Rostov State Medical University

Background . Antimicrobial resistance (AMR) has high medical and social significance, as it is shaped by clinical, veterinary, agricultural, and environmental processes, as well as horizontal transfer of mobile genetic elements. Its analysis requires the assessment of individual resistance genes, experimental models, diagnostic approaches, as well as surveillance systems that track antibiotic resistance genes (ARGs) across human, animal, and environmental reservoirs. The aim of the study was to summarize data on experimental and computational models of ARG dissemination, characterize selected AMR markers, and evaluate current methods for their detection. Material and methods . A narrative review with a transparent search strategy and thematic synthesis was conducted. The search included PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar; the last search was performed on May 2, 2026. After full-text assessment, 46 sources were included in the review. Results. The review discusses blaCTX-M-15, blaNDM, blaKPC, blaOXA-23, floR and intI1 markers, as well as mobile genetic elements involved in their dissemination. It summarizes the strengths and limitations of in vitro models, gut models, mouse models, biofilm systems, mathematical modelling, AST, PCR/qPCR, WGS, mNGS, machine learning, and CRISPR-Cas12a diagnostics. Conclusion . CRISPR-Cas12a platforms may support rapid targeted screening of predefined ARGs but do not replace phenotypic susceptibility testing or genome-scale analysis. The most robust strategy is the integration of AST, WGS/mNGS, targeted molecular diagnostics, machine learning, and One Health surveillance.

Aim. To identify the clinical, diagnostic, structural, functional, and hemodynamic parameters of the heart in patients with idiopathic pulmonary arterial hypertension (IPAH) and pulmonary hypertension (PH) associated with heart failure (HF) of ischemic origin to improve early diagnosis and differentiation of PH in primary health care, as well as to evaluate the practical applicability of a questionnaire as a primary screening tool for PH. Material and methods. A total of 63 patients were examined. There were 32 patients with IPAH and 31 with HF-related PH. Following standard diagnostic methods were used: electrocardiography, echocardiography, chest X-ray, Holter monitoring, and laboratory tests. A specialized screening questionnaire developed by specialists at the Chazov National Medical Research Center of Cardiology was used for the early detection of PH. Final diagnosis was confirmed by transvenous right heart catheterization. Results. Patients with IPAH were younger and predominantly female. This group of patients demonstrated more pronounced PH, hypertrophy and dilation of the right ventricles with preserved left ventricular function. In the group of PH with HF of ischemic origin, significant left heart structural changes were observed, including increased left ventricular size and volume, decreased ejection fraction, and increased pulmonary wedge pressure. Conclusion. The study demonstrated significant clinical, anamnestic, and hemodynamic differences between various forms of PH, as well as the effectiveness of a screening questionnaire for the early detection of PH. This allows for optimized routing and improved prognosis for patients in primary care.

INTRODUCTION. The laparoscopic IPOM hernioplasty technique using the domestic composite prolenic mushroom shaped prosthesis with polytetrafluoroethylene coating technology has been developed for the correction of ventral hernias with orifices up to 4 cm. However, publications on the use of this technique in patients with morbid obesity are limited.The OBJECTIVE was the comparative evaluation of the results of using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating alone and in combination with bariatric intervention in patients with ventral hernias and morbid obesity.METHODS AND MATERIALS. The comparative study included 64 subjects with ventral hernias <4 cm and abdominal obesity. The body mass index (BMI) in the sample was ≥35 kg/m2. The patients were divided into 2 groups: group 1 (n=35) consisted of patients who underwent laparoscopic hernioplasty using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating (LLC «Icon Lab GmbH», Russia) composite endoprosthesis, and group 2 (n=29) consisted of patients whose hernioplasty was supplemented by bariatric intervention.RESULTS. Of the early postoperative complications: in 1 case, a hematoma was observed (in a patient of group 1), 1 case in each group – the appearance of seromas. Recurrence of hernia occurred in 1 case in a patient of group 2. Weight loss over 12 months of observation in group 2 of patients was noted to be up to 28 kg/m2, while in patients in group 1, on the contrary, an increase in body weight of 8–12 kg was recorded (p<0.05).CONCLUSIONS. Performing bariatric intervention does not increase the time of hernioplasty surgery, does not increase the percentage of postoperative complications, while contributing to a 25 % reduction in patients’ weight over a 12-month observation period. In the case of a combination of a small (W1) ventral hernia with morbid obesity, in our opinion, it is advisable to perform hernioplasty using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating, simultaneously with bariatric intervention.

