On January 1, 2026, Vladimir Petrovich Fisenko, a renowned Russian scientist, clinical pharmacologist, recipient of the Lenin Komsomol Prize, Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, and Academician of the Russian Academy of Sciences, celebrated his 80th birthday.
On February 12, 2026, the 85th anniversary of the largest scientist, a unique world-renowned specialist in the field of endocrinology, an experienced organizer of healthcare and medical science, a talented teacher, a Hero of Labor of the Russian Federation, a full holder of the Order of Merit for the Fatherland, a laureate of the State Prize of the Russian Federation in the field of science and technology, a laureate of the Government of the Russian Federation in the field of science and technology, laureate of the Government of the Russian Federation Prize in education, Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences Ivan Ivanovich Dedov.
Currently, immuno-oncology is a rapidly developing field of medicine, primarily due to the integration of achievements in molecular biology and biotechnology (creation and production of modified cells and effector molecules), immunological physiology (understanding of subtle mechanisms of regulation of immune functions) and clinical medicine (adequate accompanying therapy, allowing manipulation of the patient’s immune system). A large number of tumors overexpress tumor-associated gangliosides (sialylated glycosphingolipids). For example, GD3, GD2 and GM2 are overexpressed in melanoma and neuroblastoma cells, increased expression of GD1a, GM1, GM2 is shown in carcinoma cells, GD2 is expressed by soft tissue sarcoma, osteogenic sarcoma and small cell lung cancer cells. The ratio of the number of gangliosides varies from one tumor type to another. In addition, gangliosides are found in neoplastic tissues that are not characteristic of normal transformed cells of this tissue. In particular, one such ganglioside is GD2. In normal cells, the expression of this ganglioside, as well as that of GM2, is restricted to nerve cells, but in the case of cancer transformation they are found in cells of malignant tumors. Numerous studies have shown that tumor-associated gangliosides arising from oncogenic transformation play a key role in invasion and metastasis of a number of tumors and induce tumor-associated angiogenesis. First of all, it has been established that tumor cells differ in the composition of gangliosides. the ganglioside composition of metastasis cells differs from the cells of the primary tumor focus and is characterized by a decrease in the content of complex gangliosides. Due to its high level of expression in a number of tumors and limited expression in normal tissues, ganglioside GD2 can be considered as an ideal potential target for the development of anti-tumor immunotherapies.
Background. An algorithm for the personalized selection of SSRIs based on pharmacogenetic testing is currently available. Personalization algorithms for adults are not applicable to teenagers. Previously, contradictory results were obtained regarding the association of “ultrarapid” CYP2C19 metabolism and poorer tolerability of sertraline and escitalopram. Our aim was to assess the relationships between CYP2C19*2, *3, and *17 polymorphisms and early adverse drug reactions to sertraline among adolescents with depressive episodes and suicidal intentions. Methods. Study design: observational prospective single-center. The study included 133 adolescents (89% female) with a depressive episode and suicidal tendencies. All patients received sertraline. On day 7, the safety of pharmacotherapy was assessed using the Antidepressant adverse drug reactions checklist. Each patient underwent genetic testing for CYP2C19*2, *3, *17. Statistical processing of the results was carried out using IBM SPSS Statistics 26.0. The safety of sertraline was analyzed depending on the carriage of CYP2C19 polymorphisms, the type of CYP2C19 metabolism, as well as depending on additional pharmacotherapy. Results. 96 patients had “normal” CYP2C19 metabolism, 27 had “intermediate” metabolism, 8 — “ultrarapid” metabolism, and 2 — a “poor” metabolism. There were no significant associations of the number of ADRs, as well as the frequency of individual ADRs, depending on the type of CYP2C19 metabolism. Carriage of CYP2C19*17 (CT+TT genotypes) was significantly associated with a large number of somatic and vegetative adverse drug reactions on day 7 (2 (1; 3) vs. 1 (1; 2); p = 0.017). On day 7, carriers of CYP2C19*2 (genotype GA+AA) were more likely to complain of sleep disorders (13 (46.4%) vs. 28 (26.7%); p = 0.044) and tremor (7(25%) vs. 9 (8.7%); p = 0.018) compared with homozygotes GG. Conclusion. Carriage of the CYP2C19*17 was significantly associated with an increase in somatic and vegetative ADRs frequency. This result is paradoxical, as carriage of CYP2C19*17 is more likely to lead to accelerated metabolism of sertraline. Carriage of the CYP2C19*2 was only associated with a higher frequency of sleep disturbances and tremor.
