The aim of the research: To evaluate the effect of a mobile digital assistant on the quality of the basic cardiopulmonary resuscitation (CPR) algorithm performed by first-year medical students in a simulated environment.
Materials and methods. A single-center randomized controlled trial was conducted in 2024 with 196 firstyear students. Participants were randomized into an experimental group (n = 80), who performed CPR using a digital assistant, and a control group (n = 116), who performed resuscitation without it. CPR quality was assessed using AmbuMan® CPR trainers with digital feedback. Non-parametric statistical analysis was performed: the Mann-Whitney U-test was used for quantitative variables, and Fisher's exact test with odds ratios (OR) and 95% confidence intervals (CI) was used for qualitative variables.
Results. The use of the digital assistant led to a statistically significant increase in the time to chest compressions: the median in the experimental group was 97,0 seconds [interquartile range: 56,8–125,0] compared to 55,0 seconds [42,3–74,0] in the control group (p < 0,001). At the same time, participants in the digital assistant group were significantly more likely to correctly assess consciousness (75,0% vs. 61,2%; OR 1,90, 95% CI 1,01–3,57; p = 0,047) and breathing (81,2% vs. 50,9%; OR 4,19, 95% CI 2,14–8,17; p < 0,001). No statistically significant differences in the quality of compressions (depth, rate, recoil) or ventilations were found between the groups.
Conclusion. The digital assistant effectively improves the performance of the diagnostic steps of the CPR algorithm by medical students without clinical experience. However, its use is associated with a significant delay in the initiation of compressions, which is a critical negative effect that requires further optimization of the application interface and the development of specialized training protocols.

The aim of the research. To evaluate the diagnostic and prognostic significance of the neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for predicting the severity of rotavirus gastroenteritis (RVGE) in children.
Materials and methods. A prospective study was conducted involving 45 children with RVGE, stratified into groups with mild-to-moderate (n = 16) and severe (n = 29) disease according to the Vesikari scale. NLR and PLR were calculated upon admission. Statistical analysis included the Mann-Whitney U test, ROC analysis, and multivariate logistic regression.
Results. The median NLR and PLR were significantly higher in the severe group compared to the mild-tomoderate group: 4,26 [2,01–5,76] vs 1,64 [0,95–3,71] (p = 0.010) and 165,10 [122,69–244,30] vs 84,79 [67,19–149,93] (p < 0.001), respectively. ROC analysis demonstrated good diagnostic accuracy for predicting severe disease: the area under the curve (AUC) for PLR was 0,794 (95% CI: 0,655–0,945), and for NLR it was 0,750 (95% CI: 0,588–0,912). In the multivariate analysis, only NLR remained an independent predictor of severe course (OR = 3,203; 95% CI: 1,293–7,939; p = 0.012).
Conclusion. NLR and PLR are significant and readily available biomarkers associated with the severity of rotavirus gastroenteritis in children. NLR demonstrated properties of an independent prognostic factor, supporting its use for early risk stratification and therapy optimization.

Objective. To retrospectively present histologic preparations from patients who had a history of traumatic BCA dissection and subsequently underwent aortic surgery for aortic dissection, aortic aneurysm.
Materials and Methods. In this case series, we present retrospective data of histologic and genetic study of lifetime biological material from patients who had suffered traumatic detachment of the orifices of brachiocephalic arteries but did not have a verified diagnosis of aortic dissection, aortic aneurysm.
Results. The histologic study of the biomaterial obtained at the stage of non-radical correction of cerebral ischemia revealed histologic predictors of further development of aortic events - aortic dilatation with and without development of aortic regurgitation.
Conclusions. This series of clinical cases raises the problem of indications for radical correction of the malformation, determination of histologic predictors of aortic events, revision of the criteria for the diagnosis of “aortic dissection” – consideration of such factors as laminar necrosis of the aortic wall, genetic markers associated with the development of aortic events may be useful in improving the long-term results of management of patients with type A aortic dissection.

