Objective: to investigate feasibility of using ultrasonography (US) to evaluate structural changes of salivary glands (SG) in patients with Sjögren's disease (SD).Material and methods. The study included 159 patients who were examined in V.A. Nasonova Research Institute of Rheumatology from 2016 to 2022 who met V.A. Nasonova Research Institute of Rheumatology 2001, and/or ACR 2012, and/or ACR/EULAR 2016 criteria for SD, and who had not previously received immunosuppressive therapy. All patients underwent a comprehensive classical examination (ophthalmological, dental, immunological) to diagnose SD. Disease activity was determined using ESSDAI index. US of the parotid gland (PG) and submandibular SGs was performed using a GE LOGIQ 9 device, and the images obtained were scored according to the OMERACT SGUS scoring system (SGUS SS).Results and discussion. All SGUS SS scores statistically significantly correlated (p<0.05) with mouth sicca symptoms, enlargement of PG, ESSDAI activity index, presence of lymphohistiocytic infiltrate and focus score in labial SG biopsy, and parenchymatous parotitis according to sialography. No significant correlation was found with the results of sialometry. There was a significant correlation between the changes detected by US and sialography (r=0.422; p=0.001). Considering the data obtained, the consistency of the results of the different examination methods was analyzed. Bland-Altman diagrams were created to reflect the dependence of the differences between the results of US and sialography. At various stages of the comparison, not all data points were within the standardized range. In addition, 5% of the parameters were not within the interval of two standard deviations. The Bland-Altman analysis revealed a systematic discrepancy indicating a low degree of agreement between the two methods for determining structural changes in SG. According to the ROC analysis, sensitivity of ultrasound was 94% and specificity 51%. The area under the curve (AUC) was 0.787 (95% confidence interval 0.700–0.875).Conclusion. SG US and sialography are not interchangeable, but complement each other in the assessment of SG structure. SG US is a safer and non-invasive method of SG examination that does not require contrast agent administration and is likely to play an important role in the dynamic monitoring of patients during the therapy. However, sialography is a more accurate method of diagnostics and assessment of the extent of SG lesions.

In recent years, the rapidly changing Arctic with melting ice and new discoveries of rich deposits has increasingly attracted the attention of the state and business. The transition to clean energy stimulates the growing demand for the most important metals, which are rich in the Arctic subsoil. The warming climate in the Arctic greatly facilitates the extraction of important mineral resources and the search for new deposits. The article shows the vital role that the Arctic Zone of Russia (AZRF) currently plays and will play in the future in the production and supply of strategic types of minerals and metals.

The objective : immunohistochemical and electron microscopic imaging of the SARS-CoV-2 coronavirus in lung, lymph nodes and kidney tissues of patients who died of COVID-19. Subjects and Methods . For immunohistochemical tests, specimens of sections of formalin-fixed and paraffin-embedded tissues of the lungs, lymph nodes and kidneys of patients who died from COVID-19 were used. Quantitative assessment of the SARS-CoV-2 viral load level was carried by the original RT qPCR and calculated by the formula: SARS-CoV-2 copy number/ABL1 х 100 copies, expressed as the ratio of the true number of SARS-CoV-2 cDNA copies per 100 copies cDNA of the ABL1 gene. For morphological tests, samples of native lung, lymph node and kidney tissues were taken. Results . Immunohistochemical and electron microscopic tests revealed particles of the SARS-CoV-2 coronavirus in the cytoplasm of endothelial cells of air-blood barrier of the lungs, the vascular glomerulus of the kidneys, in the cytoplasm of macrophages of the lymph node, and also in cytoplasm of lymphocytes in the lumen of lung capillaries.

An experimental in vivo model has been developed on the rabbit mandible to study reparative regeneration of alveolar bone after intercortical split osteotomy and the role of the periosteum in the process of reparative osteogenesis. The peculiarity of this model is fixation of the periosteum over the reconstruction zone, which allows preserving the bone block displaced during surgery and leads to the formation of an organotypic structure of the regenerate with cortical and spongy bone.

