The technical aspects of conducting a high-resolution multispiral study are considered. The study was performed on adult  outbred ICR mice (CD-1) of the same age, sex, and body weight. A total of 10 males aged 7 months have been studied. For the first time in the domestic scientific literature, a descriptive analysis of the results of spiral computer tomography (SCT) examination of laboratory mice is given and the density characteristics of their tissues are described. The main features of X-ray anatomy of the chest and abdominal organs are indicated. The values of X-ray density of the brain, lungs, liver, bone tissue are shown. The possibility of using various post-processing programs for in-depth analysis is considered. The absence of a significant difference in the density of bone tissue and lungs of the left and right parts of the body has been noted, the density of various parts of the bones has been assessed, differences in density between different bones and different parts of the same bones of the limbs are shown. The results obtained can be used in further assessment of age-related changes.

In connection with the intensification of anthropogenic pollution of the environment, the problem of diseases of chemical etiology has acquired particular importance. In acute poisoning with different concentrations of toxic substances, it is liver damage (liver failure) in more than 50% of cases that is one of the frequent complications of many pathological conditions, which aggravates the severity of intoxication in general. Clinical manifestations of chronic toxic liver damage are found only in 30% of patients, which can cause acute lesions of the hepatobiliary system and contribute to the development of chronic diseases. Of particular importance is the problem of possible chronicity of the pathological process in individuals employed in chemical production (occupational diseases) and the appearance of combined liver lesions in them. Against the background of combined liver lesions (for example, ethyl alcohol and CCl₄, chloroform, ethylene glycol), a previously hidden, genetically determined defect in the biotransformation function of the liver may be revealed. The severity of toxic liver damage depends primarily on the type of toxic substance (its chemical structure), the dose and duration of its administration, as well as the method of introducing the toxin into the body. These facts determine the relevance and significance of the present study.

Currently, there is a gradual transition of a new coronavirus infection to the status of a seasonal infection, and therefore, studies aimed at distinguishing common for a group of acute respiratory viral infections and specific characteristics of COVID-19, including factors that aggravate the course of the disease, are becoming increasingly relevant. The present study aimed to determine the role of diabetes mellitus as an aggravating factor in the course of COVID-19, in comparison with other acute respiratory viral infections. According to the results obtained, a significant prevalence of diabetes mellitus was observed among hospitalized patients with moderate and severe forms of the new coronavirus infection. For influenza and other acute respiratory viral infections, diabetes mellitus is also a risk factor for worsening the course of the disease. However, it has turned out that the relationship between diabetes mellitus as a comorbid condition and the new coronavirus infection is stronger than in the case of influenza and is based on slightly different pathogenetic mechanisms. Thus, the results of the study suggest a special role of diabetes mellitus as a factor aggravating the course of the new coronavirus infection, which paves the way for new clinical and basic research in this direction.

The article presents the results of the study of the components of the metabolic syndrome in children and adolescents with constitutional-exogenous obesity. A comprehensive clinical and instrumental examination of 30 children and adolescents aged 10 to 17 years with constitutional-exogenous obesity of various degrees was initially carried out in a hospital. The data of anamnesis, clinical picture, indicators of fat and carbohydrate metabolism were analyzed. All children and adolescents had a hereditary burden of obesity and associated diseases including arterial hypertension, type II diabetes mellitus. The components of the metabolic syndrome (abdominal obesity, hypertension, insulin resistance, impaired carbohydrate tolerance, hyperuricemia) have been identified in the examined patients. Abdominal obesity has been observed in 36.6% of children; arterial hypertension occurred in 60.0%. Dyslipidemia in the form of hypertriglyceridemia, hypercholesterolemia, a decrease in high-density lipoprotein cholesterol has been observed in 6.6%, 13.3%, 10.0% of patients respectively. In 16.6% of the children, impaired tolerance to carbohydrates was noted, insulin resistance — in 56.6%. After 12 months, control was carried out according to the above parameters in the study group. The statistical calculations carried out did not show significant differences between the initial data and after 12 months. The results obtained indicate that cardiometabolic risks in these patients persist and may have unfavorable prognostic outcomes.