This review systematizes modern bioengineering strategies for modeling tissue barriers, neurovascular unit (NVU) and perivascular unit (PVU) for translational neuroscience. The aim is to provide a critical analysis of the current understandings of neuroplasticity, organization of NVU, PVU and blood-brain barrier as well as advantages and limitations of currently available in vitro microphysiological models. It is clear that, despite progress in replicating three-dimensional architecture, the next key challenge is to imitate the temporal dynamics of histogenesis (angiogenesis, barrierogenesis, neurogenesis). This defines the transition towards the development of a novel class of 4D models capable of spatiotemporal self-organization. The analysis reveals the necessity to adapt model complexity to the target function: highly complex systems are a priority for fundamental research into plasticity and pathogenesis of nervous system disorders, while standardized platforms are well-suited for high-throughput pharmacological screening. It is concluded that creating relevant, validated platforms remains a critical interdisciplinary task. This will help bridge the gap between preclinical and clinical research, enhancing the reliability of studying pathological mechanisms and the preclinical evaluation of therapeutic agents.
On February 11, 2026, Natalia Valentinovna Polunina, a renowned scientist, an outstanding specialist in public health and healthcare organization, a Doctor of Medical Sciences, Professor, and Academician of the Russian Academy of Sciences, celebrated her 80th birthday.
Background. The continuing increase in the prevalence and severity of allergic diseases determines the relevance of the search for new approaches to their treatment and prevention. One of the leading areas is the study of the epithelial permeability role, including disorders in the cytochrome system that contribute to the formation of increased epithelial permeability and the development of allergies. Aims — to determine the role of the CYP3A4 gene polymorphism (rs2740574) in the development of increased epithelial permeability in children with food allergy to cow’s milk (CMA). Methods. Observational cross-sectional study of infants with a verified diagnosis of food allergy to cow’s milk (main group, n = 30). The study period was from 01.12.2023 to 30.12.2024. The target indicator of the study was the CYP3A4*1B polymorphism (rs2740574; c.-392CT) of the CYP3A4 gene (rs2740574) in children with CMA in blood lymphocytes and the level of cytochrome P450 3A4 (CYP3A4) in the serum. Additional indicators were the intestinal permeability marker zonulin in the blood serum and feces. Statistical analysis of the results - the difference in the distributions of polymorphic variants between the samples using Fisher’s exact test. Pairwise comparison of genotype and allele frequencies in the groups of patients and healthy people was performed using the chi-square test for contingency tables with Yates’ correction for continuity. The data of the variables are presented as the median and quartiles (Me (Q1; Q3)), the nonparametric Mann–Whitney test (U) was calculated to compare quantitative indicators. Differences are significant at p 0.05. Correlation analysis was performed to determine linear relationships between quantitative and between quantitative and qualitative binary indicators. Results. A statistically significant increase in the frequency of the pathological allele G in patients of the main group by 2.47 times was obtained (χ2 = 6.173; p = 0.001). Serum zonulin levels did not show statistically significant differences in patients with CMA compared to the group of healthy children (U = 0.065), but were statistically significantly higher in the group of children with skin manifestations of CMA compared to patients with isolated gastrointestinal manifestations (144.33 ng/ml (Q1–Q3: 126.32–151.78) and 118.78 ng/ml (Q1–Q3: 108.67–136.24) respectively; p 0.05). The fecal zonulin level in our study was significantly 1.9 times higher than in the group of healthy children, U = 0.0025, regardless of the clinical phenotype of CMA (1.39 ng/ml (Q1–Q3: 1.18–1.61) and 1.45 ng/ml (Q1–Q3: 1.14–1.58) respectively; p 0.05). There were no statistically significant (p = 0.071) differences in the CYP3A4 content in the serum of PA patients (Me = 0.18 ng/ml; Q1–Q3: 0.13–0.33) and children in the control group (Me = 0.17 ng/ml; Q1–Q3: 0.12–0.20). The conducted correlation analysis showed a significant association of the 392G allele of the CYP3A41B gene with changes in the level of all determined indicators. Conclusions. The results indicate the contribution of cytochrome system disorders in children with increased epithelial permeability. Understanding the molecular mechanism responsible for epithelial barrier defects is important in developing new treatments for food allergies and allergopathology.
