Liposuction as a radical technique to combat localized fat deposits is becoming more and more widely used in clinical medicine. The present review study is devoted to the analysis of published data concerning the development of possible complications during abdominoplasty and liposuction surgeries. Particular attention is paid to the study of cardiovascular and cerebral complications, their frequency, clinical spectrum, as well as the peculiarities of management of such cases by representatives of different levels of medical care. Complications during the performance of these procedures are characterized by a wide spectrum, develop in different periods of time and in the majority of cases are resolved safely. However, in some cases they occur in the first day after the operation and can be dangerous for human health. Risk factors for complications of abdominoplasty and/or liposuction are reviewed, including such as the use of general anesthesia, duration of surgical intervention, use of highdose lidocaine, large liposuction volume, inter- and postoperative volume overload or hypohydration, difficult-to-control pain syndrome, multimodal anesthesia, frequent vomiting, and late patient activation, prior use of nonsteroidal anti-inflammatory drugs, smoking, long-term contraception, pelvic inflammatory disease, body mass index ≥ 40 kg/m2, benign prostatic hyperplasia in men, elevated levels of C-reactive protein, fibrinogen, total cholesterol, triglycerides, creatinine, eosinophils, and low blood albumin and lymphocyte counts. Our findings may serve as a basis for the development of effective prevention and risk management strategies in this field of plastic surgery.

The literature review highlights the relationship between novel coronavirus infection (COVID-19) and Brugada syndrome (SB). The clinical course and treatment tactics of patients with novel coronavirus infection and SB are reviewed and analyzed. When writing the article, we used sources obtained from PubMed and eLibrary.RU - the main sources of biomedical information - to support our research. Discussion. SB is a type of arrhythmia that may not show any clinical symptoms for a long time. It is characterized by specific changes in the electrocardiogram (ECG) and can lead to serious complications such as ventricular fibrillation and sudden cardiac death. The prevalence of this condition is difficult to determine, as it can remain asymptomatic and only be detected through routine ECG testing. The occurrence of SB is associated with a malfunction of the sodium channel, which subsequently leads to dangerous rhythm disturbances. Given the well-known association of COVID–19 with various cardiovascular diseases, including myocarditis and thrombosis, it is important to investigate what effect the new coronavirus infection may have on patients with SB. The growing body of evidence suggests that COVID-19 can trigger or exacerbate the symptoms of SB, making it important to study their interaction. 

Currently, the world is seeing an increase in life expectancy. As we age, the human body undergoes various functional and structural changes, and the kidney is no exception. We also know that the prevalence of chronic kidney disease increases with age. The changes that accompany natural aging and chronic kidney disease are similar. However, it is necessary to understand which elderly person is healthy and which has a disease and requires help. Today, thanks to kidney transplantation, when a “zero” biopsy is taken, we have a large database of kidney tissue, as well as instrumental and laboratory examination data. The advantage is that donors are extremely healthy people. As a result, we have the opportunity to study the physiology of natural kidney aging. The review article includes articles published only in peer-reviewed scientific journals, posted in the bibliographic databases MEDLINE, PubMed, Google Scholar, Scopus, eLIBRARY. The search strategy was a search query for the key terms “renal aging”, “glomerular filtration rate”, “number of nephrons”, “nephrosclerosis”. As a result, the review presents data on the main functional (changes in the total glomerular filtration rate and the glomerular filtration rate of one glomerulus) and structural (changes in the volume of renal tissue, the number of nephrons) changes that accompany kidney aging. The question of diagnosing chronic kidney disease in the elderly is also considered. 

