Purpose of review To investigate the possible effects of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) on kidney function and assess the rate of viral ribonucleic acid (RNA) shedding/detection in urine. Recent findings Most of the research on the topic suggests that for the moment our ability to estimate whether SARS-CoV-2 is a direct causative agent in acute kidney injury (AKI) or whether it has a cytokine storm effect is limited. During our prospective assessment of 333 patients with COronaVIrus Disease 2019 (COVID-19) it was found that frequency of AKI of 9.6% (32 cases). Despite previous data suggestive of the ability to detect SARS-CoV-2 in urine, we were unable to identify any traces of messenger ribonucleic acid (mRNA) in our group. Both COVID-19 severity (odds ratio, OR = 23.09, confidence interval, CI 7.89–67.57, P < 0.001) and chronic kidney disease (CKD) history (OR = 7.17, CI 2.09–24.47, P = 0.002) were associated with the AKI rate. Summary AKI is a relatively frequent condition for patients with COVID-19 and is normally correlated with the severity of the disease and the patient's history of CKD. The available data fail to address whether SARS-CoV-2 mRNA is present in urine, whereas our prospective trial data suggest that mRNA is undetectable in urine irrespective of the severity of the disease.

Introduction: one of the hypotheses about the relationship between asthma (A) and obesity is that the visceral adipose tissue (VAT) produces pro-inflammatory cytokines enhancing inflammation in the bronchi. However, generally used BMI does not reflect the content of VAT in the body. Leptin is pro-inflammatory cytokine; its involvement in A pathogenesis is still unclear. Objective: to evaluate serum leptin levels, measure the VAT and subcutaneous adipose tissue (SAT) areas by CT at the level L4-L5 and explore their correlations with spirometry parameters in overweight and obese A patients (pts). Material and Methods: we examined 78 pts with A (68 women, 10 men; 19-76 yo). The 1st group included 25 pts (BMI 18.5-24.9 kg/m2), the 2nd – 21 pts (BMI 25-29.9 kg/m2), the 3rd – 32 pts (BMI≥30 kg/m2). Results: pts in the 2nd and the 3rd groups had a more severe course of A vs group 1 (p=0.02): moderate and severe A were almost twice often in pts with BMI≥25 kg/m2. Leptin levels in the 2nd and the 3rd groups (39.6[22.9;59.4], 79.8[48.3;105.1] ng/ml, respectively) were significantly higher than in the 1st group (13.4[4.9;34.7] ng/ml, p=0.002). The VAT and SAT areas were 70.7[39.3;97.2] and 169.7[133.9;226.2]cm2, 121.0[92.7;139.1] and 291.6[237.8;334.0]cm2, 179.3[128.9;217.5] and 470.7[394.4;549.5] cm2 in the 1st, 2nd, 3rd groups, respectively (p<0.05). We revealed significant correlations in the 3rd group between the VAT area and FVC (r=-0.56, p=0.001), FEV1 (r=-0.44, p=0.01), in the 2nd – between leptin and FEV1 (r=-0.48, p=0.03). Conclusion: elevated leptin levels and increased VAT areas in overweight and obese A pts apparently contribute to a more severe course of A and play an important role in this comorbidity.

