The aging process is one of the most complex problems in biology. Hundreds of research institutes around the world are studying aging at various levels of the structural organization of living matter. The results of many thousands of studies on this phenomenon have been published. More than 300 theories have been proposed that attempt to explain the causes of aging. It is important to note that almost all theories associate aging with the accumulation of negative changes in molecules and cells in the body. It seems that a person (or an individual of another biological species) lives in order to make negative changes in the structure of living matter. However, this contradicts the fact that damage and destructive changes cannot ensure progress in the evolutionary development of life. The article attempts to find the cause of this contradiction. The author puts forward a position on the dual function of the aging process in the development of living matter: on the one hand, aging causes degradation of the organism as a system, on the other, it ensures the structural improvement of its tissues at the molecular level. That is, aging, as the main mechanism of evolution, is aimed not at preserving the organism as a system, but at preserving its individual elements (information blocks) that are of interest for building new structures of living matter as a whole. An evolutionary ladder is formed from these information blocks, along which living matter rises to a higher level of its development. Aging is not decay or damage, but a mechanism for transferring one structure of living tissue to another - more perfect, with its preservation in the form of a potential phase for use by new cellular generations of the same organism or other organisms.

Atrial fibrillation is the most common cardiac arrhythmia with frequent complications. Despite a century of research and speculation, the mechanisms underlying AF have not been fully elucidated, and therapy, especially for the permanent form, remains suboptimal. The use of modern antiarrhythmic drugs is associated with a significant level of side effects, especially proarrhythmic ones. Many patients with severe atrial fibrillation symptoms do not receive any therapy for rhythm control. In this review, the main focus will be on pharmacological developments in the treatment of atrial fibrillation. We will discuss the current status of some antiarrhythmic drugs and their future potential in the treatment of atrial fibrillation, reviewing the molecular mechanisms and clinical use of some atrial-selective antifibrillatory drugs. We will review in detail the key pharmacodynamic and pharmacokinetic properties of these drugs in order to prevent proarrhythmic effects. As well as drugs that affect atrial remodeling, inflammation and fibrosis, which are being tested as potential treatments for atrial fibrillation.

Background. Human chronotype significantly influences the functioning of various body systems. Several genes determine chronotype. However, external factors, including social ones, also have a major influence on individual rhythm, among which work activity plays an important role.
Objective of this study: to identify the characteristics of cardiovascular system parameters throughout the day in students with different chronotypes.
Subject and methods. The study involved 43 students of both sexes aged 18 to 22 years. Individual circadian rhythm assessment was performed using the D. Horne – O. Östberg test modified by A.A. Putilov. Using the Korotkoff method in sitting position, systolic and diastolic blood pressure levels were recorded. Heart rate was measured at rest using a fingertip pulse oximeter "Little Doctor, MD300". Based on the recorded data, the Kerdo vegetative index was calculated to assess the leading division of the nervous system. For statistical analysis, the Shapiro-Wilk test and Wilcoxon test were used.
Results. The study found that in all groups, regardless of chronotype, an increase in certain hemodynamic parameters was observed by evening. In people with morning activity type, the greatest changes throughout the day were observed in diastolic blood pressure and heart rate. In individuals with "moderate" chronotype, the most significant changes concerned systolic blood pressure parameters. In representatives of evening type ("owls"), cardiovascular system functioning parameters were most stable throughout the day.
Conclusion. Despite the close relationship between chronotype and the dynamics of physiological processes, including the cardiovascular system, there are factors that can significantly influence hemodynamic parameters and nervous system tone throughout the day, one of which is work regime, its intensity and emotional component.

In order to indirectly prove the nature of sports vagotonia, an analysis of 15 indicators of heart rate variability (HRV) was performed, recorded using the VNS-Micro system (Neurosoft, Ivanovo) by 5-minute cardiointervalography (CIG) under conditions of active orthostasis (ortho-CIG, ortho-HRV) at the 8 elite cross-country skiers (MS, MSMC) of the team of the Republic of Tatarstan during the preparatory and competitive periods, as well as a member of this team, athlete K.D. (MS, the first author of the article), whose ortho-CIG registration was carried out during the transition period. It was found that elite skiers in all three periods (especially in the preparatory and competitive periods) are characterized by high median values of such ortho-HRV indices as TP, AMVLF, pNN50%, RRNN, RMSSD, SDNN, MxDn, and low median values of HR and SI., which, judging by the literature data, are significantly they differ from the ortho-KIG of nonathletes, novice skiers, and representatives of other sports not related to endurance development. It is concluded that sports vagotonia is detected not only during the registration of clino-HRV, but also during the registration of ortho-HRV; it is due to the high level of activity of the parasympathetic division of the autonomic nervous system and, probably, the presence of synthesis of non-neuronal acetylcholine by cardiomyocytes.