Relevance. Infection with Helicobacter pylori (НР), a class 1 carcinogen for gastric cancer development, is steadily increasing in the world population and reaches 50%. Currently, eradication therapy (ET) is considered the most relevant strategy for the prevention of gastric cancer. Due to the low eradication rates when using a triple regimen based on clarithromycin, the addition of bismuth salts and the use of double doses of proton pump inhibitors are recommended. Objective. To evaluate the effectiveness of double doses of esomeprazole and rabeprazole in ET in patients with different genotypes of cytochrome P450 2C19, infected with НР. Material and methods. 50 patients infected with Helicobacter pylori were recruited. All patients were prescribed triple therapy with a double dose of proton pump inhibitor (PPI) enhanced with bismuth preparations (clarithromycin 500 mg, amoxicillin 1000 mg, bismuth tripotassium dicitrate 240 mg, esomeprazole 40 mg/rabeprazole 40 mg.) All drugs were taken 2 times a day for 14 days. Depending on the PPI used, patients were randomized into two groups: esomeprazole 40 mg (group 1) and rabeprazole 40 mg (group 2).The genotype of cytochrome P450 2C19 was determined by PCR (test system Seeplex® CYP2C19 Genotyping Set.) Results. Genetic polymorphism of cytochrome P450 2C19 in patients infected with H. pylori in Crimea is represented by genotypes *1/*1 — 69.9% and *1/*2 — 30.1%. The eradication rate using regimens with esomeprazole and rabeprazole was 87,8% (95% confidence interval: 81.2–89.0%) and 85,7% (79.5–88.4%), respectively. The eradication rate using regimens with esomeprazole and rabeprazole did not differ significantly in patients with genotypes *1/*1 (p = 0.999) and *1/*2 (p = 0.286). On day 5, the mean intragastric pH was higher in the rabeprazole group compared with the esomeprazole group (5,7 vs. 5,4), but did not achieve a statistical difference (p = 0.308). Conclusion: The ET regimens used were equally effective in each group, regardless of the CYP2C19 genotype, and the intragastric pH profiles were comparable. 

The purpose is to study the prevalence of coronary heart disease and the structure of rhythm disturbances in overweight and obese men of working age, as well as to establish the relationship between the presence of arrhythmias and coronary heart disease, depending on various clinical, laboratory and instrumental risk factors. Material and methods. The study included 184 male patients aged 25 to 64 years [44.4 ± 8.0] who applied for routine medical examination and treatment. The patients were divided into 3 groups depending on body mass index (BMI), followed by a comprehensive clinical, laboratory and instrumental examination and analysis of the results in groups. Statistical processing was performed using parametric and nonparametric analysis methods on a personal computer using statistical programs in the environment Exel 97.0 and Statistica for Windows 6.0. The differences were considered statistically significant at p < 0.05. Results. Three groups of patients were examined depending on the BMI value: group I — 40 people with normal body weight (BW), average BMI of 23.3 ± 1.3 kg/m²; group II — 46 people with excess BW, average BMI of 27.3 ± 1.5 kg/m²; group III — 98 people with obesity 1–3 degrees, average BMI 34.9 ± 5.0 kg/m². It was found that an increase in BW is associated with an increase in the frequency of coronary artery disease (CAD): with normal BW — 10% of patients had CAD, with excessive BW — 50.0%, with obesity — 58.2% (I–II p < 0.001; I–III p < 0.001; II–III p < 0.604), and in the group of patients with CAD was not observed before the age of 35, among patients aged 35-50 years, its frequency was 23.9%, over 50 years-52.9% (pχ² < 0.001). It has been shown that the increase in BW is accompanied by a statistically significant increase in the frequency of paired supraventricular extrasystoles  ( SVES), ventricular extrasystoles ( VES) > 200 per day, allorhythmic VES and atrial fibrillation (AF). Moreover, the risk of arrhythmias, depending on BMI, increases only with associated CAD, the presence of which significantly increases the relative risk (RR) of VES in general by 3.78 times (p < 0.001), high-grade VES by 2.18 times (p < 0.002), frequent VES by 3.3 times (p = 0.017), allorhythmic VES by 4.13 times (p = 0.007). In the development of VES, such potentiating factors in the study group may play a role as: left ventricular hypertrophy (LVH) (p = 0.038), LV diastolic dysfunction (p = 0.032), low serum high density lipoprotein cholesterol (HDL) (p = 0.029), as well as an exceeding the reference values content of adiponectin (А), which directly correlated with the daily number of VES (r = +0.34, p = 0.043). Conclusion. There is a relationship between increased BW and the frequency of arrhythmias such as SVES, VES, allorhythmic VES and AF as the age of patients increases. However, this pattern is peculiar only to persons with CAD, the presence of which in case of obesity and excessive BW plays the role of a significant risk factor for the development of ventricular arrhythmias, which has not been revealed with respect to supraventricular (AF, SVES) rhythm disturbances. Among the risk factors associated with the development of ventricular arrhythmias in CAD and obesity, left ventricular diastolic dysfunction (LVDD), left ventricular hypertrophy (LVH), low serum high density lipoprotein cholesterol (HDL) and hyper adiponectinemia should be noted. 