This work presents a comparative study on the bioresorption of samples based on natural biopolymers, such as polyhydroxybutyrate, polylactide, polycaprolactone, and chitosan, in living systems and an evaluation of the tissue response to these samples. A histological examination of the polylactide-containing tissue samples revealed that the material possesses good supporting functions for connective, bone, and granulation tissues and causes no pronounced inflammatory infiltration with lymphocytes, neutrophils, and giants cells of foreign bodies. The resorption of the material proceeds slowly, and metabolites released during the resorption have no negative effect on the reparative osteogenesis. These materials seem to be quite promising in veterinary medicine.

We developed a technique for the complex modification of the surface of dental implant made of VT1-0 titanium that included sequential mechanical treatment and irradiation with powerful ion beams. The chemical composition and physical properties of the surface of titanium implants (VT1-0 grade) sandblasted with subsequent acid etching, as well as subjected to complex treatment (sandblasting and irradiation with powerful ion beams) were evaluated using micro-X-ray spectral analysis. In in vivo experiments, osseointegrative properties of the implants subjected by these treatments were compared. Microrentgenospectral analysis of dental implants subjected to irradiation with powerful ion beams revealed higher indicators of surface cleanliness; in in vivo experiments, morphometric analysis also demonstrated high osseointegrative properties.

TYPE: Late Breaking Abstract TOPIC: Cardiovascular Disease PURPOSE: to determine the frequency of lower global longitudinal epicardial strain of left ventrical (GLESLV), NT-proBNP, pentraxin, galectin-3, sST2 levels in patients (pts) with RA prior to therapy with bDMARDs. METHODS: 41 pts with RA were included: 63% of women, 56[37;66] years, disease duration 24[8;96] months; DAS28 6,01[5.3;6.3] without CVD and prior administration of bDMARDs. All pts underwent echocardiography with speckle tracking assessment of GLESLV. 44% RA pts received methotrexate, 35%-leflunomide. We measured plasma concentrations of sST2, galectin-3, NT-proBNP, pentraxin. The control group consisted of 10 healthy subjects, which were matched by sex and age. RESULTS: In RA pts speckle tracking method detected GLESLV(–16.5 [-14.6;-18.5]%), compared to control group (–21.58 [-22.1;-20.4]%, p=0.0001). 27 (67%) RA pts showed a decrease GLESLV. RA pts had higher NT-proBNP (114.8 [45.1;277.5] vs 52[40.5;69.1] pg/ml, p<0.05), lower sST2 (10.6 [9.2;13.1] vs 13.5 [11.0;19.7] ng/ml, p<0.04) compared to control group. RA pts were divided into 2 groups: group 1-with low GLESLV, group 2 -with preserved GLESLV. In group 1, ST2 were higher than in group 2 (18.3 [13.7; 60.9] vs 13.2 [10.6; 17.0] ng/ml, p<0.05) (Tabl.1). There were negative correlations between GLESLV and age (r=-0,9, p<0,02), E LV (r=-0,5, p<0,04), sST2 (r=-0,5, p<0,02). Galectin-3 correlate with LA volume (r=0,4, p<0,04), e'(r=0,6, p<0,008); ST2 correlate with ESR (r=0,6, p<0,04), CRP (r=0,5, p<0,002). Tabl.1 Biomarker levels in groups CONCLUSIONS: Conclusion: In RA pts frequently were detected lower GLES, higher NT-proBNP and lower sST2 levels. In RA pts sST2 is better associated with inflammatory activity and myocardial dysfunction. CLINICAL IMPLICATIONS: CT2 and GLESLV contribute to early diagnosis of myocardial dysfunction in RA patients. DISCLOSURE: No significant relationships. KEYWORD: myocardial dysfunction