The aim of the research. Determination of the effect of the plant extract «Brain-Profit» on spatial memory in rats using the cerebral ischemia model.
Materials and methods. The experiments were conducted on male Wistar rats.The first group consisted of sham-operated rats, the second group consisted of rats with cerebral ischemia, and the third and fourth groups consisted of rats with cerebral ischemia that received «Brain-profit» (100 mg/kg) and standardized Ginkgo biloba extract (50 mg/ kg) (EGb), respectively.
The effect of the extract on spatial memory in rats was evaluated using the 8-arm maze method.
Pathomorphological studies of rat brain samples were performed using light microscopy.
The brain content of bdnf was determined using the ELISA method. The antioxidant status was studied in brain tissue by the activity of antioxidant enzymes – superoxidismutase (SOD), catalase, and the content of lipoperoxidation products – malodialdehyde (MDA).
Results. The administration of the extract to rats with brain ischemia had a nootropic effect: the number of errors in reference and working memory was 2,9 and 6,5 times lower, respectively, compared to the control. In the morphological study, the degree of hippocampal damage was less in the experienced rats compared to the control.
Administration of «Brain-profit» and Egb to rats increased the content of bdnf in the hippocampus by 48% and 28%, respectively, compared to the control.
The SOD and catalase activities were 82% and 36% higher, respectively, and MDA content was 30% and 32% lower, respectively, compared to the control.
Conclusion. The «Brain-profit» has a positive effect on spatial memory in rats with cerebral ischemia. The extract increases the content of bdnf in the hippocampus, enhances the antioxidant potential, and prevents neuronal damage. The nootropic effect of the extract is due to the neurotrophic, neuroprotective, and antioxidant actions of the biologically active substances.

The aim of the research. To determine the contribution of genetic factors to the development of central venous thrombosis (CVT), as well as to identify changes in the biotransformation system of drugs used for its treatment and secondary prevention.
Materials and methods. The study included 30 people: patients with clinical signs suspicious for CVT, as well as patients with stroke of unknown etiology. To verify CVT, computed tomography of the brain with bolus intravenous contrast was performed. In 11 people with confirmed CVT, a genetic study of the hemostasis system and the biotransformation and detoxification system was performed to select individual therapy.
Results. The study found that all patients with verified CVT (n = 11) had polymorphisms in the genes of the hemostasis system. The most common polymorphisms were those of the plasminogen activator inhibitor PAI-1 (10 patients out of 11) and methylenetetrahydrofolate reductase (11 patients out of 11) genes. All patients with confirmed CVT underwent a genetic study of the detoxification and biotransformation system. This analysis allowed: 1) to determine the type of warfarin metabolism, which helped to personalize the initial dose of this drug, minimizing adverse events; 2) to determine the necessary drug (acetylsalicylic acid/clopidogrel) for secondary prevention of CVT in cases of thrombus regression. Thus, aspirin resistance was verified in 4 patients; allelic variants of CYP2C19 were detected in 5 patients, determining low enzymatic activity of cytochrome and, as a result, leading to a decrease in the antiplatelet effect of clopidogrel.
Conclusion. The study of hemostasis system polymorphisms confirms the theoretical and practical significance of genetic testing in patients with CVT. The study of the detoxification and biotransformation system allows for a personalized approach to treatment and reduces healthcare system costs aimed at combating undesirable effects of therapy, confirming the economic significance of the analysis.

The aim of the study is to determine the relationships between immunogenetic parameters in patients after endoprosthetics of large joints with primary osteoarthritis and to identify prognostic criteria for the development of periprosthetic infection.
Materials and methods. The study included 182 unrelated patients of middle (45–59) and elderly (60–74) age with primary osteoarthritis of large joints stage III who underwent total joint arthroplasty. Group 1 (n = 92) – patients with uncomplicated course. Group 2 (n = 90) – patients with development of periprosthetic infection. Control group – 92 practically healthy individuals. Research methods: clinical; laboratory (immunological – determination of IL-2, IL-4, IL-6, IL-17A, TNFα, IFNγ; genetic – polymorphism of the gene IL-2 (T330G), IL-4 (C589T), IL-6 (C174G), IL-17A (G197A), TNFα (G308A)); instrumental (radiography). Statistical processing of the research results was carried out using the IBM SPSS Statistics Version 25.0 software package (IBM, USA).
Results. The normalized importance was 54,2% for the IL-2 gene SNP (T330G), 100% for the IL-4 gene SNP (C589T), 24,5% for the IL-6 gene SNP (C174G), 13,7% for the IL-17A gene SNP (G197A), and 59,6% for the TNFα gene SNP (G308A). The prediction accuracy of the prognostic model was 97,3%, sensitivity 96,7%, specificity 97,8%, p < 0.001.
Conclusion. The interactions of immunogenetic indicators revealed the prognostic value of determining the SNP of genes of immunoregulatory molecules in predicting periprosthetic infection in patients after endoprosthetics of large joints in primary osteoarthritis, without a significant decrease in the significance of the prognosis, both in the complex (IL-4 (C589T) x TNFα (G308A) x IL-17A (G197A) x IL-2 (T330G) x IL-6 (C174G), and in their more simplified interactions – IL-4 (C589T) x TNFα (G308A) and IL-4 (C589T) x TNFα (G308A) x IL-2 (T330G).