Background. Neuronal damage is an important component of the pathogenesis of hemorrhagic stroke, but cellular and molecular markers of neuronal changes during the acute phase of the disease in humans have been poorly studied. One neuronal marker is the nuclear protein NeuN. Opinions on the use of NeuN as a marker of neuronal damage are contradictory. The heterogeneity of immunohistochemical (IHC) staining described in studies under various pathological and physiological conditions creates the basis for studying NeuN as a marker of the functional state of neurons in various diseases. This study aims to identify the distribution patterns of NeuN in the layers of the human cerebral cortex during the acute phase of hemorrhagic stroke. Aims — to identify the features of NeuN distribution in the layers of the human cerebral cortex in the acute phase of hemorrhagic stroke. Methods. A retrospective analysis of forensic medical examination materials was conducted from February to September 2019 and from January to February 2022. The study included cases in which the causes of death were: 1) non-traumatic subarachnoid hemorrhage (SAH group); 2) sudden cardiac death (SCD) or coronary artery disease (CAD) (control group). Standard histological processing was then performed with embedding in paraffin blocks, from which sections were prepared and stained with hematoxylin and eosin. Morphological examination of neurons was performed using immunohistochemistry with antibodies to the NeuN protein. Morphometry was performed on micrographs obtained using a scanner. Results. 16 cases were selected for the IHC study, 10 of which were SAH and 6 were SCD/CHD. In the SAH group there were 5 men and 5 women, median age — 62.5 (57.0–76.5), in all observations SAH was of basal localization. The control group included 3 men and 3 women, median age — 58.5 (46.0–73.2), in all observations the cause of death was sudden coronary death. As a result of comparison of SAH and control groups, the following significant results were obtained: in the first layer, there were more fully stained neurons in the SAH group than in the control group (22.9 ([13.6–46.4) vs. 0 [(0–6.9); p = 0.001); in the third layer, there were more unstained neurons in the SAH group than in the control group (22.7 ([16.8–37.8) vs. 5.4 [(0–9.5); p = 0.005). In the fifth layer, there were more neurons with stained nuclei but unstained cytoplasm in the control group than in the SAH group (42.3 ([28.1–73.6) vs. 22.4 [(8.6–35.8); p = 0.031). Conclusion. This study is the first to demonstrate an association between subarachnoid hemorrhage and changes in NeuN staining of neurons in human cerebral cortex. These results confirm that the use of NeuN immunohistochemical staining should not be limited to the detection of intact neurons.
On February 11, 2026, Amiran Shotaevich Revishvili, an outstanding scientist and a leading expert in surgical and interventional arrhythmology, a recipient of the USSR State Prize and the Russian Federation State Prize, a two-time recipient of the Russian Federation Government Prize in Science and Technology, an Honored Scientist of the Russian Federation, a Doctor of Medical Sciences, Professor, and an Academician of the Russian Academy of Sciences, celebrated his 70th birthday.
On February 9, 2026, Mikhail Alexandrovich Piradov, an outstanding Russian scientist with a global reputation, a leading expert in neurology, neuroresuscitation, and neurorehabilitation, and a two-time recipient of the Government of the Russian Federation Prize in Science and Technology, celebrated his 70th birthday.