Dexamethasone is a medicinal product, a synthetic glucocorticosteroid, which has an anti-inflammatory and immunosuppressive effect. It is used in the treatment of many diseases and conditions. Genetically engineered biological drugs (GEBDs) are a group of medicinal products whose mechanism of action is aimed at cytokine receptors, blocking excessive inflammation. GEBDs are mainly human monoclonal antibodies. We studied 90 case histories of patients diagnosed with the new coronavirus infection caused by COVID-19; the inclusion criterion was the presence of cardiovascular comorbidity in anamnesis. We distinguished 2 groups: patients of group 1 had received only glucocorticosteroids as anti-inflammatory treatment (52 patients) and patients of group 2 had received GEBDs in addition to glucocorticosteroids (38 patients). The effectiveness of the treatment was evaluated according to computed tomography (CT) or radiography, the results of the general blood test (leukocytes, lymphocytes), coagulogram (INR, prothrombin time, fibrinogen), and biochemical blood test (CRP). Introduction of genetically engineered biological drugs together with glucocorticosteroids promotes treatment effectiveness, in contrast to the use of glucocorticosteroids alone since there is a more pronounced reduction of CRP as one of the most important indicators of systemic inflammation.

We aimed to study the frequency of chronic hepatitis C-associated mixed cryoglobulinemia after antiviral therapy (AVT) with directacting antivirals (DAA) in patients with sustained virologic response along 2 years. Clinical cohort included 43 patients with chronic hepatitis C and symptomatic mixed cryoglobulinemia who underwent virologically effective AVT with DAA in various regimens. Patients were examined for the presence of cryoglobulinemia by visual semi-quantitative method at the beginning of the AVT, at the end of the therapy, 12, 24, 48, 96 weeks after the end of the therapy. At the end of the AVT, cryoglobulins persisted in 56% of cases, 12 weeks after the end of the AVT — in 49%, after 24 weeks — in 44%, after 48 weeks — in 37%, after 96 weeks — in 23%. The frequency of detection of cryoglobulins at each point of the examination was the highest in patients with initially high cryocrit (≥10%). The initial levels of cryocrite (at the beginning of the AVT) had significant correlation with the subsequent presence of cryoglobulins at all points of the examination. In some patients with virologically effective AVT with DAA, cryoglobulinemia was detected up to 96 weeks of follow-up, which requires special approaches to the management of this category of patients.

Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections are currently a significant problem in practical medicine. The level of diagnosis of these pathologies by local practitioners (district physicians and pediatricians) has recently been extremely low. The low detection rate of these infections is explained, first of all, by the latent, erased course of the infectious process, as well as the unavailability of a number of screening tests at the outpatient stage. This entails a number of adverse long-term effects, including on the ENT organs. There is an increase in the prescription of irrational antibiotic therapy for this pathology and, as a result, the formation of antibiotic resistance. This study aimed to analyze the number of surgical interventions on the ENT organs for 2021 and the first half of 2022 in patients who had had EBV, CMV. In recent years, we have seen an increase in the number of adenotomies, adenotonsillotomies in children who have had EBV or CMV. When collecting an anamnesis from the parents of the patients, it turned out that there was no single scheme in the treatment of the acute phase of the infectious process. Thus, the results of this work serve as a reason to improve the quality of diagnosis and develop a unified treatment regimen in patients with EBV and CMV infections.

Since 2015, an intradermal test with recombinant tuberculosis allergen (RTA) has been used in the Russian Federation for the purpose of screening for tuberculosis infection in children from the age of 8 and examination for tuberculosis in children of all ages. In order to establish the clinical and epidemiological significance of the conversion of the RTA test from negative to positive, 80 children with the presence of conversion of this test within 1 year were studied. The data on tuberculosis contacts, the dynamics of the Mantoux test 2 TU, the results of the examination, including multispiral computed tomography, were studied. As a result of the study, the children have been divided into 3 groups: group 1 — 30 (37.5%) children with latent tuberculosis infection, group 2 — 25 (31.3%) children with newly diagnosed residual post-tuberculous changes, group 3 — 25 (31.3%) patients with active tuberculosis. Most children of the 3rd group had contact with a tuberculosis patient, that was 22 (88.0%) patients; among them, there were 18 (72.0%) patients from bacillary contacts, which is significantly more than in children of groups 1 and 2. The coincidence of the conversion of the RTA test with the conversion of the Mantoux test 2 TU was observed in 33.7% of cases. These children had the greatest risk of the disease, most of them, 23/27 (85.2%), had the conversion of both tests in the presence of bacillary tuberculosis contact. In the case of contact with a tuberculosis patient in 80.4% of children, the conversion of the RTA test occurred during the first year. It is concluded that the conversion of the RTA test is a significant indicator of the activation of tuberculosis infection in the body.

