The aim of the research. Evaluation of the effect of hydrocortisone on the need for vasopressors in dynamics and on the survival of patients during ECMO.

Materials and methods. The prospective cohort study was performed in the intensive care unit (47 patients during ECMO). Patients were divided into: Ia (with vascular insufficiency and hyponatremia and Ib (with isolated vascular insufficiency without hyponatremia); group II (n18) - patients without vascular insufficiency. The appointment of intravenous therapy with hydrocortisone was carried out in patients with a need for norepinephrine of 0.25 µg/kg/min and above.

Results. In group Ia, there is a high mortality of patients due to: the obvious clinical symptoms of adrenal dysfunction against the background of low cortisol levels, the duration of the underlying disease, the transfer of patients from the primary hospitalization clinic. Patients of subgroup Ib showed a positive trend in the resolution of organ dysfunction. The best survival rate in Ib is associated with the development of an early stage of adrenal dysfunction, when the depletion of the adrenal medulla is already of clinical importance, but the compensatory abilities of the cortical layer have not yet exhausted themselves, which manifested itself in the absence of hyponatremia. At the same time, the appointment of hydrocortisone in this situation made it possible to compensate for progressive adrenal dysfunction. The main effect of the hormone therapy used was precisely the absence of differences in mortality between patients of group II and subgroup Ib, although the severity of the condition of patients in subgroup Ib was significantly higher. It should also be taken into account that ECMO is an aggressive treatment method that carries independent risks of developing complications that increase mortality in the study groups. Thus, patients who initially had clinical and laboratory signs of adrenal dysfunction (Ia) despite ongoing therapy with hydrocortisone and sodium compensation showed the highest mortality compared to subgroup Ib and II group.

Conclusion. The appointment of hydrocortisone can reduce the need for norepinephrine. The use of hydrocortisone during ECMO increases the survival rate of patients.

Aim. To study the structure of congenital heart defects and the distribution of children born in rural areas of the Omsk region with heart defects by age and gender.

Materials and methods. A population retrospective cross-sectional clinical and epidemiological study of congenital heart malformation in children in 32 districts of the Omsk region was conducted. All cases of vascular heart defects in children and fetuses were recorded, according to the International Classification of Diseases of the Tenth Revision and the Marder classification.

Results. Among all congenital malformations diagnosed in children from birth to 17 years of age inclusive, defects of the interventricular and atrial septum, pulmonary artery stenosis and common arterial trunk prevailed. According to Marder's classification, open arterial duct and septal defects were registered with the highest frequency in group I 1, and Fallot defects, transposition of the great vessels and Epstein's disease were registered in group II 2. Defects with cyanosis were noted in 12.2 ± 1.5%. When comparing children with congenital heart malformation, depending on gender, no significant differences were found between the frequency of heart defects and large vessels in children.

Conclusion. Defects of the atrial and interventricular septum prevailed in the structure of heart defects of children from rural areas of the Omsk region. Among the defects of group I 1 (according to Marder), the open arterial duct is registered with the highest frequency, and in group II 2 – Fallot defects. Among the children registered with cardiologists with a diagnosis of congenital malformation, the greatest proportion were children and adolescents of the age group of 8-14 years.

Aim. The study of the content of the intercellular adhesion molecule - sP-selectin, its ligand sPSGL-1, and platelet-leukocyte coaggregates in blood plasma in healthy children of different ages.

Methods. Whole blood was studied in 111 healthy children aged 7 months to 14 years. Peripheral blood of children was taken into vacuum tubes with EDTA. Detection of platelet-leukocyte complexes was carried out in a conventional way using monoclonal antibodies (Mab) conjugated with various fluorochromes. The content of intercellular adhesion molecules, sP-selectin and sPSGL-1, was assessed by multiplex analysis on a flow cytometer. The Kruskal–Wallis test (H) was used to compare all 6 study groups on the same quantitative basis. In the presence of statistically significant differences, a pairwise comparison was carried out using the MannWhitney test (U) with the Bonferroni correction.

Results. It was found that the content of the intercellular adhesion molecule sP-selectin gradually decreased. The maximum content of sP-selectin was observed in children under one year old, and then fell by 5.8 times in children of the older age group (children aged 12 years and older). It was found that the content of sPSGL1 did not change. The fluctuation of values in different age groups ranged from 52.8 to 140.7 pg/ml. A significant correlation was found between the content of sP-selectin and the content of PNeuC (plateletneutrophil coaggregates), PLymC (platelet-lymphocyte coaggregates) in the peripheral blood of healthy children of different ages.