Objective: to evaluate the efficacy and safety of cell therapy in hepatocellular insufficiency due to liver cirrhosis. Material and methods. The study (conducted at the S.P. Botkin Moscow Clinical and Research Center) included 58 patients: 19 received intraportal infusion of autologous bone marrow mononuclear cells (BM-MNCs), 19 underwent G-CSF therapy, and 20 received conservative treatment (control group). The groups were comparable in terms of sex, age, and severity of liver failure. CD34+ cell mobilization was performed using a gravitational separator. Follow-up was conducted at 14, 30, 90 days, and 1 year; histological analysis was performed before and 2 months after treatment. Results. The BM-MNC group showed the greatest reduction in MELD-Na scores (by 5.22 ± 2.79 at 3 months), a rapid decline in bilirubin levels (by 30.6 μmol/L by day 14), and a steady increase in albumin. The period of clinical compensation was 180 ± 12.6 days. Histological examination after BM-MNC infusion revealed positive changes: reduced lymphoid infiltration in portal tracts in 17 patients (89.5%). In two cases, liver architecture was restored, and in one case, fibrosis regression (F3) was observed. Evaluation of CD68+ macrophages at 2 months showed a decrease in levels 15% and more in 13 cases (68.4%). Conclusion. Intraportal BM-MNC infusion is an effective and safe method for correcting hepatocellular insufficiency, as confirmed by clinical, laboratory, and histological data. 

The aim of the study was to develop a non-invasive technique for the prevention of intra-abdominal hypertension in patients undergoing surgery for large postoperative hernias. Materials and methods. The prospective, direct, non-randomized study involved 50 patients who underwent surgery to repair ventral hernias of various localization and sizes and were hospitalized from 2020 to 2025 at Surgical Department No. 2 of the Republican Clinical Hospital in Nalchik. The main group (n = 21) underwent gradual tightening of the abdominal brace with a decrease in the functional vital capacity of the muscles by 10% and 20% under the control of spirometry parameters. The control group (n = 29) wore a bandage in a free mode. The average age of the patients was 51.9 ± 4.6 years. The follow-up period was 3 months. In the postoperative period, intra-abdominal pressure was measured daily using an Abdo–Preshe unometer, and spirometry was performed. The QoR-15 questionnaire was used to assess the quality of life of patients. The SPSS Statistics 17.0 software was used for statistical data processing when comparing study groups. The results of the study. As a result of preoperative preparation according to the developed methodology, spirometry indicators in the main group recovered by day 16. On day 1 of the postoperative period, the main and control groups showed an increase in intra–abdominal pressure by comparable amounts (the experimental group — 18.5 ± 6.5 mm of water, the control group — 16.1 ± 7.1 mm of water; at p = 0.112). However, the degree of respiratory disorders in the control group was signifi cantly higher. When assessing the quality of life, statistically signifi cant diff erences were noted between the groups in terms of categories of issues characterizing physical comfort, the need for psychological support and emotional state. The number of points scored by the participants of the main group was statistically signifi cantly higher than in the control group. At the same time, the number of points was comparable in the groups of questions characterizing pain and physical independence. Conclusion. The technique of preoperative preparation of the patient for the occurrence of intraabdominal hypertension using an abdominal bandage under the control of spirometry accelerates the postoperative recovery of patients, reducing the degree of respiratory disorders against the background of increased intra-abdominal pressure. In addition, this technique increases the patient's stress tolerance and reduces physical discomfort after surgery.

Effects of a stroke are very diverse. Depending on the nature and localization of brain damage a wide range of neurological disorders may be observed, including motor, speech, cognitive and psychoemotional disorders. Stroke rehabilitation requires the participation of a team of specialists, including doctors, paramedical personnel, speech therapists, psychologists and specialists in therapeutic gymnastics and physiotherapy. The main principles of rehabilitation are early onset, comprehensiveness and adequacy of rehabilitation measures, active participation in the rehabilitation process of the patient and his relatives. Medical rehabilitation of patients with a history of stroke should be carried out with an intensity commensurate with the expected benefit and tolerability of the rehabilitation measures.