The aim of the research. Is to assess the frequency of postmastectomy pain syndrome in patients with breast cancer who underwent radical mastectomy at the Moscow Clinical Scientific Center n. a. A.S. Loginov of the Moscow Department of Health.
Materials and methods. A retrospective, single-center, cohort study included 252 patients who underwent various modifications of radical mastectomy. Patients were surveyed after three months after surgery. Pain intensity was assessed using a Numerical Rating Scale (NRS 0-10), and the neuropathic component was identified using the painDETECT questionnaire. The obtained results were analyzed. The descriptive statistics of the data are presented in the format Me [Q1; Q3], where Me [Q1; Q3] represents the median and interquartile range.
Results. PMPS was diagnosed in 78 patients (30.95%). The median pain intensity was 5,0 [4,0; 6,0] points. The pain was most often described as aching, less often bursting or burning, localized in the area of the postoperative wound and axillary region. The median score on the painDETECT neuropathic pain scale was 15 [7,0; 18,0] points. The syndrome developed after all types of mastectomies, but the groups were not comparable in size to establish a statistically significant relationship with the surgical technique.
Conclusion. The study demonstrates that approximately one-third of patients (30,95%) develop postmastectomy pain syndrome after radical mastectomy, and its occurrence does not show a clear dependence on the specific modification of the surgical technique used. Clinically, this pain syndrome is characterized by predominantly moderate intensity and has a pronounced neuropathic component.

The aim of the study: to study the clinical features of anxiety disorders in patients living in the TransBaikal Territory who received inpatient treatment in 2023–2024.
Materials and methods. The study was conducted on the basis of the Regional Clinical Psychiatric Hospital named after V.H. Kandinsky. The inpatient charts of patients who were treated in the psychotherapy department in 2023–2024 were analyzed using a continuous method. 66 case histories of patients undergoing inpatient treatment for anxiety disorders were selected as the material for the study. Information was obtained from the hospital patient's charts by copying the data into a pre-prepared questionnaire.
The results of the study. Among the patients, 43,9% (29 people) lived in Chita, and the remaining 56,1% (37 people) were residents of 19 districts of the Trans-Baikal Territory. The majority of patients (80,3%) were women, while men accounted for 19,7%. More than half of the patients (51,5%) had secondary or specialized secondary education. 39 patients (59,1%), before being admitted to a psychiatric hospital, contacted therapists and neurologists about somatovegetative manifestations of anxiety disorders. The distribution of patients according to the severity of anxiety was as follows: the largest group consisted of people with moderate anxiety, and the smallest – with its mild manifestations. It was revealed that the severity of anxiety disorders did not depend on gender, level of education, social status. It was found that patients who were admitted to a psychiatric hospital for the first time had more anxiety than patients with repeated hospitalizations.
Conclusion. The results obtained indicate the need to improve the timely diagnosis and treatment of anxiety disorders in order to prevent their chronic course and the formation of comorbid psychiatric and somatic pathology.

The article describes a novel software application for assessing cardiovascular disease risk factors. The underlying intelligent model was trained on a dataset of over 5 000 shift workers from the fuel and energy industry operating in the Far North. The software incorporates explainable artificial intelligence (XAI) for enhanced interpretability, offering: feature importance plots to identify key predictive variables, local explanations for individual case predictions, error analysis capabilities, and interactive visualization tools.