Conclusions. The amount of sP-selectin decreases with age, while the content of sPSGL-1 remains unchanged. At the same time, there is a significant correlation between the content of sP-selectin and PNeuC, as well as PLymC.

The aim of the research: To study the frequency and types of complications in patients who have died from the novel coronavirus infection (COVID-19).

Materials and methods. A retrospective study of medical records of inpatients and examinations of the quality of medical care of 61 patients with severe and extremely severe COVID-19 who died in hospitals of the Irkutsk region in the period from January 1, 2021 to December 31, 2021 was conducted.

The study included patients over the age of 18 years with a positive laboratory result for the presence of SARSCoV-2 RNA. Patients with non-fulfillment, untimely or improper implementation of the diagnostic measures necessary for the patient are excluded from the study; failure to perform a mandatory post-mortem examination; with the presence of signs of distortion of information about the diagnostic and therapeutic measures taken.

The results. Pneumonia complicated by acute respiratory distress syndrome was the most common complication, in deceased patients from the novel coronavirus infection COVID-19 followed by cerebral edema, sepsis, hospital acute kidney injury, metabolic acidosis, acute myocardial damage, respiratory acidosis, arrhythmias, fluid overload, аcute cerebrovascular accident, pulmonary thromboembolism, acute heart failure, less often disseminated intravascular coagulation and delirium were recorded.

The causes of metabolic acidosis in most cases were sepsis and acute kidney injury, and respiratory acidosis - acute respiratory distress syndrome.

Conclusion. The novel coronavirus infection COVID-19 causes damage to the lungs, brain, heart and kidneys, which causes the severity of the patient's condition and leads to death.  

The aim of the research. The comparative analysis of the subcutaneous tissue topography in the young people of the Caucasian and Mongoloid races with different the body mass index.

Materials and methods. The study comprised of 1080 participants, who were adolescent people of the Mongoloid race (155 Khakass, 167 Tuvanians, 149 Buryats) and the Caucasian race (609 Tajiks). The participants were estimated by anthropometry, waist and thigh circumferences were measured). The subcutaneous tissue thickness of the 8 human body regions was measured by the skinfold measurement. The research data was analyzed by SPSS v. 22.0. The non-parametric data was analyzed by the Kruskal-Wallis test.

Results. The adolescent males and females of the Caucasian and Mongoloid races had roughly the same distribution of the body mass index groups. The one fifth of the males and females had underweight, the one third of the participants had overweight, a healthy weight was determined in one half of the people. The results of the study showed statistically significant differences in the waist and thigh circumferences between males with underweight and healthy weight. Results of the skinfold measurement and the body mass index shown the larger thickness of the skinfold at the level of abdomen and thigh (the “middle” parts of the human body) as the Caucasian adolescent people as the Mongoloid adolescent people. The smaller thickness of the skinfolds located at the level of the upper part of the human body: the anterior surface of the shoulder and forearm. 

Conclusion. The adipose tissue is an important part of the human body composition. It plays an important role in the control of metabolism, the regulation of feeding behavior, thermoregulation, the work of the endocrine and reproductive systems. The stable content of the human body fat component, the topography features of the adipose tissue distribution provide optimal conditions for human life, which, in our opinion, explains the absence of statistically significant differences in differences between the thickness of the skinfold at the participants of the Caucasian and Mongoloid races with healthy weight and overweight. The established differences of the subcutaneous fat distribution between the males of the Caucasian and Mongoloid races with underweight require further research.

The aim of the research: to study the clinical picture and risk factors for the severe course of a new coronavirus infection COVID-19 in the provision of specialized medical care in the Republic of Sakha (Yakutia).

Materials and methods of the study: An analysis was made of 404 case histories of patients with a new coronavirus infection COVID-19 who underwent inpatient treatment from 2020 to 2021. The analyzed persons were divided into 2 groups of patients: 150 patients who were hospitalized from 05/19/2020 to 12/31/2020, and in the second group - 254 patients who were hospitalized from 04/01/2021 to 07/31/2021 gg. Data processing was carried out using statistical criteria using the IBM SPSS Statistics 26.0 software package.