Background. Among the factors contributing to unsuccessful treatment outcomes in patients with drug-resistant pulmonary tuberculosis-particularly multidrug-resistant tuberculosis (MDR-TB)-considerable importance is attributed to interindividual variability in pharmacological response, which is largely determined by patients’ genetic characteristics. Recent advances in MDR-TB chemotherapy are closely associated with the introduction of bedaquiline. Bedaquiline is primarily metabolized by the cytochrome P450 enzyme CYP3A4; however, the impact of CYP3A4 gene polymorphisms on bedaquiline pharmacokinetics and treatment efficacy in patients with drug-resistant TB remains insufficiently studied. Personalized therapy based on a patient’s genetic profile represents a key strategy for optimizing dosing regimens, improving treatment efficacy, and reducing the risk of developing further drug resistance. Aims — to evaluate the influence of CYP3A4 polymorphic alleles (*1B/rs2740574 and *1G/rs2242480) on bedaquiline pharmacokinetic parameters and chemotherapy efficacy in patients with drug-resistant pulmonary tuberculosis, including those with MDR-TB. Methods. A prospective, observational cohort study was conducted involving 143 patients with pulmonary tuberculosis and confirmed drug-resistant Mycobacterium tuberculosis (including MDR, pre-XDR, and XDR-TB) treated at the Central TB Research Institute (CTRIT), Russia, between 2022 and 2024 (66 women and 77 men). Three observation groups were formed based on genotype: Group 1 — wild-type CYP3A4*1 (n = 99); Group 2 — *1B (rs2740574) carriers (n = 10); Group 3 — *1G (rs2242480) carriers (n = 34). Genotyping was performed using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). Bedaquiline was administered as part of individualized chemotherapy regimens at a dose of 400 mg once daily for 2 weeks, followed by 200 mg three times weekly for up to 6 months. Bedaquiline pharmacokinetic parameters were assessed in 30 patients using high-performance liquid chromatography. Treatment efficacy was evaluated based on sputum culture conversion by month 6. Statistical analysis employed nonparametric Kruskal–Wallis and Mann–Whitney tests for group comparisons. Results. Patients carrying the CYP3A4 *1G (rs2242480) allele showed significantly higher bedaquiline exposure compared to wild-type individuals: AUC₀–₂₄ (49.06 vs. 41.99 µg·h/mL; p 0.05), Cmax (3.13 vs. 2.21 µg/mL; p 0.05), and AUC₀–₂₄/MIC ratio (196.24 vs. 167.94; p 0.05), suggesting reduced metabolic clearance. In contrast, the *1B variant was associated with lower AUC₀–₂₄. Although culture conversion rates at 6 months did not differ significantly (p = 0.87), a trend toward higher efficacy was observed in *1G carriers (95.8%) versus wild-type patients (84.5%). Conclusion. The CYP3A4 *1G (rs2242480) polymorphism is associated with decreased bedaquiline metabolism, leading to increased systemic drug exposure and a potential improvement in treatment response. These findings highlight the role of CYP3A4 genetics in bedaquiline pharmacokinetics and support the integration of CYP3A4 genotyping into personalized MDR-TB treatment strategies. The *1G allele may serve as a promising pharmacogenetic biomarker for optimizing bedaquiline dosing in drug-resistant tuberculosis.