Objectivesto analyse rheumatoid arthritis (RA)-patients depending on their individual peak radiographic progression.Methods61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to the Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (7 years FUP, median 7,7 [7,4;8,6]). The general characteristics of the group are presented in the Table 1. Hands and feet ultrasound (US) with grayscale (GS), power Doppler (PD), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9, and 12 months after. Radiographs were obtained at baseline, at 12 months, 4 years, and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Structural damage progression was evaluated by change in the Sharp van der Heijde score (ΔSHS) between baseline and 1,4 and 7 year. We determined the individual peak radiographic progression (Δ SHS scores/time) in RA- patients.Table 1.General characteristicsCharacteristicAt baselineAfter 1 year follow-upAfter 4 years follow-upAfter 7 years follow-upMedian age, years50,0 [38,0; 59,0]Disease duration, months7 [4; 20]GS6 [4; 9]PD2 [1; 6]DAS 285,6 [4,8; 6,5]2,88 [2,02; 3,93]3,76 [2,94; 5,09]4,03 [3,42; 4,74]ESR, mm/h35,0 [13,0; 50,0]12,0 [8,0; 28,0]22,0 [14,0; 36,0]22,0 [14,0; 36,0]CRP, mg/l10,6 [3,8; 32,3]2,9 [1,1; 7,1]3,0 [1,2; 8,8]3,0 [1,2; 8,8]Rheumatoid Factor, positive results53 (87%)Anti-CPA, positive results52 (85%)Erosion score0 [0; 3]1 [0; 4]2 [0; 6]3 [1; 11]Joint-space narrowing score57,0 [31,0; 88,0]62,0 [31,0; 92,0]93,0 [77,0; 106,0]98,0 [77,0; 110,0]Modified total Sharp score70,0 [31,0; 88,0]71,0 [31,0; 93,0]97,0 [79,0; 112,0]102,0 [78,0; 117,0]ResultsRA progression by 1 years FUP was identified in 10% (6 p) of pts, 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts.All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). In the group Rg + GS at baseline was significantly higher than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04).We analyzed relation between SHS (erosion score and total Sharp score) 7 years FUP, individual peak radiographic progression and Δ erosion score and total Sharp score in the observation periods: 0-1 years, 1-4 years, 4-7 years and 0-7 years. The following correlations were identified of erosion score 7 years FUP with Δ erosion score in all observation periods (r=0,33 p=0,016, r=0,54 p=0,000, r=0,68 p=0,000, r=0,84 p=0,000, respectively) and with individual peak radiographic progression in the observation periods 1-4 years, 4-7 years, 0-7 years (r=0,54 p=0,000, r=0,49 p=0,000, r=0,84 p=0,000, respectively). The following correlations were identified of total Sharp score 7 years FUP with Δ total Sharp score in the observation periods 4-7 years, 0-7 years (r=0,43 p=0,000, r=0,34 p=0,007, respectively) and with individual peak radiographic progression in the observation periods 4-7 years, 0-7 years (r=0,43 p=0,000, r=0,34 p=0,007, respectively).ConclusionThese data show that the radiological progression increases over time at different rates.Disclosure of InterestsNone declared