Results. The clinical picture in patients with a new coronavirus infection COVID-19 is characterized by the presence of general weakness (94.3%), cough (82.4%), shortness of breath (73.01%), a feeling of pressure in the chest (50.7%) and anosmia (40.8%) in moderate and severe forms of the disease. It was revealed that the risk factors for a severe course of a new coronavirus infection are advanced age - 55.2% of patients were over 60 years old in 2020-2021. (p<0.001); elevated body mass index (BMI): 90.7% of patients with severe NCVI observed in 2020 were diagnosed with overweight and obesity (p<0.001), in 2021 - 47.6%. (p<0.001); the presence of diseases of the cardiovascular system - 35.3% in 2020 and 61.0% in 2021 (p<0.001). Of the 404 people, 39.1% developed severe NKVI (158 people), with more severe cases in 2021 (107 people). The overall mortality was 14.6%, among those with severe NKVI, 28.7% died.

Conclusion. The most common clinical manifestations of NCVI were hyperthermia, severe asthenia, cough, shortness of breath, heaviness and pain in the chest. Among people with severe COVID-19, elderly people (58.4%) prevailed, as well as patients with diseases of the cardiovascular system (57.2%), diabetes mellitus (48.5%) and oncopathology (31.2% ). In the presence of overweight and obesity, a severe course was observed in 65.1%.

Since March 2020, in connection with the pandemic of a new coronavirus infection COVID-19, the regulatory documents for 2020-2022 have been repeatedly changed. All this was reflected in the rates of temporary disability with COVID-19.

The aim of the research to study the impact of COVID-19 on temporary disability rates in the Irkutsk region.

Materials and methods. Information about the causes of temporary disability, presented in the approved form No. 16-V was analyzed.

Results. The duration of one case of quarantine was predetermined by the period of disability rates during quarantine amounted to 7.9% of all cases in 2020 and 4.4% in 2021. The share of the number of days released from work due to quarantine was 8.1% in 2020, and in 2021 it almost halved. The increase in the number in cases of temporary disability per 100 employees due to COVID-19 was 48.2%. Compared to the previous year In 2021, in the Irkutsk region. The share of COVID-19 in the nosological structure of days of temporary disability increased from 17.1% to 23.1% per 100 employees. In terms of the frequency of cases per 100 employees, only respiratory diseases, acute respiratory infections, cases of patient care were ahead of the coronovirus infection (as in the entire Russian Federation). 

Conclusions: The new coronovirus infection entered the top ten causes with the longest case duration. The high contagiousness led to an increase in the number of cases of temporary disability in 2021 and a lengthening of their duration in the Irkutsk region.

Tumors in children are characterized by a high mortality rate. The data of oncological incidence in children are contradictory in different regions of the Russian Federation, it are published individual medical institutions or research groups.

Purpose of the study. To study the structure and the incidence of malignant neoplasms (MN) in children of the Trans-Baikal Territory aged 0 to 15 years for the period from 1996 to 2020.

Materials and methods of research. A retrospective and prospective analysis of the data of the regional pediatrics cancer registry for the period 1996-2020 were carried out. Statistical processing was performed using "Excel 2013". 

Results. The oncological incidence in children aged 0 to 15 years ranged from 7.5 to 14.5 per 100 000 children population for the period 1996 - 2020, for the prospective registration period (2006-2020) - from 9.3 to 20.4 per 100 000 children population. The incidence of the malignant neoplasms among children for the prospective period 2006-2020 was 14 per 100 thousands children population. In the first place among the malignant neoplasms is leukemia – 32,4 % (3,9 per 100 thousands children population), the second place is the neoplasms of the CNS – 20.8% (2,5 per 100 thousands children population), the third place is malignant lymphomas – 12% (1,4 per 100 thousands children population), the fourth place is the neuroblastoma 6,6% (1,0 per 100 thousands children population) and malignant neoplasms of the kidneys – 6,6% (0,8 per 100 thousands children population). Boys get sick with cancer more often than girls in a ratio of 1.27:1. 

Conclusions. The accumulation of oncological incidence in children for the very long period of time is required for the correct analysis of epidemiological data. The structure of malignant neoplasms in childhood in the Trans-Baikal Territory corresponds to Russian and world data.

TB infection is often accompanied by changes in electrophysiological properties of the myocardium, which may result in rhythm and conduction disturbances; the administration of cardiotoxic TB drugs requires control of their safety for patients. 