Addressing the problem of illicit drug trafficking for non-medical use remains a global challenge for the global community, and remains relevant in the 21st century. Determining global, national, and regional trends in narcotic and psychotropic substance consumption, assessing the epidemiological situation (incidence, prevalence), harm structure, and law enforcement indicators (seizures, trafficking routes) are necessary for developing a systemic response to drug-related violence at all levels. This article explores the rationale for transitioning the Kabardino-Balkarian Republic’s anti-drug policy from a reactive model to proactive management based on the principles of a cybernetic viable system and anticipatory governance. Based on an analysis of global and regional trends, it has been established that the drug situation has entered a synthetic-polytoxicological phase, with a predominance of preclinical risk, an increase in acute poisonings, and a lack of synchronicity between law enforcement and medical indicators. The study’s materials included regional administrative reports (Forms No. 11 and No. 37) for the period from 2014 to 2024, records of the Anti-Drug Commission and the Ministry of Internal Affairs of the Kabardino-Balkarian Republic, and structured tables on mortality and poisoning. Descriptive statistical methods were used, including comparative-analytical, structural-functional, and modeling research methods. The study demonstrated the effect of asymmetric adaptation — the ability of the illegal market to change chemical formulas and distribution channels faster than control measures can be updated. The aim of the study was to justify the need to implement a three-loop anticipatory management system: monitoring predictive patterns, scenario-based predictive assessment of probabilistic trajectories, and adaptive adjustment of measures in real time. According to the researchers, the proposed digital toxicology surveillance architecture will reduce the time lag between risk and response, shift from recording consequences to managing probabilities, and increase the resilience of the regional healthcare system to new forms of drug addiction.
Background. Oligometastatic disease (OMD) represents an intermediate state between localized and disseminated cancer, characterized by a limited number of metastases (typically 1–5). Stereotactic ablative radiotherapy (SABR) is a precise local treatment modality capable of delivering ablative doses to metastatic lesions of various sites with minimal toxicity. Despite growing clinical evidence, the impact of primary tumor type and metastatic site on survival outcomes after SABR remains insufficiently explored. Aim — to evaluate overall survival (OS) and progression-free survival (PFS) in patients with oligometastatic disease treated with SABR, and to analyze the association of these outcomes with the localization of the primary tumor and distant metastases. Methods. This retrospective cohort study included 68 patients with 1–5 metastatic lesions treated with SABR at the European Medical Center (Moscow) between 2015 and 2024. Total radiation doses ranged from 16 to 60 Gy in 1–7 fractions, depending on tumor histology and anatomic site. The median follow-up was 51 months (range: 11–75). Forty-nine patients (72%) received systemic therapy — chemotherapy, immunotherapy, or targeted therapy — selected individually according to treatment guidelines for each tumor type and clinical status. Treatment toxicity was evaluated according to CTCAE v4.0. Results. The 1-, 3-, and 5-year OS rates were 97.1%, 83.6%, and 73.4%, respectively; corresponding PFS rates were 57.3%, 36.6%, and 28.0%. Patients with bone metastases demonstrated a tendency toward improved OS (p = 0.049), whereas the localization of the primary tumor had no significant impact on survival (p = 0.41). Grade ≥ 2 toxicity occurred in 5.8% of patients. Conclusions. SABR was associated with favorable survival outcomes and acceptable tolerance in patients with oligometastatic disease. The site of metastases may represent a prognostic factor influencing long-term outcomes. Further prospective studies are warranted to validate these findings and to refine patient selection criteria for SABR as part of combined-modality treatment.
