–4-fold increase in serum levels of inflammatory mediators such as interleukin-6 and C-reactive protein. Many other cellular and molecular mediators of inflammation are also involved in the development of CLIP. CLIP typically occurs in older people, hence also known as aging inflammation, and is an integral part of the aging spectrum of the immune system. Causal factors may include: persistent viral infections such as chronic cytomegalovirus infection; cellular aging and the inability, in this regard, to eliminate degraded materials and waste products; dysbiosis and impaired intestinal permeability, obesity and others. A significant body of evidence suggests that CLIP is a powerful contributor to senility and many other adverse health chronic conditions associated with aging. Many inflammatory mediators and their regulatory mechanisms in CLIP can serve as potential targets for therapeutic intervention. However, the complexity of the inflammatory network should be taken into account when developing new interventional strategies for the treatment of CLIP and associated chronic conditions. Non-pharmacological interventions such as caloric restriction and exercise have beneficial effects on CLIP and its causative factors, which in turn can provide significant health benefits. Metformin and resveratrol have anti-inflammatory properties and, in this regard, may serve as promising therapeutic agents for the treatment of chronic low-grade inflammation and frailty.

The high pathogenicity of SARS-CoV-2 and the airborne transmission mechanism are a public health concern. At first, it was believed that a history of allergic reactions aggravated the course of the disease. Later, it turned out that bronchial asthma (BA) in patients or other allergic diseases did not affect the severity of coronavirus infection (CVI).

Objective. The aim of the study is to identify the relationship between the course of COVID-19 in patients with asthma and allergies.

Material and methods. As a result of the cross-sectional study of the hypothesis, a retrospective analysis of people was conducted for the years 2019–2023. The study group — patients with confirmed COVID-19 and the presence of dispensary registration for bronchial asthma, patients with confirmed COVID-19 and a history of allergies. To assess the severity of the disease, laboratory parameters of patients in dynamics and symptoms were taken.

Results. Women with COVID-19 have lower ESR levels than women with concomitant asthma and allergies; men have identical results. The CRP indicators in women with an aggravated anamnesis increase sharply, in contrast to individuals with COVID-19. In men, no significant differences in the CRP results were found.

Conclusion. In women and men with bronchial asthma and/or a history of allergies, the course of COVID-19 was milder, both according to laboratory data and the corresponding clinical picture.

30 patients with hydrothorax on the background of bacterial pneumonia were examined, who were divided into 2 groups depending on the amount of effusion. Group 1 (n = 13) had partial effusion, the average age was 58.5 ± 4.9 years, there were 5 (38.4%) women and 8 (61.5%) men. Group 2 (n = 17) with total effusion, age 60.1 ± 5.3 years, there were 7 (41.1%) women and 10 (58.8%) men. The research methods included clinical, biochemical, and instrumental methods. Genetic analyses investigated the methylation of the SHOX2, DAPK1, RAR-beta, and miR-375 genes. It was found that with hydrothorax, patients with bacterial pneumonia develop significant changes in the homeostasis system — endogenous intoxication and a decrease in reactive processes. These disorders were associated with the type of pleural effusions and the severity of the patients. In patients with total effusion, where the incidence of severe forms was 64.7%, changes in the homeostasis system were greatest. In the group with partial effusion, the majority of patients were of moderate severity, and the changes in the homeostasis system were the least. A genetic test showed the absence of methylation of the SHOX2, DAPK1, RAR-beta, and miR-375 genes in patients with hydrothorax and bacterial pneumonia. The amplification curves had no pathological abnormalities. The PCR signals in the studied groups and the norm were the same. The results of the study draw attention to the need to further study the pathogenetic mechanisms of hydrothorax in patients with bacterial pneumonia in order to optimize diagnostic and treatment methods.

Aim. To study the relationship between changes in clinical blood test (CBT) and vascular dysfunction in patients with obstructive sleep apnea (OSA) and comorbid pathology.

Material and methods. A total of 152 patients were examined. The main group consisted of patients with OSA (n = 83), and the control group (n = 69) — without apnea. The subjects underwent anthropometry, polysomnography, transcranial Doppler, ultrasound examination of the brachial artery, and CBT examination.

Results. In patients with OSA, significantly higher values of 50% of the CBT indices, systemic immune inflammation index (SII), leukocyte shift index (LSI), and neutrophil-to-lymphocyte ratio (NLR) were found than in the control group. The timeaveraged maximum blood flow velocity (TAMV) in patients of the main group before the tests was significantly lower only on the right (0.55 (0.43; 0.62) m/s, p = 0.004) compared to the control group (0.59 (0.51; 0.72) m/s) and remained lower after the tests. The cerebrovascular reactivity index values during the hypercapnic test in patients with apnea were within 0.90–1.00 and significantly lower after the 1st and 5th minutes on both sides and the 10th minute on the left than in the control. Endothelial dysfunction was detected in 66.30% of patients in the main group when assessing endothelium-dependent dilation (p = 0.000) and in 50.60% with endothelium-independent dilation of the brachial artery (p = 0.000) compared to the control group (26.10% and 17.40%, respectively).