Aim. To evaluate the structure and frequency of heterotopic rhythm disturbances in patients with different forms of pulmonary TB. 

Materials and methods. We studied 116 pulmonary TB patients without heart disease – 57 men and 59 women aged 18-78 years; the average age was 45.8 ± 14.77 years. All underwent 24-hour ECG monitoring. The monitograms were analyzed using the 24-hour ECG. The results were processed using MS EXCEL 2016 for Windows. 

Results. The average heart rate (HR) throughout the day, average HR in the afternoon, and average nighttime HR did not differ from those in general population. Heart rhythm disturbances were detected in 94.83% of cases (110 patients). Supraventricular extrasystoles prevailed over other rhythm disorders. Among ventricular extrasystoles the most common were rare monomorphic ventricular extrasystoles, class 1 according to the classification of B. Lown, M. Wolf, and M. Ryan. Combined supraventricular and ventricular rhythm disorders were detected in 21.6% of cases (25 patients). Prognostically unfavourable rhythm disorders were detected in 45.6% of cases (25 patients). Rhythm disorders were more common in middle-aged or older male patients with pulmonary TB (р˃0.05).

Conclusion. Practically all types of heart rhythm disturbances were diagnosed in pulmonary TB patients, including co-existing several types of arrhythmias. Prognostically unfavourable disorders were detected in 45.6% of cases. Pulmonary TB patients need regular control of heart rhythm and timely correction of disorders; 24-hour ECG monitoring is strongly advised since rhythm disorders may be unexpressed and not detected at rest. 

A meta-analysis of the recent years indicates an increase rate of morbidity in pregnant women, leading to the development of hypoxic conditions in the fetus. It often leads to future brain lesions. Lesions of the central nervous system in children place a heavy social burden on the state and society. Therefore, the search for solutions to the problems of early disease detection does not lose its relevance throughout the entire world.

The aim of the study: To develop a technology for early diagnosis of hypoxic conditions in full-term newborns. Material and method: The study included 105 full-term newborns, which were divided into 3 groups: group 1 - full-term newborns born in moderate asphyxia, group 2 - full-term newborns who experienced chronic fetal hypoxia and were born with a normal Apgar score, group 3 - full-term newborns who did not experience chronic fetal hypoxia and were born with a normal Apgar score. Statistical analysis was carried out using the IBM SPSS Statistics (Version 25.0) software package. Statistically significant parameters were included in the database, which formed the basis for training the multilayer perceptron.

Results: The structure of the trained neural network included 12 input neurons, reflecting the level of significant anamnestic risk factors for pregnancy (threatened miscarriage, preeclampsia, placental insufficiency) and immunological parameters (interleukin (IL)-1β, IL-4, IL-6, IL-8, tumor necrosis factor (TNF)-α, neuron-specific enolase (NSE) in cord blood). The resulting neural network has high sensitivity and specificity for all the studied groups, the accuracy of predictions was 96.2%.

Conclusions: The combination of parameters of anamnestic risk factors for the course of pregnancy and data on the concentrations of IL-1β, IL-4, IL-6, IL-8, TNF-α, NSE in cord blood, included in the structure of the neural network, makes it possible to diagnose the development of hypoxic conditions with a high degree of probability in term newborns. The use of this technology in practical healthcare will allow early detection of the pathology of the central nervous system.

Traditionally, the success of treatment is associated with the patient's awareness of the need for treatment, regular observation in medical specialized institutions and the mastery of certain social, professional, neurocognitive and other skills. The result of treatment of a patient with HIV infection also depends on these factors, especially at the present time, during the HIV epidemic.

The aim of the research. To assess adherence to treatment in patients with HIV infection depending on the presence of pulmonary tuberculosis using a universal questionnaire for quantitative assessment of treatment adherence.

Materials and methods. The study involved 106 patients with HIV infection and 106 patients with tuberculosis, on the background of HIV infection, who were treated in a hospital. An anonymous survey was conducted using the universal Russian questionnaire for the quantitative assessment of adherence to treatment. The authors added questions of a social nature to the questionnaire. In the groups, the patients were comparable in terms of gender, age, drug history. For comparison, the nonparametric Mann-Whitney test was used. Correlation analysis was carried out to determine the influencing factors.