Aim To evaluate dynamics of biomarkers for endothelial dysfunction (ED), including endothelin-1 (ET-1) and von Willebrand factor (VWF) in patients with stomach cancer (adenocarcinoma) before and after polychemotherapy (PCT); to compare these results with respective values in healthy volunteers and patients with cardiovascular diseases (CVD); to study correlations of the ED biomarkers with indexes of instrumental evaluation of endothelial dysfunction.Material and methods The study included 75 participants, including 25 healthy volunteers (control group), 25 patients with documented CVDs (arterial hypertension + ischemic heart disease), and 25 patients of the main group with histologically documented stage II-IV stomach cancer (adenocarcinoma) who received different courses of PCT with platinum-based agents (oxaliplatin, cisplatin) and fluoropyrimidines (5 fluorouracil, capecitabin). Laboratory measurement of ED biomarkers, computerized nailfold video capillaroscopy (CNVC), and finger laser photoplethysmography (PPG) (methods for noninvasive evaluation of vascular wall and ED), electrocardiography, 24-h ECG Holter monitoring, and echocardiography (EchoCG) were performed for all patients of the main group prior to PCT and within one months after the last course completion. This evaluation was performed once for healthy volunteers and patients of the CVD group upon inclusion into the study.Results In the main group, ET-1 levels were non-significantly lower than normal and did not change during the courses of antitumor treatment (0.95 [0.6; 1.4] and 0.94 [0.7; 1.4] pg /ml (р<0.9) before and after PCT, respectively). Statistically significant differences were found between the control group and oncological patients after the treatment (р<0.04). Levels of VWF remained within the normal range in all examined participants and did not significantly differ between study groups, including oncological patients before and after the specific treatment (р>0.05 for all comparisons). The correlation analysis detected significant correlations of ET-1 levels with functional disorders of microcirculation, ET-1 with the occlusion index (rs=0.56; p=0.005), ЕТ-1 with percentage of capillary restoration (PCR, rs= –0.72; p=0.018) and with the incidence rate of supraventricular extrasystole (rs=0.48; p=0.032).Conclusion The dynamics of ED biomarkers was studied for the first time in patients with stomach cancer receiving a specific antitumor therapy. Although no significant changes in ЕТ-1 and VWF were observed during the PCT (probably due to exhaustion of the endothelial system and a small patient sample), these indexes can be considered as early vasculotoxicity markers due to the presence of significant correlations with indexes of impaired endothelial function according to the results of instrumental evaluation.

Objective. To assess androgen secretion and its possible effect on pregnancy in women with threatened miscarriage in the first trimester. Patients and methods. This prospective observational study included 120 pregnant women divided into four groups. Group I comprised 32 patients with threatened miscarriage and hyperandrogenism who received corticosteroids; Group II was composed of 28 patients with threatened miscarriage and hyperandrogenism who did not receive corticosteroids; Group III included 30 patients with threatened miscarriage and no hyperandrogenism; and Group IV comprised 30 women with normal pregnancy. Serum levels of dehydroepiandrosterone sulfate (DHEA-S), 17-hydroxyprogesterone (17-OHP), and total testosterone were measured on the following weeks of gestation: 5–8, 9–12, 13–18, 19–24, and 25–32. We also evaluated clinical outcomes of pregnancy. Results. We observed no significant differences in 17-ОНР and DHEA-S secretion between women from Group III and controls. Patients from Group II demonstrated higher hormone levels than controls; however, their dynamics of 17-ОНР and testosterone secretion was similar to that in women without hyperandrogenism, so their DHEA-S levels decreased and reached control values by the third trimester. Corticosteroids reduced 17-ONR secretion in the second and third trimesters and DHEA-S secretion in the third trimester. Women receiving corticosteroids demonstrated the poorest clinical pregnancy outcomes. Conclusion. Hyperandrogenism should be considered as one of the risk factors for poor pregnancy outcomes. Administration of corticosteroids to reduce androgen levels impairs normal dynamics of their secretion, does not improve pregnancy outcomes, and is potentially harmful; therefore, these drugs should not be used for such purposes. Key words: pregnancy, hyperandrogenism, corticosteroid therapy, pregnancy outcomes, pregnancy loss, androgen secretion, threatened miscarriage

The article contains the literature review on laboratory criteria of detection and monitoring of the progression of the disease in patients with the diagnosis of diabetes mellitus. It also covers the issues of methodical approaches to the identification of glycated hemoglobin (HbA1c). The findings of author's researches of glycated hemoglobin in 149 patients have been given within the framework of comparison of two methodical approaches and comparison of the results with the subsequent classification of the received data. A random laboratory finding of qualitative hemoglobinopathy has been demonstrated, and the results recognized as unqualifiable and the approach to classification of such values have been discussed.Comparison of the results of glycated hemoglobin identification performed by different methods. 149 patients underwent a one-stage identification of glycated hemoglobin from plasma stabilized with K2-EDTA on Bio-Rad D10 and Sebia Capillarys Flex Piercing 2. Comparative study of the results of glycated hemoglobin identification has shown a difference in absolute values. However, a statistically reliable (p < 0.05) correlation between the values of glycated hemoglobin, expressed as a percentage obtained by different methods, has been revealed. In this case, the choice of a method for identifying glycated hemoglobin is not a matter of principal but it is important to adhere to the same method in treatment and long-term monitoring.