Objectives to identify the prognostic role of ultrasound signs (US) in radiologic progression in RA patients Methods 61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to the Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (7 years FUP, median 7,7 [7,4;8,6]). Among them 40 patients with early RA, mean age 51,0 [43,0; 60,0], disease duration 5 [3; 6,5] months. The general characteristics of the group are presented in the Table 1. Hands and feet ultrasound (US) with grayscale (GS), power Doppler (PD), and destructive changes (erosion), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9, and 12 months after. Radiographs were obtained at baseline, at 12 months, 4 years, and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Radiographic progression was documented based on Sharp/Van der Heijde modified score changes during the follow-up. Table 1. General characteristics Characteristic At baseline After 7 years follow up Median age, years 50,0 [38,0; 59,0] Disease duration, months 7 [4; 20] GS 6 [4; 9] PD 2 [1; 6] DAS 28 5,6 [4,8; 6,5] 4,03 [3,42; 4,74] ESR, mm/h 35,0 [13,0; 50,0] 22,0 [14,0; 36,0] CRP, mg/l 10,6 [3,8; 32,3] 3,0 [1,2; 8,8] Rheumatoid Factor, positive results 53 (87%) Anti-CPA, positive results 52 (85%) Mean erosion score 0 [0; 3] 3 [1; 11] Mean joint-space narrowing score 57,0 [31,0; 88,0] 98,0 [77,0; 110,0] Modified total Sharp score 70,0 [31,0; 88,0] 102,0 [78,0; 117,0] Results 52 ACPA+ (85%) and 9 ACPA− (15%) patients presented among the 61 patients with RA. RA progression by 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts. During the 7 years FUP 42 of 61 patients had radiographic progression: the count of erosion increased from 0 [0; 3] to 3 [1; 11]. At the same time, on the background of therapy during the first year, a decrease in ultrasound signs of inflammation was determined according to the GS and PD: from 6 [4; 9] to 4 [2; 6] p = 0.000 and from 2 [1; 6] to 0 [0; 2] p = 0.000, respectively, and increase in the number of joints with erosions (from 1 [0; 2] to 2 [0; 3], p = 0.000). All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). In the group Rg + GS at baseline was significantly higher than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04). CRP at 3 months and at 6 months was significantly higher in RG+ group than in RG- group (4,15 [1,2; 8,7] and 1,2 [0; 3,5], respectively, p=0.03 and 2,35 [0,8; 10,1] and 0,4 [0; 4,3], respectively, p=0.025). Conclusion Thus, we obtained the first data on the important prognostic role of ultrasound in assessing the progression of early RA in a prospective seven-year follow-up. Disclosure of Interests None declared

TYPE: Late Breaking Abstract TOPIC: Cardiovascular Disease PURPOSE: to study the dynamics of myocardial dysfunction (lower global longitudinal epicardial strain of left ventrical (GLESLV)), pentraxin, galectin-3 and ST2 levels after biological therapy during 12 month follow-up. METHODS: A total of 19 pts with RA (EULAR) were included: 84% of women, age 53[37;65] years, disease duration 19[8;96] months; DAS28 6,0[5.3;6.8], positive for ACCP (89%), RF (78%), without prior administration of biologic therapy (BT) and CVD. All pts underwent blood pressure monitoring, echocardiography and speckle tracking assessment of GLES LV. Methotrexate therapy was started in 68% pts, leflunomide–2%, glucocorticoids–32%. BT was administered in all RA pts (adalimumab and abatacept). After 12 months 21% of RA pts remained highly disease active. ST2, pentraxin and galectin-3 levels was assessed in 19 pts with RA before and after 12 months of BT. RESULTS: After 12 months GLESLV has increased from -15,9[-14,3;-18,5]% to -18,8[-16,0;-21,0]%,(p<0,04); ST2 level decreased from 13,8[11,5;20,1] to 12,5[9,6;14,5]ng/ml, (p<0,003). The incidence rate of lower GLESLV decreased by 41% (from 67% to 26%, p<0.008), There were no significant changes in the pentraxin and galectin-3 levels in RA pts after BT. After 12 months RA pts with preserved high disease activity had higher level of systolic blood pressure (120[100;130] vs 100[92;117]mm Hg,p<0.001), lower LV ejection fraction (58[56;63] vs 68[60;69]%,p<0.05) and GLESLV (-16,8[-15,0;-18,8]% vs -20,1[-18,0;-21,1]%,p<0.05), than in pts whose disease activity decreased. There were negative correlation between ΔGLESLV and ΔESR (r=-0,4;p<0,03), ΔST2 (r=-0,4;p<0,05). CONCLUSIONS: In RA pts decrease disease activity on BT leads to an improvement in GLESLV and pronounced reduction ST2 levels. CLINICAL IMPLICATIONS: That can contribute to reduce the risk of CVD. DISCLOSURE: No significant relationships.