Objective of the work: conducting a histological study of heart valve bioprostheses (HVB) with varying degrees of structural abnormalities to identify key mechanisms of infective endocarditis (IE) pathogenesis and determine morphological predictors of its development.
Methods and materials of the study. In this work, a comparative analysis of three groups of explanted xenopericardial bioprosthetic heart valves (BHVs) of the aortic and mitral positions, differing in the degree of preservation of the endothelial coating and the structure of the stromal leaflets was performed:
1. Intact BHVs (control group).
2. BHVs with minimal structural damage.
3. BHVs with pronounced destructive changes.
Results. Against the background of a tendency to increase the number of patients with implanted BHVs for acquired heart defects (AHDs) and a statistically significant increase in antibiotic resistance of pathogenic microorganisms, cases of IE of bioprostheses of various etiologies are becoming an increasingly frequent and formidable complication. Infective endocarditis of bioprosthetic heart valves is a serious complication initiated, as a rule, by a violation of the integrity of the endothelial monolayer, which performs barrier and thromboresistant functions. In recent years, there has been a steady increase in the number of patients with prosthetic valves, which, combined with the global problem of antibiotic resistance, makes the study of IE of the BCS particularly relevant. This study focuses on a detailed analysis of the histological features of bioprostheses demonstrating varying degrees of degenerative changes in order to identify morphological patterns associated with the development of this pathology.
Conclusion. A deep analysis of structural rearrangements of the BCS tissue will not only predict the risk of developing infective endocarditis, but also identify key factors that determine the vulnerability of prostheses to microbial colonization and subsequent infectious complications.

Brain death in children after clinical death is one of the most complex and urgent problems of modern pediatric intensive care. Immaturity of the nervous system, high metabolic activity, functional instability of the blood–brain barrier, and incomplete myelination determine the increased vulnerability of the child’s brain to ischemia and hypoxia. This article reviews the main pathogenetic mechanisms: primary (global ischemia, energy deficit, ion imbalance, excitotoxicity), secondary (mitochondrial dysfunction, reperfusion injury, oxidative stress, blood–brain barrier disruption, neuroinflammation), as well as different forms of cell death (apoptosis, necrosis, pathological autophagy). Particular attention is paid to the morphological consequences for the developing brain, including white matter injury, delayed myelination, and loss of neuronal networks. In children, the transition from reversible to irreversible damage occurs faster than in adults, which significantly complicates prognosis and therapeutic interventions. Current understanding of the molecular and morphological mechanisms of brain death has practical significance for improving diagnostics, prognosis, and treatment in pediatric intensive care.

Breast cancer is the most common malignant tumor in women. Breast cancer screening plays a key role in the it’s early detection, but i effectiveness of screening depends on many factors.
Objective. To summarize the results of modern studies on the effectiveness of breast cancer screening, to identify contradictions in its implementation.
Materials and methods. The systematic review of original publications and reviews was performed. The study included publications in the PubMed, eLIBRARY and Google Scholar databases for the period 2020– 2025, using the keywords "breast cancer", "screening", "screening effectiveness".
Research results. The article provides a detailed description of the effectiveness of diagnostic methods that have been proposed at different times as screening methods: breast self-examination, clinical breast examination, breast ultrasonography, mammography, tomosynthesis, breast magnetic resonance imaging. According to the recommendations of the World Health Organization, the European Society for Medical Oncology, the National Comprehensive Oncology Network, and the Russian Association of Oncologists, the main method of breast cancer screening for women aged 40–74 is mammography, performed every 2 years or annually. The contradictions of screening are caused by the possible occurrence of psychological stress, the risk of obtaining an incorrect conclusion, which is associated with the imperfect accuracy of mammography. This requires additional costs for additional examination and retreatment of non-neoplastic diseases. In addition, there is a possibility of implementing interval breast cancer between screening rounds, which is prognostically more unfavorable. To achieve the main goal of screening, it is necessary to adhere to the recommended breadth of population coverage, which is not observed in many countries of the world due to low compliance of the population with medical services, insufficient awareness.
Conclusion. Thus, despite significant success in the implementation of breast cancer screening, there are still unresolved contradictions. They can be eliminated by conducting further research to increase the effectiveness of screening programs and improve the quality of medical care.