Currently, despite the gradual transition of a new coronavirus infection to a state of seasonal exacerbations, complications from COVID-19 still remain an urgent problem, especially those that affect the central nervous system. In this regard, studies aimed at distinguishing common for a group of acute respiratory viral infections and specific characteristics of COVID-19, including the development of post-COVID complications, namely mental and neurological disorders, are becoming increasingly relevant. The aim of this study was to determine the role of viruses (by the example of herpes viruses and the COVID-19 virus) as an etiological and pathogenetic factor in the development of mental and neurological disorders in different periods of the disease. Mental and neurological health disorders during the Covid period are characterized by clinically significant impairments in cognitive function, emotional regulation, or human behavior, accompanied by distress, as well as serious functional impairment.

The COVID-19 pandemic has become a major burden on the global health system and has had a significant impact on other global programs, including monitoring, screening, and elimination of hepatitis A. Considering several possible ways of transmission of SARS-CoVi-2 and due to its diverse effects on the body, it is important to study and differentiate the impact of COVID-19 on the epidemiology and course of other diseases, including hepatitis A. The aim of the work is to characterize the epidemic situation of hepatitis A in the North-West of Russia during the COVID-19 pandemic in 2021. The data of the state statistical reporting of Rospotrebnadzor obtained from the internal databank based on daily regional reports, as well as analytical tables developed by specialists of the Scientific and Methodological Center for Epidemiological Surveillance of Viral Hepatitis of the St. Petersburg Pasteur Institute and the Reference Center for Monitoring Viral Hepatitis of the Central Research Institute of Epidemiology of Rospotrebnadzor were analyzed. There was a clear decrease in the incidence of hepatitis A in the period from 2008 to 2021. In 2020 and 2021, in the context of the COVID-19 pandemic, the incidence of hepatitis A in the North-West of Russia reached the lowest values: 2.0 and 1.3 per 100,000 population. It is possible that the restrictive measures introduced to combat coronavirus infection led to the interruption of the common transmission routes of SARS-CoVi-2 and hepatitis A virus, helping to reduce the incidence.

Hepatitis B is an infection of viral etiology, which is spread all over the world and can be handled by vaccination. The epidemiological situation of this infection has improved tremendously for the last 25 years with the help of different vaccination plans. Extensive practical experience of vaccination proved that the duration and intensity of post-vaccination immunity analysis has to be considered as an essential step of the preventive and anti-epidemic actions to eliminate the hepatitis B. The article examines the evaluation of post-vaccination immunity against hepatitis B among young people living in St. Petersburg. The subjects were measured on the levels of specific antibodies to the hepatitis B virus surface antigen and the duration of post-vaccination immunity. As a result, it has been found that there is no correlation between anti-HBs levels and the duration of post-vaccination immunity.

Maladaptation circulatory disorders associated with intrauterine hypoxia are a predictor of the development of cardiovascular pathology (rhythm disturbances, vascular dystonia, etc.) in subsequent age periods, therefore, the search for safe and effective medicines that have an anti-ischemic, antioxidant, positive hemodynamic effect, reducing the electrical instability of the myocardium and stabilizing the autonomic system during the newborn period is relevant. The aim of the study was to evaluate the safety andeffectiveness of levocarnitine in the complex treatment of newborns with perinatal pathology of the nervous system and with posthypoxic cardiopathy. An open simple comparative controlled study of the effectiveness of the drug L-carnitine Elkar® (PIK-PHARMA LLC, Moscow) was conducted. The study included 128 newborns (52 boys and 76 girls) who were hospitalized in neonatal pathology departments. The examination included neurosonography, electrocardiography, echocardiography in dynamics. Therapeutic efficacy and tolerability of the drug L-carnitine Elkar® was assessed according to the dynamics of clinical signs, changes in the parameters of the functioning of the autonomic nervous and cardiovascular system, the results of neurosonography conducted before and after the end of the course of treatment, as well as in dynamics after 12 months. According to repeated neurosonographic studies, after a course of treatment with L-carnitine Elkar®, 65,7% of newborns showed a decrease in the severity of ischemia in the periventricular areas, the number of children with signs of periventricular leukomalacia decreased 2,3 times, intracranial hemorrhages were recorded 1,5 times less. A distinct positive effect was noted, confirmed by ECG studies (restoration of normal rhythm, metabolic processes, stabilization of myocardial repolarization processes), positive dynamics of linear indicators of chronotropic heart function, indicators of heart rate dispersion in 71.42% of newborns (p ˂ 0.05) receiving levocarnitine. The drug L-carnitine Elkar® (PIK-PHARMA LLC, Moscow) meets all the requirements of pharmacology, is convenient to use, is an effective, safe, and universal remedy for the treatment of perinatal central nervous system damage, as well as diseases of the cardiovascular system, which are based on hypoxic disorders and vegetative dysfunction.