Background. The main characteristics of augmented reality (AR) and virtual reality (VR) technologies are immersion, presence, and interaction, which are defined by the technology used and individual perception. AR and VR automate processes and assist in areas that require repetitive tasks, particularly in medical education and training, including surgery. Recently, VR and AR have significantly entered the fields of maxillofacial surgery and dentistry, allowing doctors to create 3D models and conduct virtual surgeries, as well as train specialists on virtual models. These new methods require assessment of their usability and accuracy. Aims — to evaluate the accuracy of our developed augmented reality system for creating surgical access in radicular cysts of the jaws. Methods. We conducted a clinical comparative study to assess the accuracy of our developed augmented reality system using HoloLens software and Medgital Vision Editor for creating surgical access in radicular cysts of the jaws. Forty patients were selected and divided into three groups: Group 1 (n = 10) consisted of patients operated on using a surgical template; Group 2 (n = 20) consisted of patients operated on using a virtual template and augmented reality (AR); Group 3 (n = 10) consisted of patients operated on using the freehand method. In all three groups, preoperative computer modeling for surgical access, with a diameter of 5 mm, corresponding to a bone trephine, was performed based on CT scans of the jaws and intraoral scanning. Subsequently, all patients underwent surgical access to the cyst using a surgical trephine, followed by cystectomy and closure of the surgical wound. After the surgical intervention, all patients underwent a follow-up CT scan. The obtained CT data (DICOM files) were uploaded into Exoplan 3.0 software. We assessed the differences between the planned preoperative computer modeling and the actual surgical access performed. Furthermore, we analyzed the deviation angles of the formed surgical access and the depth preparation deviations. A statistical analysis of the obtained data was conducted. Results. The analysis of the angle of deviation of the formed surgical access was 2.82, 2.25, and 9.77 in Groups I, II, and III, respectively. Significant differences were established (p 0.001; method used — Kruskal–Wallis test). The analysis of the depth preparation deviation showed results of 0.53, 0.73, and 2.38 in Groups I, II, and III, respectively (p 0.001; method used — Welch’s F-test). The accuracy results of our augmented reality navigation system are comparable to the accuracy achieved with surgical templates and significantly surpass the results obtained with the freehand method. Conclusion. The accuracy of AR navigation is sufficient for clinical use, but some improvements are necessary.
An important problem remains drug addiction in the population of most countries, including residents of Russian regions. A significant transformation of the drug situation in the world is associated with changes in the motives for initiation and drug use, with the social portrait and lifestyle of drug and psychoactive substance users, and the composition of the substances taken. On the other hand, there is a weakening of social control institutions due to emerging trends in the “everyday” use of illegal substances. The authors noted that the trend of growth and transformation of drug addiction registered in the world community is also registered in the regions of Russia, the distinctive features of which are considered using the example of the Kabardino-Balkarian Republic. The purpose of the study was to analyze and summarize the causes of drug use in the world, country, region in order to establish emerging trends. Based on the results of the analysis of domestic and foreign sources, the researchers noted that scientists tend to divide the problems of drug addiction into “sectoral” aspects: medical, psychological, legal, pedagogical, sociological. The above determines the relevance of a systematic study of medical-social, medical-organizational and medical-legal aspects of combating illegal trafficking and non-medical use of narcotic drugs and psychotropic substances. As part of the review, the authors came to the conclusion that the multifaceted nature of the problems of drug addiction in society requires solving not individual, isolated, mainly departmental, regional, country problems, but a set of problems of drug addiction in society that have common features at all levels. Apparently, an important aspect is a comparative legal analysis of the emerging national anti-drug policy aimed at finding tools for its implementation in accordance with international principles, norms, country and regional specifics. The formation of a well-developed scientific methodology and effective measures aimed at managing the growing set of trends, potential threats and ways to eliminate the consequences of the addiction in society will allow forming the right anti-drug patterns.
Sarcopenia is defined as a decrease in muscle mass, strength, and function. The primary population affected by sarcopenia consists of elderly and old-aged individuals, which is caused by an imbalance between anabolic and catabolic processes in the muscles, leading to a reduction in their volume and function. Loss of muscle mass during aging due to chronic diseases has serious negative effects: development of weakness, inability to perform self-care, worsening of existing somatic pathology, and an increased risk of mortality. As the global elderly population continues to grow, a sharp increase in sarcopenia cases is expected. Currently, the prevalence of sarcopenia worldwide ranges from 10 to 27% among people aged 60 and older. Sarcopenia is classified into primary sarcopenia, which is considered an independent disease, and secondary sarcopenia, which occurs against the background of existing chronic illnesses. The diagnosis of sarcopenia is confirmed based on measurements of muscle mass, strength, and physical performance. Assessment of muscle mass is performed using dual-energy X-ray absorptiometry (DXA) and bioimpedance analysis (BIA) — these are the most common methods. Muscle strength is evaluated with handgrip dynamometry, while physical performance (daily activity) is assessed using specific tests: the Short Physical Performance Battery (SPPB) and the “Get Up and Go” test (Timed Up and Go, TUG).Special questionnaires also play a significant role in confirming sarcopenia: the SARC-F questionnaire for rapid screening of sarcopenia (SARC-F-Sarcopenia Fast), the “Sarcopenia and Quality of Life” (SarQol) questionnaire, and the short form of the International Physical Activity Questionnaire (IPAQ-SF).The aim of this work was to analyze the prevalence and role of non-instrumental methods in diagnosing sarcopenia based on data from literary sources in foreign and domestic bibliographic and abstract databases (PubMed, Science Direct, Google Scholar, Elibrary) from 2014 to 2024.