Objective: to demonstrate a previously unreported variant of gallbladder malformation as an incidental finding. Material and methods. A clinical observation of an elderly patient with no pathological process and a gallbladder malformation is presented. Results. Based on a preliminary examination in a neurological department of a hospital, the patient was suspected of having a peri-vesical abscess or an abscess in the right lobe of the liver. This was evidenced by persistent low-grade fever and the results of instrumental examinations (ultrasound and CT scans of the abdominal cavity). After the treatment of acute cerebrovascular accident, the patient was transferred to the surgical department. An MRI scan of the abdominal cavity suggested a double gallbladder, and a subsequent MRCPG scan confi rmed this diagnosis. Thus, based on the results of the examination, the patient’s development of a perivesical abscess as a source of fever of unknown origin was excluded. The absence of a clinical picture of acute and chronic (calculous) cholecystitis at the time of the additional examination allowed the patient to be discharged without undergoing surgical treatment. Conclusion. The presented case remained diagnostically unclear for a week. The clinical picture was complicated by an acute period of cerebrovascular disorder and the development of idiopathic subfebrile fever, which was compounded by the lack of information from the main diagnostic methods. The final clinical diagnosis allowed us to determine the further tactics and describe a previously unreported variant of gallbladder malformation.

Myocarditis is an infl ammatory disease, one of the most common non-coronary myocardial diseases. During the COVID-19 pandemic, SARS-CoV-2-associated myocarditis has attracted particular interest from the cardiology community. Acute myocardial damage caused by SARS-CoV-2 is based on diff erent mechanisms. At the same time, the nature of the body’s response to various infections, including viral and, in particular, coronavirus, is individual and is largely determined genetically. We present a description of a clinical observation that shows the signifi cance of myocarditis joining a previously asymptomatic genetically determined myocardial damage. A 62-year-old female patient was admitted to the clinic due to shortness of breath with minimal physical exertion and at rest, dilation of the heart chambers, a drop in the ejection fraction (EF) of the left ventricular (LV) myocardium to 25%, and bilateral hydrothorax. Throughout her life, she tolerated stress well and maintained good physical fi tness until the sudden development of biventricular heart failure. The sudden death of her father at the age of 62 and the diagnosis of dilated cardiomyopathy (DCM) in her twin brother could indicate the presence of a genetically determined form of DCM. Myocardial infarction was excluded as a cause of acute decompensation; the later diagnosed thromboembolism of small branches of the pulmonary artery (PE) did not explain the full severity of the myocardial damage. The acute development of myocardial dysfunction in the absence of atrial fi brillation made the diagnosis of myocarditis no less likely, which was subsequently confi rmed morphologically, as well as its coronavirus nature. A month after the start of complex cardiotropic therapy, its ineff ectiveness was established (refractory critical heart failure), which required immediate heart transplantation, for which the patient was transferred to the Federal Scientifi c Center of Therapy and Orthopedics named after N.N. Acad. V. I. Shumakova. A week later, while waiting for a transplant, ventricular fi brillation and circulatory arrest developed. Resuscitation measures were ineff ective, the patient was declared dead. DNA diagnostics, completed after death, revealed a likely pathogenic variant in the titin gene and a variant with unknown clinical signifi cance in the myopalladin gene. Cases of morphologically verifi ed post-COVID myocarditis in patients with titinopathy have not been previously described in the literature. This observation clearly illustrates the insuffi cient information content of all noninvasive methods for diagnosing myocarditis, including magnetic resonance imaging (MRI) of the heart with contrast. In a situation where the patient initially had indications for a heart transplant, an attempt at active immunosuppressive therapy for the identifi ed myocarditis was justifi ed, but it had no eff ect, as did the maximum tolerated cardiotropic therapy. It is highly probable that it was the initial genetic inferiority of the myocardium that predetermined the severe course of myocarditis and the unfavorable outcome of the disease as a whole. In this clinical case, the combination of primary (familial) DCM and morphologically confi rmed SARS-CoV-2-induced lymphocytic myocarditis is of particular interest. Diagnosis and treatment of non-coronary myocardial diseases still pose signifi cant diffi  culties. The insuffi  ciently studied combination of myocarditis and primary cardiomyopathies may be the reason for the ineff ectiveness of conservative therapy, and heart transplantation remains the only way to save patients. Despite the unfavorable outcome of the disease, this observation demonstrates the need to use all available methods to identify the causes of DCM syndrome (not only MRI, but also myocardial biopsy and whole exome sequencing).

The article presents historical information and biographical data of military doctors and nurses during the First Wave of emigration and their lives and activities in the United States of America (on the Atlantic and Pacifi c coasts). Information is provided on the ROKK institutions for providing assistance to Russian emigrants, the work of shelters and sanatoriums in this region, and the work of the Tolstoy Foundation in the United States. The biographical information of some doctors and nurses, their places of life, work and burials are indicated.