The main cause of death in COVID-19 patients is acute respiratory distress syndrome (ARDS) and multi-organ failure, which is often caused by extrapulmonary dissemination and the direct damaging effect of SARS-COV-2 on the vital organs tissues. However, the nature of histopathological changes in vital organs and their significance in the thanatogenesis of COVID-19 remain insufficiently studied. Purpose of the research. To study the nature of histopathological changes in organs in COVID-19 patients, and to conduct a comparative analysis of the data obtained with the results of foreign countries’ studies with high mortality rates. Materials and methods. A pathologic study of 179 deceased COVID-19 patients was conducted. The median age of patients was 71 years. In 83.8% (150/179) of cases, COVID-19 was the main disease, and in 16.2% (29/179) of cases, it was concomitant. Results and discussion. Histopathological changes in COVID-19 were multi-organ in nature, which caused ARDS in 91.62%, cardiovascular insufficiency in 27.4%, brain edema – in 20.1%, pulmonary edema – in 3.9%, and pulmonary embolism – in 3.9% of cases. The morphological signs of ARDS in COVID-19 were: lung mass increase in 78.2% of cases, foci of pulmonary parenchyma compaction – 74.8%, discoloration of lung tissue – 60.3%, signs of congestion – 58.1%, the histological basis of which was diffuse alveolar damage. Conclusion. Old age and concomitant chronic diseases of vital organs are the main risk factors for death in COVID-19. Histological changes in organs can be the result of both direct exposure to the virus and hypoxic, metabolic, and ischemic damage.

The objective: to perform quantitative analysis of SARS-CoV-2 viral load (VL) levels in lung tissues in deceased patients with COVID-19 and to evaluate its association with the nature of histological changes in the lungs and the duration of stay in ICU till the lethal outcome.Subjects and Methods. Sections of formalin-fixed and paraffin-embedded lung tissues of 36 deceased patients with COVID-19 were used. The SARS-CoV-2 viral load was quantitatively assessed using the original qPCR. VL was calculated using the following formula: copies SARS-CoV-2 / copies ABL1 × 100, expressed as the ratio of the true number of SARS-CoV-2 cDNA copies per 100 copies of ABL1 gene cDNA.Results. In cases with no histological changes typical of diffuse alveolar lung injury (DAI), the detection rate of SARS-CoV-2 RNA and the average level of the SARS-CoV-2 viral load were 62.5% (5 out of 8 observations) and 104.75 (range 0-313) copies of SARS-CoV-2 cDNA per 100 copies of human ABL1 gene cDNA. The average level of the SARS-CoV-2 viral load in the lungs with prevailing histological changes characteristic of the proliferative and exudative phases of DAI differed by 60 times and amounted to 909 (18-2,657) and 54,924 (834-250,281) copies of SARS-CoV-2 cDNA per 100 copies of human ABL1 cDNA, respectively. The average duration of stay in the intensive care unit in the group of patients with exudative and proliferative phases of DAI was 10.64 (1-22) and 8.14 (1-21) bed-days, respectively. The detection rate of the SARS-CoV-2 RNA in patients with diffuse alveolar lung injury was 100%.

We studied the effect of porous composite scaffolds based on poly(3-hydroxybutyrate) (PHB) loaded with simvastatin on the growth and differentiation of mesenchymal stem cells. The scaffolds have a suitable microstructure (porosity and pore size) and physicochemical properties to support the growth of mesenchymal stem cells. Scaffold loading with simvastatin suppressed cell growth and increased alkaline phosphatase activity, which can attest to their osteoinductive properties.