Physiotherapy for pregnant women is a significant area of modern medicine aimed at maintaining the health of both the mother and the fetus. It is relevant due to its safety and the ability to address a wide range of obstetric and gynecological issues. One of its key advantages is its non-invasive nature, making it an optimal choice for use in pregnant women when pharmacological treatment options are limited. The purpose of this work is to study the features of applying physiotherapeutic procedures during pregnancy, their effectiveness, and their role in improving the health of the mother and fetus. Materials and methods: The authors conducted an analysis of scientific works related to the peculiarities of using physiotherapy during pregnancy, employing sociological methods and content analysis. The results confirmed the effectiveness of physiotherapeutic methods in improving the health of pregnant women, reducing the risk of complications, and enhancing their quality of life. Conclusions: Thus, physiotherapy is an important component of comprehensive medical care during pregnancy, providing pain relief, improving the overall condition of women, and preventing complications.

To assess cardiovascular risk, old methods are being reviewed and new, more objective and easy-to-use methods are being proposed, taking into account new epidemiological, economic and nutritional transformations. This approach allows you to expand the circle of people who need to be monitored.
Objective. To compare the level of cardiovascular risk on the SCORE and SCORE2 scales among an almost healthy male population.
Object and methods. The study was conducted among the male population aged 40-59 years. 419 people were included. The risk of cardiovascular complications was calculated for each respondent using SCORE and SCORE2. The statistical analysis was carried out in the StatTech v. program. 4.7.1.
Results. According to the SCORE scale, the respondents were distributed as follows: in the 40–44–year–old group, 10 subjects were in the low-risk group, 38 were in the moderate group; in the 45–49-year-old group, 59 were in moderate risk, 22 were in high risk, and 1 was in very high risk. In the 50–54-year-old group, 56 were at moderate risk, 40 were at high risk, and 7 were at very high risk. In the 54–59- year-old group, 36 people were in the moderate-risk group, 48 were in the high-risk group, and 34 were in the very high-risk group. On the SCORE2 scale, the same respondents were included in the high- and very high-risk groups. At the same time, the risk of complications increased by 9% (p < 0.001). The respondents with HDL-C levels of less than 3.99 mmol/L on the SCORE scale were distributed as follows: in the 40–44 year group, 3 were in the low–risk group, 6 were in the moderate risk group; in the 45–49 year group, 16 were in the moderate risk group. In the 50–54 year old group, 19 were at moderate risk. In the 54–59-year-old group, 20 people were in the moderate risk group, 4 were at high risk, and 34 were very high. According to the SCORE2 scale, the same respondents were included in the high and very high risk groups. The risk of complications increased by 10% (p < 0.001).
Conclusion. The SCORE2 scale makes it possible to assess the risk of cardiac events in a wider range of people, to monitor them more actively in the future, and to expand indications for therapy.

Background. Diaphragmatic injuries caused by ribs or direct blunt diaphragmatic injuries at various periods after trauma are associated with the development of hemothorax, pneumohemothorax, and pulmonary contusion, which lead to secondary pulmonary complications. Issues of diagnosis and management of direct diaphragmatic injuries remain largely unresolved.
Objective: to evaluate the capabilities of radiological diagnostic methods and determine treatment approaches for direct blunt diaphragmatic injuries.
Object and methods. The study included 66 patients with combined and isolated chest trauma, rib fractures, and direct blunt diaphragmatic injuries requiring pleural drainage and other surgical treatment methods (video-assisted thoracoscopy, video laparoscopy, laparotomy, thoracotomy). Patient age ranged from 16 to 84 years, with 54 men and 12 women. The sample was formed over the period from January 1983 to December 2024 from patients treated at the N.V. Sklifosovsky Research Institute of Emergency Medicine.
Results. Diagnosing direct blunt diaphragmatic injuries using radiological diagnostic methods is quite challenging, as direct signs require proof of abdominal organ displacement through the diaphragmatic defect. Diagnostic difficulties of direct blunt diaphragmatic injuries are due to small penetrating diaphragmatic defects or absence of penetrating defects in incomplete injuries. The leading role in detecting direct blunt diaphragmatic injuries belongs to methods that allow visual assessment of diaphragmatic condition (video-assisted thoracoscopy, video laparoscopy, laparotomy, thoracotomy, autopsy).
Conclusions. Extended use of video-assisted thoracoscopy in blunt chest trauma reveals direct blunt diaphragmatic injuries in early stages and allows avoidance of late complications.