Results. Adherence to drug therapy was the lowest observed in HIV-infected patients with pulmonary tuberculosis. Medium and high levels of adherence were more often observed in the main group of patients with HIV infection. A similar situation was observed in the analysis of adherence to medical support. Adherence to lifestyle modification was the highest in patients in the main group. When assessing the integral adherence to treatment in the main group of patients with HIV infection, an average and high level was observed in almost half of the patients.

When conducting a correlation analysis, a number of factors were identified that influenced the formation of all types of adherence.

Conclusion. The results revealed two main categories of factors influencing the formation of adherence to treatment in patients with HIV infection. Medical factors: primary hospitalization in a hospital and the absence of a secondary disease; social: minor children, monthly material income, HIV-negative sexual partner. The results of this study confirm the need to rethink the formation of patient flows, the selection of newly identified patients and work with this contingent to improve adherence to treatment.

Military Medical Academy named after S.M. Kirov, 6 Academician Lebedev str, St. Petersburg, 194014 The aim of the research. To assess the effect of the substrate antihypoxant Cytoflavin on the frequency of bacteremia and the type of microorganisms sown in severe combined trauma.

Materials and methods. The results of bacterial cultures and PCR-analysis of venous blood of 2 groups of victims who received severe concomitant injuries accompanied by shock of the 2nd and 3rd degree are presented. The main group - 39 patients treated with Cytoflavin, and the control group - 41 patients in whose treatment Cytoflavin was not used. To assess bacteremia, bacterial cultures and PCR-analysis of venous blood of the victims were used. For statistical processing, we used the assessment of the reliability of differences in the means of disconnected (independent) samples according to the t-test (Student) and the assessment of the normality of the distribution using the Kolmogorov-Smirnov test.

Results. Fungi of the genus Candida, St. haemolyticus, Corynebacterium spp., Klebsiella pneumoniae, Toxoplasma gondii, E. coli, Ps. aeruginosa, Acinetobacter baumannii, Enterobacter spp., St. pneumoniae, Enterobacter cloacae, Ps. alcaligenes, gr. + cocci, Pseudomonas spp. In the main group, 76,9 % of negative cultures were obtained, in the control group, only 24 %. The maximum number of positive blood cultures was observed on the 3rd and 5th days in the control group. Most often, 2 microorganisms were sown in the 1st sample, no stable combinations were obtained. 

Conclusion. The revealed signs of an almost 3-fold decrease (from 76.9 % in the control group to 24 % in the main group) in the frequency of blood cultures suggest a positive effect of the use of the cytoflavin substrate antihypoxant in the treatment of patients with severe concomitant trauma.

The aim of the research. To investigate the informativeness of calculated hematological indices in prediction of mortality in patients with severe community-acquired pneumonia caused by new coronavirus infection (COVID-19). 

Materials and methods. We conducted a prospective case-control observational study which included 450 patients with severe community-acquired COVID-19-associated pneumonia treated in the Anesthesiology and Intensive Care Unit (AICU). Several indices were calculated: the ratios of neutrophils (count) to lymphocytes (count) (NL), neutrophils (%) to albumin (g/L) (NA), fibrinogen (g/L) to albumin (g/L) (FA), platelets (count) to lymphocytes (count) (PL), lactate dehydrogenase (LDH) (U/L) to lymphocytes (count) (LDH-L), C-reactive protein (CRP) (mg/L) to albumin (g/L) (CRP-A), LDH (U/L) to platelets (count) (LDH-P), LDH (U/L) to albumin (g/L) (LDH-A), fibrinogen (g/L)*100 to platelets (count) (FP). Systemic immuno-inflammation index (SII) was calculated according to the formula: platelets (count)*neutrophils (count) / lymphocytes (count). The end point was mortality. The statistical analysis was carried out using the SPSS 26.0 program. To compare prognostic value of hematological laboratory parameters and calculated indices univariate and multifactorial analyses were carried out with prognostic models using binary logistic regression.

Results. The prognostic value of hematological indices was determined in comparison with hematological laboratory indicators. LDH-L (78%), LDH-P (83.9%) and LDH-A (84.4%) indices had the highest prognostic sensitivity and odds ratio 3.27, 4.55, 5.58, respectively. Prognostic models with hematological indicators (specificity  50.7%, sensitivity  88.3%) and calculated indices (specificity  51.1%, sensitivity 90.8%) were constructed.

Conclusion. Calculated hematological indices are highly informative and can be used to predict mortality in patients with severe community-acquired COVID-19-associated pneumonia. Hematological indices include LDH ratio with lymphocytes, platelets and albumin have highest sensitivity and specificity.