BACKGROUND:Reported levels of hepcidin, the major regulator of systemic iron homeostasis in CHF patients, are controversial. Relationship of hepcidin with inflammation markers, which are typically increased in CHF, is understudied; this issue is practically unstudied in old and older CHF patients.AIM:To study the role of hepcidin in development of anemia of chronic disease (ACD) and the association of hepcidin with inflammation in old and older CHF patients.MATERIALS AND METHODS:Ninety old and older patients with IHD were evaluated. 35 of these patients had CHF and ACD and 35 patients had CHF without ACD. The control group (CG) consisted of 20 IHD patients without CHF and ACD. Serum concentration of hepcidin was measured using ELISA by the competitive binding principle.RESULTS:Patients with severe, congestive FC IV CHF prevailed among CHF patients with ACD, and their CHF was characterized with longer duration, more frequent hospitalizations, and lower compliance with the treatment. Significantly higher mean levels of hepcidin, C-reactive protein (CRP), erythrocyte sedimentation rate, and insignificantly higher levels of ferritin were observed in CHF patients with than without ACD. The high hepcidin, indexes of inflammation tests, and a significant positive correlation of hepcidin with hemoglobin levels suggested inflammation as a cause for the increased hepcidin, which induced anemia in old and older CHF patients with ACD.

Intrahepatic cholestasis of pregnant women (ICPW) is associated with an increased risk of complications of pregnancy. Objective prognostic markers of adverse pregnancy outcomes except for a high level of bile acids (BA) in the mother's blood serum, exceeding 40 μmol/l, do not currently exist. However, the determination of the BA levels is not available in all laboratories, which indicates the need to search for other informative prognostic markers of complications of pregnancy in patients with ICPW. Objective: to determine the risk factors for adverse pregnancy outcomes in ICPW. Materials and methods. A prospective study included 97 pregnant women diagnosed with ICPW. The diagnosis was established with an increase in the serum level of the BA in excess of 10 μmol/l. Patients underwent clinical and laboratory examinations with assessment of biochemical markers of liver damage, antioxidant status (determination of superoxide dismutase, glutathione peroxidase, selenium, zinc level). Biochemical indices and severity of pruritus were assessed at the time of diagnosis of ICPW, after 1 and 2 weeks of treatment with ursodeoxycholic acid (UDCA) at a dose of 500 mg to 2 g per day. In the study of perinatal outcomes, the term of delivery, the method of delivery, the presence of signs of intrauterine fetal hypoxia, the state of the fetus at the time of birth were taken into account. Results of the study. In the observed group of patients, the incidence of preterm birth was 31.9%, intrauterine fetal hypoxia 29.9%, pre-eclampsia 23.7%, the need for a cesarean section due to the development of pregnancy complications arose in 40 (41.2%) cases. The risk factors for complications of pregnancy in patients with ICPW were: early onset and longer duration of ICPW, reactivation of cholestasis after its regression against the background of UDCA treatment and less effective treatment of skin itching in patients with manifest forms of ICPW. The laboratory markers of adverse pregnancy outcomes were a high level of maternal total serum BA and a low efficiency of its reduction against the background of treatment, a slow rate of decrease in hepatic transaminase activity against the background of treatment, a low level of antioxidant protection enzymes. The use of sex hormones during pregnancy promoted more frequent development of preeclampsia and increased the frequency of indications for cesarean delivery. The conclusion. Patients with early manifestation of ICPW and reactivation of cholestasis after its regression on the background of treatment, low effectiveness of treatment of pruritus, and also taking drugs of sex hormones require special attention and active management in connection with an increased risk of complications of pregnancy. It is advisable to carry out dynamic monitoring of the level of BA, hepatic transaminases and antioxidant enzymes in dynamics against the backdrop of treatment with ICPW to assess the effectiveness of treatment and timely prediction of possible complications of pregnancy.

Цель исследования. Оценить особенности течения, диагностики и лечения бессимптомных форм внутрипеченочного холестаза беременных (ВХБ). Материал и методы. Лабораторным маркером ВХБ служило повышение уровня определявшихся суммарных сывороточных желчных кислот (ЖК). У пациенток оценивали клинико-анамнестические данные, исход беременности, лабораторные биохимические показатели до лечения, а также в динамике через 1 и 2 нед после начала терапии урсодезоксихолевой кислотой в дозе от 500 мг до 2 г в сутки. Результаты. Из 97 беременных с лабораторно подтвержденным ВХБ кожный зуд наблюдался у 70 (72,2%), отсутствовал в 27 (27,8%). Достоверных различий в клинико-анамнестических показателях, частоте неблагоприятных исходов для плода, биохимических показателях до начала лечения между пациентками с манифестным и бессимптомным течением ВХБ не отмечено. При ВХБ, сопровождавшемся кожным зудом, скорость и выраженность снижения активности печеночных трансаминаз были достоверно выше, чем при бессимптомных формах (p