Background: Ultrasound (US) is a non-invasive and safe imaging method that allows in vivo differentiation of the morphological structures of subcutaneous fat (SCF) tissue in in normal and pathology. Objectives: Reveal features of ultrasound changes in SCF in panniculitis (Pn). Methods: 57 patients (f – 45, m - 12) aged 18 - 67 years with an initial diagnosis of erythema nodosum and a disease duration of 3.6 ± 1.4 years were examined. In addition to the general clinical examination, a computed tomography of the chest organs and a pathomorphological examination of a skin biopsy from the site of the node were performed. Ultrasound was performed on a MyLabTwice apparatus (ESAOTE, Italy) using a multi-frequency linear transducer (10-18 MHz) with the PD technique, the parameters of which were adapted for recording low-speed flows (PRF 300-600 Hz, low filter, dynamic range - 20-40 dB), the presence of vascularization was assessed not only in the affected area, but also on the contralateral side using high-energy Doppler. Results: 33 patients were diagnosed with septal Pn (SPn), 24 - lobular Pn (LPn). In all cases, the diagnosis was verified by histological examination. Ultrasound made it possible to assess the thickness, echoicity and vascularization of the SCF. In 35 patients, significant thickening of the SCF was revealed (as compared to the contralateral side), of which in 14 cases with SPn, in 21 - with LPn. Significant diffuse thickening of the SCF with the contralateral side was observed in 18 patients, incl. in 12 (66%) patients with LPn. Limited thickening was more typical for SPn (73%). A significant increase in the echoicity of the SCF was noted in all forms of Pn. A “lobular” echo pattern with an anechogenic environment was observed in 25 patients, of which 18 (72%) had LPn. An increase in vascularization compared to the contralateral side was recorded in 30 cases (SPn-17, LPn-13). Conclusion: The obtained preliminary results indicate the important role of ultrasound in assessing the depth and prevalence of the inflammatory process at Pn. To clarify the diagnostic value of this method, further studies are needed on a larger sample of patients. Disclosure of Interests: None declared

Background:The risk of developing cardiovascular complications and death in rheumatoid arthritis (RA) is 50% higher than in the total population. These clinical events depend from risk factors for cardiovascular diseases, chronic inflammation and inflammatory myocardial infiltration. А new method for detecting early myocardial dysfunction is echocardiography using speckle tracking echocardiography.Objectives:to determine the frequency of myocardial dysfunction (lower global longitudinal epicardial strain of left ventrical (LV), diastolic dysfunction of left ventricle (LVDD)) using standard and novel echocardiographic methods in patients (pts) with RA prior to therapy with bDMARDs, examine its relationship with markers of inflammation.Methods:a total of 28 pts with a valid diagnosis of RA (ACR/EULAR, 2010): 23 f (82%) /5 m (18%) were included, median (Me) age - 56 [interquartile range (IR) 34;65] years, Me RA duration-14,5 [IR 7;87] months; all pts with RA demonstrated a high disease activity (Me DAS28 6.06, [IR 5,4;6,6]), seropositive for IgM RF (88%) and/or ACCP (84%) without any experience of administration of bDMARDs. The control group consisted of 10 healthy subjects, which were matched by sex and age. All pts were assessed for traditional risk factors for cardiovascular disease (ESC guidelines, 2011), echocardiography, tissue Doppler imaging, and the speckle tracking assessment of left ventricle longitudinal strain. DD was allocated according to the ESC guidelines for the diagnosis and treatment of heart failure (2018). Arterial hypertension was detected in 5 pts with RA.Results:In pts with RA LVDD was more often detected (8 (31%) vs 0%, p=0.05) than in controls. The values of E LV (0.77 [0.62;0.94] ms vs 1.25 [1.03;1.51] ms, p=0.0001) were lower than in control group. Speckle-tracking method detected lower global longitudinal epicardial strain (–16.5 [-18.9; -13.6]% vs –21.58 [-22.1;-20.4] %, p=0.0001). 17(61%) RA pts showed a decrease global longitudinal epicardial strain. There were no between-group differences in left ventricular ejection fraction, LV sizes, LV myocardial mass index in RA pts with controls. There were correlations between the global longitudinal epicardial strain and DAS28 (r=0,9, p<0,02), tender joint score (r=0,6, p<0,02), radiological stage (r=0,6, p<0,008); the presence of systemic manifestations (r=0,5, p<0,03).Conclusion:In pts with RA frequently (61%) were detected lower global longitudinal epicardial strain, which are associated with a high activity of the inflammatory process. Speckle-tracking echocardiography is better at detecting early myocardial dysfunction than tissue Doppler.Disclosure of Interests:None declared