Conclusion. For patients with OSA, the most significant changes in the CBT are the “red blood” indices, as well as LSI, NLR and SII. An increase in these blood parameters in patients with apnea may indicate the development of systemic inflammation and oxidative stress. The revealed decrease in TAMV, resistance index, impaired adaptation of cerebral circulation against the background of intermittent hypoxemia, endothelial dysfunction may be etiopathogenetic factors in the development of chronic cerebral ischemia in patients with OSA.

Objective: the study objective is to identify etiological factors and pathogenetic mechanisms of anemia development in geriatric patients hospitalized in therapeutic and surgical departments.

Material and methods. А retrospective analysis of 415 elderly, senile and long-lived patients hospitalized in the therapeutic departments, urological and gynecological departments of the Irkutsk Regional Clinical Hospital, who were diagnosed with anemia during the examination, was carried out.

Results. An analysis of medical records showed that 3,632 patients over the age of 60 were treated in the departments. The incidence of anemia was 11.4% among all hospitalized patients over the age of 60. Of the examined patients, women predominated in 61% of cases. Anemia of mild severity was diagnosed in 50% of patients. Anemia of chronic diseases prevailed in the structure of anemia and was diagnosed in 208 (50%) patients, iron deficiency anemia was detected in 91 (22%) patients.

Conclusions. Thus, as a result of the study, the structure of anemia was revealed in elderly, senile and long-lived patients hospitalized at the Irkutsk Regional Clinical Hospital. The high prevalence of anemia of chronic diseases in this age group was revealed, due to the comorbidity of geriatric patients and the multifactorial genesis of anemia. The above causes the difficulty of diagnosing anemia in patients over 60 years of age.

Objectives. To assess the associative relationship between genotype distributions of polymorphic variants of COL1A1, VDR, NOS3, IL6, RANKL, MTHFR, MTR, MTRR genes and risk of sarcopenia in women over 60 years of age.

Materials and methods. This cross-sectional study enrolled 67 women aged 61 to 82 years. Dynamometry and a “Chair rising test” test have been performed. Polymorphic variants of the COL1A1, VDR, NOS3, IL6, RANKL, MTHFR, MTR, MTRR genes have been identified. The participants were divided into 2 groups: group 1 consisted of 34 subjects without sarcopenia and group 2 included 33 persons with sarcopenia.

Results. In group 1, the GG G894T NOS3 genotype significantly prevailed, and in group 2, the GT and TT variants were most frequent, p = 0.035. In group 1, the recessive TT genotypes G894T NOS3, GG A66G MTRR prevailed. CC variant G(-174)IL6 prevailed in group 2, as did the TT C677T MTHFR genotype, which was not detected in group 2, p < 0.05.

Conclusions. Age is an independent risk factor for sarcopenia development. Presence of the TT G894T NOS3, GG A66G MTRR genotype is likely to increase the risk of sarcopenia. While the CC G174C IL6, TT C677T MTHFR genotype is probably protective against the development of sarcopenia. There was no association between the genotype distributions of polymorphic variants of the COL1A1, VDR, RANKL, MTR genes and the risk of sarcopenia in women over 60 years of age.

A clinical case of atypical hemolytic uremic syndrome in an adult man is presented. Atypical hemolytic uremic syndrome (aHUS) is an orphan disease that affects various organs and systems and is accompanied by extremely high mortality. aHUS is based on uncontrolled activation of the alternative complement pathway, leading to generalized thrombus formation in the vessels of the microcirculatory bed. High mortality in aHUS is due to several reasons: extremely rare incidence of the disease and, as a result, low awareness of it by doctors, nonspecific symptoms at the onset of aHUS, rapid development of multiple organ failure with kidney damage due to catastrophic generalized thrombus formation in the microcirculatory bed.

Parsonage–Turner syndrome (PTS) is a form of brachial plexus neuropathy characterized by acute pain followed by weakness in the upper limb. Due to its rarity, reporting individual clinical observations remains relevant. This article presents a case of a 59-year-old woman who developed left shoulder pain and upper limb monoparesis almost simultaneously. An ischemic stroke was suspected at the pre-hospital stage but was ruled out by brain MRI. The diagnosis of PTS was made based on the clinical presentation and findings of stimulation electromyography. Corticosteroid therapy resulted in a marked reduction of pain and improvement in muscle strength.

The article provides research materials on the founding date of the Medical and Surgical Academy, the Decrees of the Emperor, the Reforms of Paul I, and the approval of the historical date “The Academy’s Birthday”. The Medical and Surgical Academy was founded by Decree of Paul I on 18.12.1798; It was first named the “Academy” on 12.02.1799. Some authors consider the earlier date of the Academy’s foundation.

The article examines the activities of the Japanese Red Cross Society (JRCS) in organizing and providing medical care to wounded sailors of the cruiser “Varyag”. The conducted archival search made it possible to see not only the general nature and the volume of medical work, nursing care, but also the sanitary conditions of stay, as well as measures for the rehabilitation of wounded Russian sailors. The authors claim that Japanese specialists provided the wounded ones with sufficiently qualified and compassionate care. The article provides examples of individual cases of treatment. The authors argue that the medical side of this issue directly intersected with the political goals of the Japanese side to become a “great” power, and the JRCS was an instrument for implementing the tasks set.