Цель исследования. Оценить особенности течения, диагностики и лечения бессимптомных форм внутрипеченочного холестаза беременных (ВХБ). Материал и методы. Лабораторным маркером ВХБ служило повышение уровня определявшихся суммарных сывороточных желчных кислот (ЖК). У пациенток оценивали клинико-анамнестические данные, исход беременности, лабораторные биохимические показатели до лечения, а также в динамике через 1 и 2 нед после начала терапии урсодезоксихолевой кислотой в дозе от 500 мг до 2 г в сутки. Результаты. Из 97 беременных с лабораторно подтвержденным ВХБ кожный зуд наблюдался у 70 (72,2%), отсутствовал в 27 (27,8%). Достоверных различий в клинико-анамнестических показателях, частоте неблагоприятных исходов для плода, биохимических показателях до начала лечения между пациентками с манифестным и бессимптомным течением ВХБ не отмечено. При ВХБ, сопровождавшемся кожным зудом, скорость и выраженность снижения активности печеночных трансаминаз были достоверно выше, чем при бессимптомных формах (p <0,001). Значимых различий в динамике уровня сывороточных ЖК на фоне лечения в изучаемых группах не выявлено. Заключение. Отсутствие достоверных различий в клиническом течении, частоте развития осложнений беременности и лабораторных признаках повреждения печени позволяет рассматривать ВХБ без кожного зуда как бессимптомную форму заболевания. При бессимптомных формах ВХБ существуют такие же риски для плода, как и при его классических формах. В связи с этим представляется целесообразным проводить лабораторный скрининг беременных на содержание сывороточных ЖК для выявления субклинически протекающего ВХБ.

Adipose tissue fulfills different functions, related to homeostasis, consequently, excess of adipose tissue may have a negative influence on endocrine and metabolic parameters. The relationship of separate components of metabolic disorders with reproductive disturbance remains under-investigated. Notably, the role of dyslipidemia (DL) as an independent risk factor of menstrual function and fertility disorders remains unknown. Objective. To evaluate fertility and menstrual disturbance in women with obesity and/or DL. Patients and methods. 150 women aged 18-37 years were divided into 3 groups: 1st - 50 women with body mass index (BMI)>24.9 kg/m2 and DL, 2nd - 46 women with BMI>24.9 kg/m2 and normal blood lipids; 3rd - 54 women with BMI

192 patients with acromegaly were examined. Their reproductive disorders were found to be a result of the suppressed synthesis of gonadotropin hormones due to the tumor compression of the adenohypophysis, due to blocking effect of hyperprolactinemia on the gonadotropic function or as a result of the direct impact of insulin-like growth factor-I stimulating hyperplastic processes in target organs, such as ovaries, the glandular epithelium of the breast and myometrium. The structure of reproductive disorders in patients with acromegaly includes menstrual disturbances, infertility, early menopause and hyperplastic processes. Close management of the reproductive system, early detection of neoplasia and correction of the existing disorders are highly required during therapy for acromegaly.

192 patients with acromegaly were examined. Their reproductive disorders were found to be a result of the suppressed synthesis of gonadotropin hormones due to the tumor compression of the adenohypophysis, due to blocking effect of hyperprolactinemia on the gonadotropic function or as a result of the direct impact of insulin-like growth factor-I stimulating hyperplastic processes in target organs, such as ovaries, the glandular epithelium of the breast and myometrium. The structure of reproductive disorders in patients with acromegaly includes menstrual disturbances, infertility, early menopause and hyperplastic processes. Close management of the reproductive system, early detection of neoplasia and correction of the existing disorders are highly required during therapy for acromegaly.

Obesity plays a key role in reproductive disorders. Xenical administration results in recovery of menstrual function in 78.9% and ovulation in 26.3% of patients with obesity. Hormone therapy in patients with obesity should be accompanied with Xenical therapy, which has a favorable impact on further body weight reduction (13.95% from baseline) and improvement (or stability) of metabolic parameters.