More than 200 amino acids are known to be of natural origin, and only 20 of them are proteinogenic. Proteinogenic amino acids and their metabolites perform important physiological functions in the processes of neurotransmission, neurotrophy, and neuroprotection. Neurotransmission refers to the propagation of nerve impulses through neurotransmitters, and neurotrophic effect refers to the growth and renewal of nervous tissue. The neuroprotective effect is characterized by the prevention of apoptosis of neurons and glia, inhibition of neurodegenerative processes. Many amino acids exert neurological effects through N-methyl-D-aspartate (NMDA) receptors, some directly — glutamine, aspartate, glycine; others indirectly — alanine. Ionotropic NMDA receptors play a significant role in the correct transmission of nerve signals by regulating the duration of the excitatory potential. Based on this, proteinogenic amino acids and their metabolites play an important role in the functioning of the nervous system. The work carried out a comprehensive analysis of the molecular mechanisms of action of proteinogenic non-essential amino acids and their derivatives based on molecular, biological, and physiological data from scientific literature.

The article contains materials of the study of the effect of combined (osteopathic and standard) treatment of patients with poststroke arthropathy of the shoulder joint in the late recovery period of a stroke. The study involved 40 patients of both sexes aged from 40 to 65 years (mean age 52,5±12,5 years) with the diagnosis of acute cerebrovascular disorder of ischemic type in the middle cerebral artery, the type of lacunar stroke, with hemiparesis development and shoulder arthropathy formation. Patients in the early recovery period, after hemorrhagic stroke, with low rehabilitation potential were excluded. The study evaluated the level of quality of life of the patients, the level of pain according to visual analogue scale, the volume of passive and active movements, and osteopathic status. The main group received combined treatment, and the control group received treatment according to conventional methods. The results of the study have showed that the combined approach to rehabilitation significantly improves patients' quality of life, reduces pain, and increases the range of motion in the affected joint.

The aim of the study was to evaluate the long-term result of treatment of a patient with caries of the dentin of the tooth after filling with a chemically curing polymer composite material. The following methods were used: analysis of a clinical example of treatment, radiation imaging, three-dimensional (3D) computed tomography. After 6 years, a periapical abscess without a sinus was revealed due to painless necrosis of the dental pulp. Thus, it has been found that it is necessary to limit the filling of a tooth with dentin caries with a chemically curing polymer composite for teeth with live pulp, to use the “sandwich” technology.

A clinical case of facial nerve neuropathy in a young female patient with a confirmed case of COVID-19 was analyzed in terms of pathogenetic mechanisms of neuropathy development. The data of the study of neurological status were compared with the indicators of instrumental methods of research; the fact of the absence of vegetative symptoms in terms of differential diagnosis of the genesis of neuropathy was considered. Among the discussed aspects of the formation of pathological clinical symptoms, pathophysiological mechanisms of infectious-allergic edema of the myelin sheaths of the affected nerve according to the peripheral type are identified as significant.

Today, the main method to solve practical issues for the diagnosis and treatment of diseases is enzyme immunoassay. Molecular methods, primarily polymerase chain reaction combined with reverse transcription, make it possible to detect hepatitis A viral RNA (HAV RNA) in clinical samples (blood serum, saliva), determine the duration of virus replication, and confirm the diagnosis in complex diagnostic cases. The study found that in severe hepatitis A (GA), the RNA of the virus was determined in 100% of cases. Correlation analysis showed medium positive relationships between viral load and alanine aminotransferase activity (ALT), which were significant. In patients of the first group with severe GA, there was a statistically significant increase in ALT compared with the mild course. Thus, the determination of HAV RNA in the blood serum of patients with GA may have a diagnostic significance for the clinical course of the disease.

The analysis of clinical data of 154 patients were treated for obstructive jaundice of non-tumor etiology has been carried out. Depending on the amount of pre-operative care, the patients were divided into two groups. Patients of the first group in the amount of 82 were operated on urgently after a short-term traditional care. Patients of the second group in the amount of 72 were operated on after a complex multicomponent pre-operative care proposed by the authors and lasted 3–7 days. The volume of surgical interventions in both groups was comparable, cholecystectomy was performed, as well as, according to indications, removal of stones from the ducts and drainage of the biliary tract. In patients with obstructive jaundice without pre-operative care, there was no complete normalization of homeostatic parameters. In the group of patients with complex pre-operative care, the post-operative period was more favorable and homeostasis indicators returned to normal. A comparative analysis of the state of liver and kidney functions in a patient after emergency biliodecompressive surgical interventions and the same volume of operations after multicomponent pre-operative care indicates a fourfold decrease in mortality in the second group of patients, an improvement in liver function and, thereby, contributing to the normalization or improvement of electrolyte balance and functional capacity of the kidneys.