Background. Infective endocarditis caused by gram-negative microorganisms of the HACEK group represents a rare and poorly studied form of the disease. HACEK group bacteria are part of the normal flora of the oral cavity and upper respiratory tract, but under certain conditions can cause severe infectious complications. Understanding the pathogenicity mechanisms of these microorganisms is key to improving the diagnosis and treatment of infective endocarditis.
Objective: to describe the virulence factors of HACEK group bacteria and elucidate their role in the onset and development of infective endocarditis through analysis of current literature.
Materials and methods. A systematic analysis of scientific literature devoted to studying the virulence factors of HACEK group microorganisms (Haemophilus spp., Aggregatibacter spp., Cardiobacterium spp., Eikenella corrodens, Kingella spp.) and their role in the development of infective endocarditis was conducted. Mechanisms of adhesion, invasion, biofilm formation, and toxin production were reviewed.
Results. It was established that the main virulence factors of HACEK group bacteria include: capsule that protects against phagocytosis; type IV pili that ensure adhesion to endocardial cells; ability to form biofilms; production of exotoxins (leukotoxin, cytolethal distending toxin, RtxA); presence of proteases and endotoxins. It was shown that different representatives of the HACEK group have varying abilities to cause infective endocarditis: the highest risk was noted for Aggregatibacter, Cardiobacterium, and Kingella (23-60% of bacteremia cases), lower risk for Haemophilus and Eikenella (6–14%).
Conclusion. Study of virulence factors of HACEK group bacteria contributes to understanding the mechanisms of infective endocarditis development and may help in developing new methods of diagnosis, treatment, and disease prevention. Special attention should be paid to preventive measures in risk group patients, including oral hygiene maintenance and antibiotic prophylaxis during medical procedures.

Relevance. Currently, the issues of treatment of type 1 and type 2 diabetes mellitus are along with serious pathologies of the cardiovascular system, bronchopulmonary diseases and are a major medical and social problem. According to the Endocrinological Research Center, as of January 1, 2023, type 2 diabetes mellitus occupies a leading place in terms of morbidity in Russia. It accounts for 92.33% of the total number of patients with diabetes in the Russian Federation registered at the dispensary (4.58 million people). The total number of patients with diabetes in the Russian Federation registered at the dispensary as of 01.01.2023, according to the Federal Register of Diabetes Mellitus, amounted to 4,962,762 (3.31% of the population of the Russian Federation) and their number is steadily increasing in rapid progression. Diabetic foot is a serious problem that requires an interdisciplinary approach in treatment and prevention. In the XXI century, it is important to understand that the treatment of diabetic foot requires not only blood glucose control, but also the use of modern diagnostic and therapeutic methods, including surgery.
The purpose of the study. The purpose of this scientific study is to improve the clinical results of treatment of patients with diabetic foot syndrome by developing a new method of complex (combined) surgical treatment based on the results of the physiological response of the human body to inhalation of a heated helium-oxygen mixture. To investigate the physiological properties of a heated oxygen-helium mixture in terms of its effect on central and peripheral hemodynamics in various phases of the wound process. To compare the effectiveness of therapy in patients using national clinical guidelines and therapy using an oxygen-helium mixture. To develop an optimal treatment plan for patients with diabetic foot syndrome complicated by diabetic angiopathy, both at the hospital stage and in the outpatient clinic.
Materials and methods. The authors have made a detailed analysis of Russian and foreign literature. The literature review is devoted to the physiological and pathophysiological aspects of the effect of a heated oxygen-helium mixture on the treatment of complications of diabetes mellitus, especially ulcerative lesions of the lower extremities.
Conclusion. From the data obtained from the study, it can be concluded that the identification of a clinically important property of a heated oxygen–helium mixture will help improve the effectiveness of combined treatment and the quality of life of patients. To open up new opportunities for the use of heated oxygen-helium mixtures in clinical practice, as a result, to reduce the inpatient bedday and outpatient duration of therapy, to reduce the disability of patients from crippling surgical interventions.

Posterior Reversible Encephalopathy Syndrome (PRES) – a clinical and radiological syndrome characterized by acute cerebral endotheliopathy, impaired permeability of the blood-brain barrier with limitations of vasogenic cerebral edema, usually of the occipital and posterior lobes, and known to develop mental illnesses such as headache, decreased alertness, seizures, and visual disturbances. The initial manifestations of the disease are associated only with arterial hypertension, but after investigating the phenomenon, PRES can also be caused by other factors such as infections, kidney disease, or the use of certain medications. This article will discuss the main causes of PRES, the consequences and methods of verifying the manifestation, as well as the principles of treatment of this condition.