Glycocalyx (GC) is a polysaccharide-protein gel-like layer on the luminal side of blood vessels. GC supports homeostasis of the vascular network, including controls vascular permeability and microvascular tone, prevents microvascular thrombosis and regulates leukocyte adhesion. Damage of GC is a universal link of pathogenesis in various pathological processes. Many chronic diseases at the stage of decompensation are often accompanied by degradation of GC caused by inflammatory reactions, hypoperfusion, shock, which leads to disruption of microcirculatory perfusion and organ dysfunction. Drug prevention and treatment of GC damage, as well as the possibility of its recovery, are promising areas of research. This review analyzes the main mechanisms of GC destruction, as well as methods of medical correction of GC damage. In animal experiments, the possibilities of restoring HA using an infusion of albumin and freshly frozen plasma are described. In preclinical and clinical studies, the use of glucocorticoids, sulodexide, 6-hydroxyethyl starch, antithrombin III, in various pathological conditions, was considered in order to correct the dysfunction of GC. Pharmacological correction of GC disorders is still far from being fully resolved and is at the stage of clinical research, which requires additional scientific work on this topic.

The causes of the formation of bronchial asthma (BA) are the object of most research to this day. It is known that past acute respiratory diseases, having a certain seasonality, can cause periodic occurrence of airway obstruction, with the further formation of BA, which leads to an increase in requests for medical help and a deterioration in the quality of life.

The scientific review is devoted to summarizing the results of modern research on the long-term consequences of respiratory syncytial virus infection (RSVI) transferred at an early age. The databases PubMED, RSCI were used. The search keywords were: respiratory syncytial virus infection, early childhood, broncho-obstructive syndrome, bronchial asthma, palivizumab, nirsevimab, motavizumab. Found 42187 publications for search words over the past 5 years. Most publications note a pathogenetic relationship between RSVI and BA. The authors also note the need for immunization of infants with monoclonal antibodies to prevent the development of complications.

The review contains up-to-date data on the physiological role of ryanodine channels and the involvement of their genetic polymorphism in the pathogenesis of cardiovascular diseases.

The geographical distribution, pathogenesis and clinical picture of alimentary-toxic paroxysmal myoglobinuria (ATPM) are considered. Data are presented for the differential diagnosis of ATPM with hemorrhagic fever with renal syndrome, leptospirosis, trichinosis and enterovirus infection, including anamnestic data, pathogenesis, pathomorphology, clinical manifestations, complications and laboratory data. Difficulties in the differential diagnosis of ATPM with these diseases may arise due to the presence of similar symptoms and the coincidence of the localization of natural foci of diseases. 

Hemorrhagic fever with renal syndrome is distinguished from ATPM by the presence of high fever, hemorrhagic syndrome, visual impairment, thrombocytopenia, the absence of significant myolysis and myoglobinuria. In contrast to ATPM, jaundice, meningeal and hemorrhagic syndromes, exanthema, lymphadenopathy, hyperbilirubinemia and thrombocytopenia are observed in leptospirosis. The main differences of trichinosis with ATPM are edematous syndrome, severe blood eosinophilia and possible eosinophilic infiltration of lung tissue. With enterovirus infection, in contrast to alimentary-toxic myoglobinuria, serous meningitis, enanthema and exanthema can be observed.

Objective. To review current data about the participation of kynurenine pathway’s intermediate products in the pathogenesis of complications of diabetes, namely angiopathy.

Materials and methods. There was an electronic research of the scientific literature in PubMed and Embase published up to March 2023 for articles that reported on the features of the metabolism of tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), xanthurenic acid (XA), anthranilic acid (AA) and QUINoline acid (QA) in normal state and during diabetes mellitus (DM). Special attention was paid to the role of kynurenines in the development of endothelial dysfunction.

Results. A descriptive research of the variety of kynurenines’ influence on carbohydrate metabolism, free radical processes, immune responses is described, as well as their role in the formation of some pathologies, including metabolic syndrome, diabetes mellitus and its vascular complications, is presented.

Conclusion. The kynurenine pathway of TRP conversion performs several important functions in the body; the results of studies of its course features gradually reveal the complicated relationship between metabolic disorders of tryptophan metabolism, diabetes mellitus and vascular complications. Many issues remain unexplored; some pathogenetic relationships are outlined in currnet literature review.