Multiple myeloma (MM) accounts for about 1% of oncological diseases and more than 10% of the total number of hemoblastoses. High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (autoHSCT) is the standard treatment. An essential role in the development of bloodstream infections in hematological malignancies and, particularly, in MM is played by endogenous infection of the blood through the intestines. The leading factor contributing to the occurrence of microbiome disorders is antibacterial therapy. The emergence of new drugs such as proteasome inhibitors and monoclonal antibodies did not rule out autoHSCT and retained its importance in the treatment of patients. The aim of our study was to investigate changes in the gut microbiome before and after autoHSCT in patients with MM.

This study investigated the prevalence of structural abnormalities of left ventricular (LV) and carotid arteries in untreated patients with grade 2 essential hypertension older than 40 years without clinical manifestations of target organ damage. Subgroups were formed depending on age: group 1 (n = 23; average age 45.13±0.95 years) and group 2 (n = 23; average age 54.93±0.46 years). The average duration of hypertension was 4.5 years. Ultrasound examined interventricular septum and posterior wall thickness, variants of myocardial geometry, common carotid intima–media thickness (IMT). As a result of the study, there were no significant differences in the prevalence of LV hypertrophy in the groups depending on age (34.8% and 39.1%). Concentric variants of myocardial remodeling were more prevalent than eccentric hypertrophy (p<0.05), which occurred mainly in group 1. In patients in group 2, the increased IMT of the common carotid artery was greater than in group 1 (82.6% and 34.8%, p<0.05) and most often associated with LV hypertrophy. Isolated LV hypertrophy, isolated LV concentric remodeling and isolated increased IMT were diagnosed more often among patients with AH younger than 50 years of age. Thus, a significant proportion of untreated patients with grade 2 essential hypertension have signs of hypertensive remodeling of the left ventricle and carotid artery wall, which are interrelated with age. More pronounced changes in the heart and blood vessels are observed in people over 50 years of age, in whom remodeling processes run in parallel. At the same time, concentric types of LV remodeling correlate with vascular remodeling.

The impact of social well-being on the level of blood pressure in adolescents aged 12–13 is a topical issue today. The significance of comfort is an important component of life of any person, especially a teenager. During the study, the influence of various social aspects and lifestyle of adolescents aged 12–13 on the increase in blood pressure levels was studied. The study included data from a survey of 1519 adolescents aged 12–13: boys — 49.1% (n = 745), girls — 50.9% (n = 774). A connection between the well-being of housing and high blood pressure, significant among girls, and ethnic differences among Kazakh adolescents were revealed. Own wellbeing in the eyes of a teenager in more than 76% of cases appears to be the best.

Nodular melanomas of the skin occur in 47% of cases of melanoma diagnosis and require more complex and expensive treatment. The analysis of the level of diagnosis of skin melanomas in the Novgorod region shows an increase in the incidence of this pathology by more than 1.5 times over the past ten years. For the first time, a non-invasive ZOOM diagnostic method using a portable USB microscope was used for the early diagnosis of superficial spreading melanomas. Neoplasms were preliminarily stained using the Van Gieson procedure for the purpose of early diagnosis of skin melanomas and activation of pigmented nevi. In the case of activation with a possible transformation of pigmented nevi, changes in the structure are observed, which are displayed on the screen. Based on the data obtained, an electronic library can be formed. This method has been tested on 43 patients, it does not require invasive interventions, and can be used at the pre-hospital stage of medical care, as well as in remote counseling, which is especially important during a pandemic. Based on the results of the study, an application for an invention was submitted and approved.

The incretory function of the gonads was studied in 18 healthy men and in 47 men aged 18–28 years, who were treated for cryptorchidism 10–15 years ago. The incretory function of testicles in healthy men and in those who had cryptorchidism was judged by the concentration of fructose in semen, which was determined by the Roe method modified by V.I. Chemodanov. In 68 men aged 18 to 28 years who had cryptorchidism 10–15 years ago and in 18 healthy men of the same age, the concentration of testosterone in the blood serum was studied by radioimmunological method using standard test kits from Cea-Jre-Sorin (France). It has been found that the determination of testosterone in the blood serum by radioimmunological method is 2.5 times more likely to reveal endocrine insufficiency of the testicles in men who suffered cryptorchidism in childhood.