Objective: to study the effect of enalapril and valsartan + sacubitril on the reduction of CHF symptoms, on the change in functional and radiological parameters in patients with hypersensitivity pneumonitis (HP) combined with coronary heart disease.
Materials and methods. 183 patients with hypersensitivity pneumonitis were examined: 88 patients with coronary artery disease and 95 patients without it. CHF was diagnosed in 39 (44.3%)% of CHD patients and in 13 (13.68%) "isolated" SHG. General clinical, instrumental and functional study methods were performed in each group. When assessing the effectiveness of CHF treatment, patients are divided into two groups: еnalapril was prescribed to 20 patients in the main group: 21 patients in the comparison group received valsartan + sacubitril.
Results. 24-week therapy allowed to reduce the manifestations of diastolic dysfunction: a decrease in the indexed end-systolic volume of the left atrium by 5.13% in the main and 11.2% in the group, comparisons;, end-diastolic volume of the left ventricle by 4.13 and 11.4%, respectively; reduction of signs of left ventricular hypertrophy- reduction of its posterior wall thickness by 3.2% and 7.5%. The improvement in ECHOCG parameters was accompanied by a decrease in interstitial changes in CT, an improvement in the patency of small and medium bronchi and indicators of lung diffusion, a decrease in the severity of clinical manifestations of CHF, which justifies the use of sartans in the complex therapy of CHF in patients with hypersensitivity pneumonitis combined with coronary artery disease.

Introduction. Corrective knee joint osteotomy is used as a joint-preserving surgery for varus deformity. Longer-term functional outcomes have not been studied well enough yet. The study objective was to assess longer-term functional, clinical, outcomes and gait biomechanics in patients after 6 and 18 months after surgery correction.
Object and methods. The study included 20 patients with medial osteoarthritis of the knee of grade 2–3 and a varus deformity of > 4°. A total of 21 surgeries were performed on the patients. Full length weightbearing (FLWB) X-ray and corrective knee joint assessments were done using the KSS, KOOS and VAS scoring systems were obtained from all the patients. Biomechanical gait parameters were captured using an inertial sensor system at the timepoint of before the surgery, 6 months, and 18 months after surgery. Temporal and kinematic parameters of walking were analyzed.
Results. The radiological parameters showed stable varus deformity correction. According to the KOOS, KS and VAS scores, there was a moderate dynamic improvement in the operated knee function during the follow-up period before surgery to 6 and to 18 months after surgery. Biomechanical parameters showed an improvement in corrective knee joint function of the operated side in the first 6 months after surgery. In the following year, there were some subjective improvements but without any significant changes in gait biomechanics or knee kinematics.
Conclusion. Thus, the main changes in the clinical and functional state occur in the first 6 months after surgery. According to the study data, there was a moderate clinical improvement, as assessed by VAS, KOOS and KSS, in the long-term follow-up period. The biomechanical changes were minor.

Objective: this study aims to evaluate the prevalence of cardiovascular diseases (CVD) and associated risk factors in patients with prostate cancer (PCa) prior to initiation of endocrine therapy (ET), as a basis for reducing treatment-related complications and improving patient outcomes.
Materials and Methods. A total of 59 newly diagnosed, treatment-naïve PCa patients with potential indications for ET were enrolled at Sechenov University Clinical Hospital No. 1 between May 2018 and July 2022. Clinical and laboratory data were collected, and cardiovascular risk was assessed using ASCVD stratification.
Results. 83% of patients had at least one CVD; hypertension (79%) was the most prevalent condition. Blood pressure control was insufficient among patients at high cardiovascular risk. Dyslipidemia was present in 61%, mainly characterized by low HDL-C and elevated triglycerides. Only 19% of patients were on lipid-lowering therapy, and LDL-C target attainment was especially poor among high-risk patients.
Conclusion. The high prevalence of CVD and poor control of modifiable risk factors prior to ET initiation emphasize the need for early cardiovascular risk assessment and management. A multidisciplinary care model is essential to optimize treatment outcomes in PCa patients.

The use of cadaveric material has found its application for educational purposes in veterinary and medical universities. The obvious disadvantages of this approach are the requirements for maintaining the operational capacity of the cadaver material, as well as the peculiarities of changing the morphological structure of the organ with some cooking technologies. The article examines the application of modern methods of spleen plastination based on a sample from scientific data from PubMed, eLibrary and Google Scholar in the period from 1994 to 2024. 21 articles from a sample of 252 articles were analyzed. Currently, the authors propose standard Hagens plastination techniques with Biodur S10; using various fixing solutions (in particular, 0.56% glutaraldehyde and 2% formaldehyde in 0.1 M phosphate buffer (pH 7.4) containing 1.2 mM MgCl₂ and 2.5 mM CaCl₂); with Biodur S10/S15; with Brazilian polysiloxane P1; сryodehydration methods, room-temperature plastination technique, as well as methods of own production.

Neuroendocrine carcinomas are rare and aggressive types of cervical tumors. Available literature contains limited descriptions of mixed carcinomas, and knowledge about this type of mixed carcinoma remains limited. Morphological diagnosis of this carcinoma type can be difficult due to the fact that neuroendocrine carcinoma cells can resemble squamous cell carcinoma. Additional complications can be caused by the lack of expression of some specific neuroendocrine markers. Incorrect diagnosis of this carcinoma can lead to incorrect patient management tactics or treatment delays. This article presents a clinical observation of a 45-year-old female patient who was diagnosed with mixed neuroendocrine and squamous cell carcinoma of the cervix, HPV-associated, with multiple metastases. This case is of particular interest due to the rarity of this pathology and diagnostics challenges it presents.