Background. Minimally invasive surgery (MIS) is widely used for pediatric intussusception, yet advantages over open laparotomy across key outcomes remain uncertain. Aims — compare outcomes of laparoscopic (including laparoscopic-assisted) versus open surgery in children with intussusception. Methods. PRISMA 2020 systematic review; searches in Medline/PubMed and eLibrary with no language/date limits, plus manual reference screening; last search September 15, 2025; inclusion—comparative clinical studies in patients 0–18 years after failed pneumatic/hydrostatic reduction or when contraindicated; exclusion — non-comparative case series/reports and studies without stratification by approach; risk of bias — RoB 2 (RCTs), ROBINS-I (observational); random-effects meta-analyses (RR, MD, 95% CI); certainty—GRADE. Results. 7 studies (1 RCT, 6 retrospective), n = 518 (MIS 281, open 237); complications — no difference (RR≈1.0; 95% CI: 0.5–1.9); bowel resection — no difference (RR 0.78; 95% CI: 0.45–1.33); recurrence — no difference (RR 1.29; 95% CI: 0.63–2.64); operative time — no difference (MD 0.8 min; 95% CI: –16.6 to 18.2); length of stay shorter with MIS (MD –1.25 days; 95% CI: –2.46 to –0.04); overall GRADE certainty low/very low. Limitations: predominantly retrospective designs with serious risk of bias, small samples, heterogeneity; protocol not registered (PROSPERO). Conclusions. MIS shows comparable safety and effectiveness to open surgery and is associated with shorter hospitalization without increasing complications or resections; further RCTs are warranted.
Background. To improve the effectiveness of measures to strengthen public health and prolong working life, it is necessary to systematically study the lifestyle of students as the future reproductive and economic potential of the country. Studying the socio-environmental risk factors that affect the development of diseases among students is essential for developing preventive measures to maintain and improve health. The obtained data on socio-environmental risk factors for the development of chronic non-communicable diseases should be taken into account when implementing corporate medical and preventive measures and developing individual programs for promoting a healthy lifestyle. Aims — to study the social and environmental risk factors that affect the development of diseases among students. Methods. In the Udmurt Republic, on the basis of the Federal State Budgetary Educational Institution of Higher Education “Izhevsk State Medical Academy” of the Ministry of Health of the Russian Federation, a study was conducted on the risk factors for the development of diseases among students using a questionnaire survey. A total of 351 students from the 5th and 6th years of the medical, pediatric, and dental faculties were surveyed, with a majority of female students (76.1%, 267) and male students (23.9%, 84) aged between 21 and 30 years. Results. Today’s youth is characterized by a high level of exposure to socio-related risk factors, which can lead to the development of chronic non-communicable diseases. Two-thirds of the respondents were satisfied with their living conditions, while less than half were satisfied with the environmental conditions. One-third of the respondents reported a lack of opportunities for physical activity and sports. Two-thirds of the respondents showed no interest in any leisure activities and did not see the need for health-promoting behaviors, despite being future healthcare professionals who play a crucial role in shaping healthy lifestyle habits among the population. Conclusions. The study showed the need to train specialists in higher medical educational institutions, along with teaching professional skills and abilities, to teach them the values of preserving their own health. It is necessary to monitor the social and environmental risk factors among students on a regular basis and to develop measures to promote healthy behavior.