Background: The leading cause of mortality in more than 2.5 million COVID-19 patients is the development of acute respiratory distress syndrome and multiple organ failure associated with thrombotic events (TE). However, information on the nature of TE and the pathogenetic significance of hereditary thrombophilia factors in patients with COVID- 19 is still not completely understood. Aims: To study possible correlation of TE with the profile of FV 506R/Q, MTHFR 223A/V, F2 20210G/A, and PAI-1 4G/5G mutations in patients with COVID-19. Methods: Autopsy studies of 179 COVID-19 patients were performed from April to July 2020. Median age of the patients was 73 (range 37 to 99).Control healthy group was 71 individuals with median age of 56 (range 25 to 71). DNAs were isolated from formalin-fixed and paraffin-embedded spleen tissues using a QIAamp DNA FFPE Tissue Kit (QIAGEN, USA) according to the manufacturer's instructions. FV 506R/Q, MTHFR 223A/V, F2 20210G/A, and PAI-1 4G/5G alleles were assessed by an allele-specific real-time polymerase chain reaction. Results: According to the results of postmortem examinations, 87 patients with TE were identified (see Figure 1). Pulmonary artery thrombosis was detected in 37.9% (33/87) of cases. Pulmonary embolism (PE) was detected in 27.6% (24/87) of cases, of which 87.5% (21/24) PE was combined with deep vein thrombosis (DVT) of the lower extremities, in two patients - with intracardiac thrombi, and in one case - both with DVT and intracardiac thrombi. The frequency of PE in women was twice as high. The incidence of pulmonary vein thrombosis was 18.4%, with a predominance in men (62.5% vs. 37.5%). Isolated intracardiac thrombi were found in 11.5% (10/87) of patients, with a predominance in women. Hepatic vein thrombosis was 4.6% (4/87) of cases. Cerebral artery, coronary vessels, and mesenteric veins thrombosis was detected in 2.3% (2/87) of cases. FV 506R/Q, MTHFR 223A/V, F2 20210G/A, and PAI-1 4G/5G allele patterns were identified for 122 cases 62 of which had TE (see Figure 1). The group of patients with TE revealed a higher incidence of heterozygous genotypes MTHFR 223A/V compared to those without TE (40.3% versus 25%), but relatively similar to the control healthy group (40.3% vs. 39%), and higher incidence of heterozygous PAI-1 4G/5G compared to both groups (58% vs. 48.3% vs. 39%). On the contrary, the incidence of FV 506R/Q and F2 20210G/A heterozygotes was lower compared to the group without TE, and control healthy group. The incidence of homozygous MTHFR 223V and PAI-I 4G did not differ significantly between COVID-19 patients groups, however the latter genotype incidence was lower compared to control healthy group. Summary/Conclusion: Thrombosis and thromboembolism of arteries and veins of vital organs are detected in about half of patients who died from COVID-19. No significant trends in the distribution of genotypes of predisposition to thrombophilia between groups of COVID- 19 patients with TE and without them, and the control healthy group have been revealed. This is quite unexpected that patients who died from thrombotic complications do not show any signs of hereditary predisposition to thrombophilia. Especially concerning no bias in PAI-4G allele incidence. Probably we do not have enough sample strength to reveal possible differences. Therefore, establishing the role of hereditary thrombophilia factors in the development of COVID-19 associated TE requires further studies with an extended cohort of patients.