Introduction. Subcutaneous adipose tissue represents a complex multi-component system playing a pivotal role in metabolic, immunological, and thermoregulatory processes. Contemporary understanding of structural and functional heterogeneity of adipose tissue has fundamentally changed our perception of its role in metabolic disease pathogenesis and aging processes.
Objective. To conduct a systematic analysis of current data on morphological organization of subcutaneous adipose tissue, its layered structure, and age-related changes with emphasis on clinical significance for aesthetic medicine.
Materials and methods. A systematic literature search was performed in PubMed, Scopus, Web of Science, and RSCI databases for the period 2015-2024. Keywords included: "subcutaneous adipose tissue", "dermal white adipose tissue", "superficial fascia", "aging", "morphology". Of 89 sources analyzed, 52 were included in the final analysis according to inclusion criteria.
Results. Subcutaneous adipose tissue is characterized by pronounced morphological heterogeneity and can be divided into dermal white adipose tissue (dWAT) and superficial white adipose tissue (sWAT). dWAT is localized in the lower dermis as discrete adipose clusters, while sWAT forms a continuous layer separated from dWAT by the superficial fascia. dWAT cells are characterized by smaller size (30-50 μm), high expression of UCP1 and PRDM16 markers, and active participation in wound healing and thermoregulation. sWAT contains large adipocytes (80-130 μm) organized into lobules separated by fibrous septa. Age-related changes include progressive reduction in dWAT volume (up to 40% by age 60), altered collagen I/III ratio, decreased vascularization and lymphatic drainage. Molecular aging mechanisms are associated with suppressed PPARγ and CEBPα expression and reduced Wnt/β-catenin signaling pathway activity.
Conclusion. Understanding the morphological heterogeneity of subcutaneous adipose tissue is critically important for developing personalized approaches in aesthetic medicine. Future research should focus on studying molecular mechanisms of different adipocyte population differentiation and developing targeted methods for age-related change correction.

Background. The current methods of cryopreservation, working with pooled platelet concentrates (PPC), require optimization. An urgent task is to select adequate dilution of thawed doses in order to reduce the toxic effect of cryoprotector.
The aim of work. To evaluate the effect of plasma-substituting solutions on the morphofunctional properties of pooled platelet concentrates after their cryopreservation, cryopreservation and defrosting.
Materials and methods. We studied morphofunctional properties of platelets, cryopreserved in the presence of 5–6% dimethyl sulfoxide and 0.5% dextran and diluted after defrosting with different media. Autologous cell-free medium, isolated from PPC before platelet freezing, allogeneic fresh-frozen plasma (FFP), plasma-substituting InterSol solution, plasma substitute rheopolyglucine were used for platelet resuspension. To assess the quality of platelets we used the method of thromboelastography and the method of morphofunctional platelet analysis, including vital staining with fluorochrome dyes.
Results. The initial PPC-samples significantly differed in the viability, structural and functional features of platelets. When thawed PPC-samples were diluted with in ratio 1:9, in experiments with autologous medium or FFP the safety of the total number of biologically complete platelets averaged 52–53%, with InterSol solution – 37%, rheopolyglucine – 8%. InterSol solution caused spontaneous platelet activation, while rheopolyglucine caused spontaneous activation associated with massive platelet destruction. Correlation was revealed between the preservation of biologically complete platelets after defrosting of the PPC and morphofunctional parameters in the initial PPC. When thawed PPC-samples were diluted with autologous medium or FFP in ratio 1:9, the morphofunctional status of platelets did not change for 2–3 hours, in ratio 1:4 – for 30 minutes.
Conclusions. Before cryopreservation PPC presented decrease of morphofunctional characteristics of platelets, followed with their increased reactivity. Resuspension of thawed PPC in pure InterSol solution or polyglucine leads to rapid loss of platelet quality and is ineffective. For the dilution of thawed PPC it is recommended to use autologous plasma medium or allogeneic fresh frozen plasma.