Background. Clozapine is recognized as the most effective medication for treatment-resistant schizophrenia (TRS). However, the use of clozapine in clinical practice remains limited due to challenges related to its efficacy and safety. Pharmacogenetics may help enhance both the effectiveness and safety of its use. Aims — to analyze the role of polymorphic variants in genes associated with pharmacogenetic factors in the development of adverse reactions and the efficacy of clozapine therapy. Methods. We conducted a prospective pharmacogenetic study of the efficacy and safety of clozapine in patients with TRS (F20 according to ICD-10). The observation period was 28 ± 3 days. The primary endpoint was the change in the severity of psychopathological symptoms, assessed using the PANSS, CGI-S, and CGI-I scales. Treatment safety was evaluated using the UKU Side Effect Rating Scale. Genotyping was performed using the real-time PCR method. Results. The study included 61 patient receiving treatment in a psychiatric inpatient facility. According to our data, clozapine efficacy was associated with CYP2C9 rs1799853, DRD4 rs1800955, and ABCB1 rs1128503. The final clozapine dose was influenced by ABCB1 rs1045642, rs2032582, and rs1128503. Associations with safety were identified for CYP2D6 rs3892097 and rs1065852; CYP2D6 rs3892097; CYP2C19 rs4244285; CYP2C9 rs1057910; CYP3A4 rs2740574; CYP2C19 rs12248560; ABCB1 rs1045642, rs2032582, and rs1128503; HTR2A rs6313; DRD2 rs1800497 and DRD4 rs1800955. Conclusions. Our study revealed considerable interindividual variability in clozapine treatment outcomes among patients with TRS. Polymorphisms CYP2C9 and DRD4 were associated with improvements in negative symptoms, while ABCB1 variants showed the strongest impact, influencing both final clozapine dose and tolerability. Additional associations with CYP2D6, CYP2C19, CYP3A4, HTR2A, and DRD2 were observed for adverse drug reactions such as sedation, weight gain, memory impairment, and depression. These findings highlight the importance of pharmacogenetic profiling in optimizing clozapine therapy, though replication in larger and ethnically diverse cohorts remains necessary.
Postpartum purulent-inflammatory diseases remain one of the leading causes of maternal mortality, second only to extragenital pathologies and amniotic fluid embolism in frequency. According to several authors, the incidence of postpartum inflammatory diseases (PID) ranges from 2.0 to 54.3%, while in high-risk women, the frequency of such complications reaches 80.4%. Objective — to conduct a systematic review and meta-analysis of current data on the effectiveness of organ-preserving surgical methods for treating obstetric peritonitis after cesarean section, with an evaluation of favorable outcomes regarding uterine preservation and postoperative complications (adverse events). This study presents a systematic review and meta-analysis of the effectiveness of organ-preserving metroplasty for obstetric peritonitis, conducted in accordance with the PRISMA 2020 international standards and GRADE criteria. The analysis included 12 studies (n = 1,386 patients) published since 2010, ensuring data completeness, reliability, and relevance. The results showed that the average clinical success rate of metroplasty was 79.96% (95% CI: 20.7–100.0%), with significant variability depending on the surgical technique. Classical methods demonstrated an efficacy of 85–100%, while innovative approaches (ultrasonic cavitation, local antibiotic therapy) showed only 33–70%. The hysterectomy rate as an adverse outcome was 20.04%, reaching 66.7% in some studies. The complication profile included: generalized peritonitis (33.64%), surgical site infection (14.04%), sepsis (6.13%), uterine suture dehiscence (11.38%). High heterogeneity (I²=97.41%) and signs of publication bias indicate the need for cautious data interpretation. The meta-analysis highlights the importance of strict patient selection for organ-preserving techniques and standardization of surgical protocols. The uniqueness of this review lies in its comprehensive analysis of complications and comparison of different metroplasty techniques, which is absent in similar studies. The findings may be used to develop clinical guidelines for reducing risks in organ-preserving surgeries during the puerperium.