Abstract Pulmonary hypertension (PH) is a frequent hemodynamic condition that is highly prevalent in patients with left heart diseases (LHD). Patients with PH-LHD usually have post-capillary PH, which is now defined by a mean pulmonary arterial pressure (mPAP) of >20 mm Hg and a pulmonary arterial wedge pressure (PAWP) of >15 mm Hg. When assessing PAWP in LHD patients, it must also be acknowledged that pretreatment with diuretics leads to lowering of left-sided filling pressures and thus PAWP, and this bears the potential of misclassifying post- as pre-capillary PH if the PAWP should be lowered to a value below 15 mm Hg. In this context, in cases of borderline PAWP (13–15 mm Hg) a “volume challenge” (500 ml of saline within 5–10 min) has been proposed in order to reverse the diuretic effect and to uncover “occult HFpEF”, but the therapeutic consequences of such testing remain unclear. In acute circulatory failure, passive leg raising (PLR) is a test that predicts whether cardiac output will increase with volume expansion. By transferring a volume of around 300 mL of venous blood from the lower body toward the right heart, PLR mimics a fluid challenge. However, no fluid is infused and the hemodynamic effects are rapidly reversible, thereby avoiding the risks of fluid overload (safety). There are those who believe, that most PH in connective tissue diseases (CTD), espesially systemic sclerosis (SSc) is post-capillary and that many patients are receiving pulmonary vasodilator therapy inappropriately. The aim of this study to investigate possibility PLR test in the diagnosis of PH due to left heart disease. PLR test is applied during 77 catheterizations in 69 patients with CTD and PH, among them 14 patients with established PH-LHD and 55 patients with precapillary PH (45 with PAH, 10 with PH, associated with SSc interstitial lung diseases). The diagnosis of PH-LHD was established in the presence of lesions of the left heart (CHD or cardiomyopathy), identified using echocardiography, coronaroangiography and heart MRI. It was determined that despite approaching a valid difference between the PAWP 12 (7; 14) mm Hg and 8.5 (6; 12) mm Hg, p=0.06), in the PLR test, the level of PAWP increased significantly only in patients with PH-LHD (up to 17 (11; 19) mmHg than precapillary PH (9 (8; 13) mm Hg, p=0.00026). The increase of PAWP was 4 (3; 8) mm Hg and total 1 (0; 3) mm Hg, respectively, differences are valid (p=0.ehab724.19142). The PAWP was measured before the test, and on 5 and 10 minutes during test. It was found that the maximum increase in PAWP occurred 10 minutes from the start of the test. The ROC analysis of PAWP in this two groups showed the area under the curve was 0.837 (0.737; 0,937), p<0,0001. The cutt-off of the growth of PAWP was 4 mm Hg with a sensitivity of 82% and a specificity of 73%. Thus, an increase in PAWP more than 4 mm Hg can indicates the presence of PH-LHD in the patient with CTD. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of science and higher education, Russian Federation

Difficulties in diagnosis and therapy of scleroderma-panniculitis (S-PN), one of the variants of the septal PN, are discussed. Feasibility of ultrasonography, magnetic resonance imaging of soft tissues and histological examination of the lesions in order to set the diagnosis of PN in time is considered. The clinical case of S-PN combined with antiphospholipid syndrome is presented.

We studied biocompatibility and bioresorption of 3D-printed polylactide and polyglycolide tissue membranes. Ultrasound microscopy and histological examination showed that membranes fabricated of a copolymer of lactic and glycolic acids in a mass ratio of 1:9 are bioresorbed and have good biocompatibility with soft tissues (connective tissue, adipose tissue, and epithelium). An important feature of the copolymer membranes, which differs them from pure polylactide membranes, is the formation of a thin fibrous capsule that did not interfere its destruction by the mechanism of hydrolytic resorption.