Background. Pattern Recognition Receptors (PRRs) represent fundamental components of the innate immune system responsible for detecting pathogenassociated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs). Understanding PRR-mediated effector responses is essential for developing therapeutic strategies and enhancing disease protection mechanisms.
Objective. To comprehensively review the mechanisms of PRR activation, classification, and their pivotal role in orchestrating effector responses for disease protection, while examining their therapeutic implications and potential clinical applications.
Methods. This review analyzes current literature on PRR biology, focusing on their classification into membrane-bound (Toll-like receptors, C-type lectin receptors), cytoplasmic (NOD-like receptors, RIG-I-like receptors), and soluble (collectins, pentraxins) types. The study examines intracellular signaling pathways, including MyD88-dependent and TRIF-dependent pathways, and their downstream effects on immune cell activation.
Results. PRRs demonstrate remarkable versatility in detecting diverse microbial threats and initiating tailored immune responses. Upon activation, PRRs trigger complex signaling cascades involving NF-κB and interferon regulatory factors (IRFs), leading to cytokine production, inflammation, and immune cell recruitment. Different infection types (bacterial, viral, fungal, parasitic) elicit specific PRR-mediated responses: bacterial infections activate complement and promote phagocytosis; viral infections induce interferon production and cytotoxic T lymphocyte responses; fungal infections stimulate Th1-mediated immunity; and parasitic infections trigger eosinophil activation and Th2 responses. PRRs also play crucial regulatory roles, preventing hyperinflammation and promoting immune tolerance.
Conclusions. PRRs function as master regulators of immune responses, serving not only as pathogen detectors but also as sophisticated coordinators of immune activation, tolerance, and resolution. While dysregulated PRR signaling contributes to autoimmunity and chronic inflammatory diseases, targeted modulation of PRR pathways offers promising therapeutic opportunities. Future research directions include exploring novel PRR subtypes, developing precision immunomodulatory therapies, and addressing challenges in translating PRR-based interventions from bench to bedside.
Clinical Significance. Understanding PRR-mediated effector responses provides insights into disease pathogenesis, offers potential drug targets for infectious and inflammatory diseases, and supports the development of individualized treatment approaches for enhanced immune protection.

Introduction. The clinical case discussed in this article highlights the challenge of managing extra organ retroperitoneal cysts. Extraorgan retroperitoneal formations are considered a rare pathology, often being incidental findings during examinations or surgical interventions.
The aim of this work is to describe a clinical case of surgical treatment of a retroperitoneal cyst with a long history.
Materials and methods. A retrospective analysis of the medical history of a patient with extraorgan retroperitoneal cyst was carried out. She was treated in the surgical department No. 2 of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan in May 2024.
Results and their discussion. Patient Z., 64 years old, consulted a surgeon in May 2024 complaining of dull pain in the right iliac region. The anamnesis includes observation of a retroperitoneal cyst for about 15 years. Puncture sanitation in 2009 and 2013 in the surgical department No. 2 of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan. Due to the large size of the neoplasm, a decision was made to perform a midline laparotomy.
Conclusion. A long history of disease, recurrence after puncture sanitation and the presence of pain syndrome became decisive in the choice of surgical removal of the cyst in this case.

Relevance. Anti-MOG-associated diseases are a relatively new and poorly studied group of autoimmune demyelinating disorders. Description of clinical cases helps to expand the understanding of the pathology, its diagnosis and treatment. The relevance of the article also lies in the demonstration of diagnostic algorithms, including the use of specific markers (anti-MOG antibodies) and neuroimaging methods (MRI). Despite the growing interest in this pathology, the number of described cases remains limited.
Objective: to study a clinical case with antiMOG-associated demyelinating disease and to identify the relevance of this disease in our time.
Materials and methods: a clinical case provided in the neurological department of the Republican Clinical Hospital No. 1, Izhevsk.
Results. Upon discharge, the following diagnosis was made: "Demyelinating disease of the central nervous system with the phenotype of ZONM (myelitis with complete regression of symptoms against the background of GC therapy), anti-AQP 4(-) (anti-MOG-associated disease) in the form of mild coordination disorders, mild subcortical syndrome, optic neuritis on the right, asthenic-subdepressive syndrome."
Conclusions. Anti-MOG-associated demyelinating disease is relevant at present, positive dynamics are observed during treatment.

Deep (aggressive) angiomyxoma is a rare benign mesenchymal tumor that usually arises from the soft tissues of the perineum and pelvis in premenopausal women. As of September 2020, only 88 cases of aggressive angiomyxoma in men have been reported. Deep or aggressive angiomyxoma is usually asymptomatic. At the same time, it is characterized by slow growth, a tendency to deeply invade the tissues of the retroperitoneal space and the muscles of the pelvic diaphragm. The article discusses a clinical case of deep angiomyxoma detection in a man during a medical examination. The importance of conducting a thorough differential diagnosis, regular preventive examinations and medical examinations by patients, as well as the significance of an objective physical examination of the patient at each visit to the doctor for the earliest possible detection of signs of neoplasms is shown.

Genital tuberculosis is a specific lesion of the female genital organs by an infection caused by mycobacteria of the Mycobacteriaceae family. The disease is most often registered in reproductive age, the leading complaints are infertility, menstrual irregularities, pelvic pain. Diagnosis of tuberculosis of the female genital organs is a complex task: the absence of specific clinical symptoms, the duration of the course, as well as the low level of alertness of doctors and patients do not always allow for a timely diagnosis and the beginning of appropriate treatment. In addition, patients with infertility against the background of undiagnosed genital tuberculosis can be subjected to assisted reproductive technology procedures. In the article, we present a clinical example of a patient with secondary infertility against the background of tuberculous lesions of the uterine appendages demonstrating all of the above.