Adrenocortical cancer is a rare and highly aggressive tumor of the adrenal cortex, which is most often diagnosed in advanced stages, resulting in an unfavorable prognosis for most patients.
This article describes a clinical case of hormone-active adrenocortical cancer of the left adrenal gland in a young woman. The patient had symptoms of hypercorticism (dysplastic obesity, bluish-purple striae, hypertension, diabetes mellitus, amenorrhea, hirsutism). An examination at the outpatient stage revealed an increased level of cortisol in daily urine >100 micrograms / day, an ultrasound of the abdominal cavity organs in the projection of the left kidney with the size of 200*129*195 mm, with fuzzy uneven contours. Ultrasound signs of multiple focal liver formations (probably mts). An additional examination by an endocrinologist is recommended, but the patient did not seek advice.
After 5 months, due to the increased symptoms of hypercorticism and the appearance of abdominal and lumbar pain, the patient urgently went to the hospital on duty. Where the additional examination was carried out: a laboratory study aimed at detecting hormonal disorders and topical diagnostics (MSCT of the thoracic and abdominal organs – in the projection of the left adrenal gland, and the upper pole of the left kidney, the formation is determined by the size of up to 22*12*10 see, secondary damage to the liver, lungs, and lymph nodes).
The patient was consulted by an oncologist at an oncological dispensary. Surgical treatment is not indicated for the patient, palliative treatment is recommended.
6 months after the onset of symptoms, the patient develops hepatic-renal insufficiency, cerebral edema and death of the patient occurs.

Atypical hemolytic-uremic syndrome (aHUS) is a serious problem in pediatrics and pediatric nephrology due to its severe course, tendency to progression, high mortality, and unresolved issues of early diagnosis and therapy. This circumstance dictates the need to improve existing diagnostic approaches and allows timely detection of aHUS and initiation of treatment at an early stage, which will significantly increase the chances of a favorable outcome. This publication presents 2 clinical cases of aHUS associated with antibodies to factor H in patient K., 4 years old, and patient U., 5 years old, who were treated at the state budgetary healthcare institution Children's Regional Clinical Hospital of the Ministry of Health of the Krasnodar Territory. Both children were admitted to the aHUS clinic, but genetic studies have not revealed mutations in specific genes associated with this disease. An increased titer of antibodies to factor H was found, which may indicate an acquired form of thrombotic microangiopathy. Positive dynamics was observed against the background of complement inhibitory therapy

Cockayne syndrome (CS) is a rare autosomal recessive neurodegenerative disorder associated with impaired DNA repair, developmental delay, and multisystem involvement. This article presents a rare clinical case of type II CS in a child with a confirmed ERCC6 gene mutation and a severe disease course. Symptoms manifested in the neonatal period and progressed with profound neurological deficits, sensorineural hearing loss, ophthalmologic disorders, epileptic syndrome, and persistent malnutrition. A distinctive feature of this case is the unusually long survival (up to 17 years), which is exceptional for CS type II, typically associated with a poor prognosis. The diagnosis was confirmed by molecular genetic testing, and neuroimaging revealed characteristic brain abnormalities. The patient received supportive care based on a multidisciplinary approach, including nutritional, symptomatic, antiepileptic, and palliative treatment. The condition remained stably severe and required continuous medical supervision. This case emphasizes the importance of early diagnosis, ongoing multidisciplinary management, and clinical vigilance in children with rare neurodegenerative disorders.

Duchenne muscular dystrophy is the hereditary progressive neuromuscular disease associated with mutations in the DMD gene encoding dystrophin protein and is characterized by striated muscles and cardiomyocytes impairment. It is X-linked recessive disorder and more prevalent in males. Females are carriers of the pathological mutation. It leads to impediment to diagnosis of this disease in women. Mild and severe clinical manifestations can also appear in women and they are attributable to chromosomal aberrations on the short arm of X-chromosome (Xp21.2) and skewed X-chromosome inactivation. The article presents a case of Duchenne muscular dystrophy in a girl with a nonsense mutation in the DMD gene. Primary diagnosis was suspected by gastroenterologist due to elevated levels of creatine phosphokinase and transaminase. The importance of diagnosis in preclinical stage of the disease is highlighted, moreover it became significantly relevant with appeared therapeutic options for patients with this mutation.

The article is devoted to a rare pathology of the small intestine, which is extremely difficult for preoperative diagnosis. Most often, the disease manifests itself as a result of complications, acute intestinal obstruction, intestinal perforation or intestinal bleeding. The case of own observation and successful treatment of small intestine leiomyoma complicated by intestinal obstruction is given. A review of the literature devoted to the discussion of the problems of diagnosis and therapeutic tactics in this pathology has been conducted. Early diagnosis of leiomyomas is very difficult. When intestinal dyspepsia occurs, one of the most effective diagnostic methods is MSCT of the abdominal organs. In case of complications, an emergency operation is indicated, the volume of which is determined individually.

A review of the literature is presented with a clinical example of poisoning with a mixture of psychotropic substances such as methadone and tetrahydrocannabinol, complicated by toxic pulmonary edema.