Aim: to characterize specific metabolomic alterations associated with endometriosis, with a particular focus on neurotransmitter metabolism disturbances, and to assess their correlation with clinical manifestations as well as their longitudinal changes during hormonal therapy. Materials and Methods: a prospective comparative cohort study was performed. The study group included 60 reproductive-age female patients with histologically verified ovarian endometriomas who were administered progestogen therapy following surgical intervention. The control group comprised 30 female patients without endometriosis. Clinical symptomatology was evaluated using validated instruments (pain — PainDetect; fatigue — MFI-20 (The Multidimensional Fatigue Inventory); anxiety and depression — HADS (Hospital Anxiety and Depression Scale); gastrointestinal symptoms — GSRS (Gastrointestinal Symptom Rating Scale)). Plasma and urinary concentrations of amino acids and their derivatives, including metabolites of the kynurenine pathway, were quantified using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). Statistical analysis was carried out employing nonparametric methods. Results: patients with endometriosis exhibited significantly higher baseline pain, anxiety, and gastrointestinal symptom scores compared with controls (p<0.001). Notably elevated concentrations of kynurenic acid (1.82 [1.13; 2.31] μmol/L versus 1.05 [0.84; 1.80] μmol/L; p=0.001) and glycine (238.04 [221.59; 270.14] μmol/L versus 203.61 [99.75; 250.43] μmol/L; p=0.008) were documented in the endometriosis group. Over the course of hormonal therapy, significant reductions in kynurenic acid, glycine, glutamine, and picolinic acid levels were observed (p<0.05), concurrent with amelioration of gastrointestinal symptoms (p<0.001). Paradoxically, depressive symptomatology worsened significantly (p=0.017). A positive correlation was identified between changes in picolinic acid concentrations and the dynamics of fatigue severity (ρ=+0.28; p=0.03). Conclusion: endometriosis is associated with upregulation of the kynurenine branch of tryptophan catabolism and dysregulation of glycine homeostasis. Hormonal therapy partially ameliorates these metabolic derangements; however, it confers a concomitant risk of depressive symptom exacerbation. Picolinic acid emerges as a potential metabolic biomarker for monitoring therapeutic response. KEYWORDS: endometriosis, metabolomics, kynurenic acid, glycine, picolinic acid, hormonal therapy, depression, chronic pelvic pain. FOR CITATION: Dubrovina S.O., Berlim Yu.D., Kukes I.V., Aleksandrina A.D., Vovkochina M.A., Bogunova D.Yu., Gulyan M.V., Karachevskaya O.S. Metabolomic landscape of endometriosis: clinical-metabolic correlations and changes during hormonal treatment. Russian Journal of Woman and Child Health. 2026;9(2):98–106 (in Russ.). DOI: 10.32364/2618-8430-2026-9-2-2

Mineralocorticoid receptors (MRs) play a significant role in the pathogenesis of a number of internal diseases, including heart failure, hypertension, and chronic kidney disease. Their excessive activation contributes to the development of inflammation, fibrosis, tissue remodeling, and the development of cardiovacular-kidney-metabolic syndrome. The effectiveness of MR antagonism in promoting cardiac and renal protection has been confirmed by large experimental and clinical studies. However, there are significant differences in pharmacological properties between steroidal and nonsteroidal MR antagonists. This article presents the characteristics of MR antagonists registered in the Russian Federation, including their clinical effects, safety profile, and indications for use. Particular attention is paid to the drug selection algorithm, taking into account individual patient characteristics and the balance of potential benefits and risks. The material is based on current European and Russian clinical guidelines and is intended for practical use by internists in the management of patients with cardiovascular and renal diseases.