In the last decade, there has been an active growth in the number of studies devoted to multiparametric ultrasound examination (MPUS) of the thyroid gland and the use of elastography in thyroid nodules, as well as the effectiveness of radiofrequency ablation (RFA). Experts note that multiparametric ultrasound – a comprehensive assessment of the node using gray-scale ultrasound, Dopplerography, elastography and, if necessary, contrast enhancement – significantly improves the differential diagnosis of thyroid nodules. Modern literature reflects an increased interest in the use of new ultrasound technologies to improve the diagnosis and treatment of thyroid nodules. In the review, we presented current literature data on the diagnostic effectiveness of multiparametric ultrasound of thyroid nodules, the use of radiofrequency ablation.

Relevance. Dysbaric osteonecrosis is a pathology of the skeletal bones that develops against the background of decompression disorders in divers, submariners, divers and caisson workers. The highest frequency of this pathology is observed in divers-fishermen (50–77%); in commercial divers it is 16–55%, in caisson workers – 25–35%, and in military divers this figure is significantly lower – 2–5%. The main pathogenetic causes of the development of dysbaric osteonecrosis are gas embolism of blood vessels of the microcirculatory bed by bubbles of free gas (nitrogen), as well as mechanical damage to the endothelium of capillaries and bone marrow, which leads to their inflammation, edema, hypercoagulation and compartment syndrome. This causes a violation of intraosseous blood flow, the development of ischemia and the initiation of necrotic processes in bone tissues.
The aim of the study: to study the MR semiotics of dysbaric osteonecrosis in divers.
Materials and methods. The studies were conducted on high-field magnetic resonance tomographs with a magnetic field induction of 1.5 T "Ingenia" (Philips) and "Magnetom Symphony" (Siemens) according to standard protocols with obtaining T1, T2 and PD-weighted images, as well as images using the effect of signal suppression from fat tissue (FS). MRI scanning was performed of the most frequently affected, according to literary sources, anatomical areas - shoulder, hip and knee joints, covering the parts of the diaphyses adjacent to the joints. The localization, distribution and type of specific pathological changes characteristic of dysbaric osteonecrosis were assessed. A total of 54 divers were examined, who were divided into 3 groups: 1. Divers performing deep-sea diving descents of more than 60 m (having additional diving qualifications of deep-sea diver and aquanaut). 2. Divers performing diving descents up to 60 m. 3. Divers performing diving descents in normobaric conditions (having an additional diving qualification of hydronaut).
Results. The conducted MRI studies have shown that dysbaric osteonecrosis most often affects deep-sea divers and aquanauts, and the presence of episodes of acute decompression sickness in the anamnesis increases the risk of its occurrence. The published data on the predominant localization of lesions: in the head of the humerus, metaepiphyses and diaphysis of the femur have also been confirmed.
Conclusion. Based on the results of the study, it can be stated that regular MRI monitoring of the skeletal bones is indicated for divers at risk (performing deep-sea diving descents and having episodes of acute decompression sickness in the anamnesis).

Relevance. Assessment of clinical data and psychological profile in occupational chronic obstructive pulmonary disease (OCOPD) in its isolated and comorbid course opens up new opportunities in assessing the development, predicting the course characteristics and personalized approach to pharmacotherapy of OCOPD, as well as in developing an individual strategy for its primary and secondary prevention.
The aim of the study was to determine the psychological characteristics of OCOPD in its isolated course and combination with arterial hypertension (AH).
Object and methods. The study involved 235 patients: Group 1 (n = 60) (control) – healthy volunteers; Group 2 (n = 35) – OCOPD of the first degree of severity; Group 3 (n = 50) – OCOPD of the second degree of severity; Group 4 (n = 40) – a combination of OCOPD of the second degree of severity and AH; Group 5 (n = 50) – isolated course of AH. All patients were tested using two methods: the Bass-Darkey questionnaire and the Plutchik-Kellerman-Conte Life Style Index (LSI) questionnaire, described in 1979 based on the psychoevolutionary theory of R. Plutchik and the structural theory of personality of H. Kellerman, adapted by E.S. Romanova and L.R. Grebennikov. Group data were assessed using oneway ANOVA with intergroup comparisons using Dunnett's test.
Results. For the first time, the features of psychological manifestations in COPD of varying severity were established in its isolated course and in combination with arterial hypertension. Limitations of the study. The study has regional (Samara Region) and professional (in terms of detailing the working conditions in the comparison groups under study) limitations.
Conclusions. Exposure to industrial dust is a stress factor leading to the development of severe psychoemotional disorders in occupational chronic obstructive pulmonary disease in its isolated and comorbid, combined course with arterial hypertension. In our opinion, it is necessary to include a comprehensive psychological examination with a consultation with a psychologist and the use of the Bass-Darkey questionnaire and a survey using the Plutchik-Kellerman-Conte method - Life Style Index (LSI), described in 1979 on the basis of the psychoevolutionary theory of R. Plutchik and the structural theory of personality of H. Kellerman in the program of in-depth periodic medical examinations of persons working in the Context with industrial aerosols of chemical and fibrogenic nature, potentially dangerous for the formation of occupational chronic obstructive pulmonary disease, and in the program of providing medical care to patients with COPD in its isolated and combined course with hypertension in pulmonology centers and occupational pathology centers at the federal and regional levels, taking into account the identified psychological changes and the need for their timely psychological correction, including the use of pharmacological drugs.

Objective: to develop a comprehensive protocol for the transportation of donor organs and tissues for transplantation, taking into account modern international standards, Russian legislation requirements, and identified legal conflicts.
Materials and methods. An analysis of current Russian and international legislation in the field of biological materials transportation, IATA standards, aviation security requirements, and practical experience of leading transplantation centers was conducted. Regulatory documents from the Ministry of Health of Russia, Ministry of Transport of Russia, Roszdravnadzor, and customs authorities were studied.
Results. A protocol has been developed that includes requirements for couriers, packaging of biomaterials according to IATA P650 standard, donor organ labeling, documentation workflow, and incident management. Significant legal conflicts were identified: contradiction between the requirement of Ministry of Health Order No. 567n regarding the use of special signals and the prohibition of their use in the absence of a patient; exceeding the volume of liquid in organ packaging beyond the established aviation regulations (100 ml); non-compliance of container sizes with airline hand luggage requirements.
Conclusions. Modern donor organ transportation requires a comprehensive interdisciplinary approach involving medical professionals, aviators, and regulatory authorities. It is necessary to eliminate the identified legal conflicts, develop special agreements with airlines, and create unified standards to ensure efficient and safe delivery of vital biomaterials.
Practical significance. The protocol can be used by transplantation centers to organize donor organ transportation, while the identified legal conflicts require attention from legislators to improve the regulatory framework.

The article is dedicated to the 80th anniversary of the naval doctor, retired colonel of the medical service, full academician of the Academy of Military Sciences of the Russian Federation, doctor of medical sciences, professor Yuri Evlampievich Barachevsky, who taught at the naval department of the Arkhangelsk State Medical Institute (ASMI) for 40 years, and since 2009 has been the head of the department of mobilization training of healthcare and disaster medicine of the Northern State Medical University (NSMU). The authors of the article collected, summarized and analyzed data obtained from various historical sources: archival documents (personal files, orders of ASMI-NSMU), scientific literature; conducted interviews and supplemented the material with the memories of the hero of the day. Yuri Evlampievich Barachevsky is a talented doctor, healthcare organizer and teacher, who is warmly spoken of by colleagues, students and friends. He made a significant contribution to the development of mobilization training of healthcare and disaster medicine in the Arkhangelsk region, achieved great heights as a military doctor, as a teacher of a higher educational institution, as a scientist. The enthusiasm and determination of people like him are what makes medicine advance by leaps and bounds, which has a positive effect on the lives of millions of people. The career of Yuri Yevlampievich, presented in the article, is a bright page in the history of Russian medicine.

Of great importance for the history of medicine is the coverage of the life path of people who left a bright mark on the history of the Fatherland, contributing to the development of the medical field. This article is dedicated to one of such people – Professor Nikolai Nikolaevich Dyakov (1875—1954) in honor of the 150th anniversary of his birth, who during his life lived through several wars, a change of power in the country and many other famous historical events. Archival documents, scientific literature, books and articles served as materials for the study. The life story of N.N. Dyakov is amazing in that, being the son of a sailor, he became a doctor of medical sciences, professor and headed the departments of medical institutes for more than 20 years. The last position he held was the head of the department of hospital therapy at the Arkhangelsk State Medical Institute from 1936 to 1953. For half a century of impeccable work in the field of public health, for the good organization of the scientific, pedagogical and medical process at the department, he was awarded the Order of Lenin. The professor's scientific works were devoted to the study of the medicinal properties of birch bark, wild rosemary, the development of methods for treating alimentary dystrophy, vitamin deficiencies, the study of the therapeutic factors of mineral waters and northern resorts, the study of the effect of ascorbic acid isolated from pine needles on the treatment of patients with vitamin deficiencies, etc. Nikolai Nikolaevich Dyakov is a bright representative of the northern scientific school, an experienced therapist who enjoyed authority among colleagues and the population of the Arkhangelsk region, whose life story deserves coverage.