The study involved 83 patients with passing infringements of brain blood circulation (PIBBC), among which  are 55 patients with a transient ischemic attack and 28 patients with a cerebral hypertensive crisis, 13 volunteers. On the 1st  and 10th day after PIBBC for patients and once for volunteers the state of heart rate variability with the indices: a standard  deviation of consecutive RR-intervals (SDNN), ms; percentage of pairs of consecutive RR-intervals differing by more than 50  ms during the recording period (pNN50), %; a mode (Mo), s; a mode amplitude (AMO), %; a range of ΔX, s were determined.  To determine a vegetative tone, a stress index (IN) was calculated. The second stroke or ischemic events were detected by  means of telephone interviews over the period of 3 months. In the group with the use of addition cholinomimetic therapy on the first day of hospitalization, a higher SDNN value was in comparison with the control group (р = 0.048); in the comparison  group (р = 0.003), SDNN exceeded 75 % of the interquartile range of normal values   (25–36 ms). After the 10-day course of  treatment, changes in SDNN were not observed in the both groups, and in the main group SDNN remained above the control  indices (р = 0.016). During therapy this group showed a tendency to decrease IN1/2 with significantly lower values   compared  in the control group (р = 0.009) and in the comparison group (р = 0.008). The unfavorable prognosis of acute ischemic events  in the PIBBC group with the use of parasympathomimetic therapy was determined during a 3-month period as a greater percentage of recurrent ischemic events.  Based on the data obtained, SDNN is proposed for use as a predictive parameter for the personification of the appointment of cholinomimetic therapy.

The dependence of increase in arterial stiffness on changes in the intima-media thickness and elasticity of  material of a vascular wall is established. On the basis of this dependence it is shown that for the common carotid artery of  healthy people, the contribution of changes in the intima-media thickness to the general change in arterial stiffness is 2−3  times more than the contribution of changes in elasticity of material of a vascular wall.

The characteristics of the gestation and the condition of newborns by 156 pregnant women with metabolic  syndrome (MS) were studied. It was identified that the pregnancy course of patients with MS has frequently been complicated  by the progression of gestational hypertensive disorders, chronic placental inadequacy, and gestational diabetes. Taking into  account a high risk of intranatal complications, the patients’ preparation of parturition with the birth activity induction was  made more often. Among the abdominal delivery were the leading positions of a scar on the womb after the cliohysterectomy  in previous parturition and a long-term history of infertility. The patients with MS were observed to have a high rate of descent birth activity, placental inadequacy decomposition. The post-natal period of the patients with MS has frequently been  complicated by the womb subinvolution. The children, born by mothers with MS, are characterized by a higher body mass  index at birth, a higher proportion of the hypoxic and ishemic damaged central nervous system.

Glomerular extracapillary proliferation in IgA nephropathy is one of the unfavorable prognostic signs that in  some cases, contributes to a rapid progression of the renal failure.  The aim of the study was to assess the effect of extracapillary proliferation and its degree on clinical and morphological  parameters and the prognosis of IgA nephropathy.  Two hundred and six cases of IgA nephropathy diagnosed on kidney biopsy with light and luminescence microscopy using  the Oxford classification were analyzed. Quantitative evaluation of the crescents was done by calculating their percentage and  crescent score. Extracapillary proliferation was detected in 64 cases (31.1 %) and was associated with more frequent deposits  of IgA and C3 in the glomerular basal membranes. In most cases (59.4 %), extracapillary proliferation affects less than  a quarter of the glomeruli, while more than half of the glomerulus lesions develops only in single cases (6.3 %). Clinical  manifestations of cases of IgA nephropathy with crescents were overwhelmingly characterized by nephritic syndrome  (71.9 %) in single cases (3.1 %) there was a rapidly progressive lesion, not associated with the presence of more than half  of crescentic glomeruli in the biopsy. Glomerular extracapillary proliferation in every fourth patient was accompanied by  isolated urinary abnormalities. The crescent score of 0.75 and more, associated with impaired renal function, revealed more  frequently  hypertension  and  more  pronounced  sclerotic  glomerular  and  interstitial  changes.  The  progression  of  IgA  nephropathy with extracapillary proliferation in the form of reduction in glomerular filtration rate by 50 % or the onset  of dialysis (12.5 %) was combined with a high level of proteinuria and marked interstitial fibrosis in the biopsy. The kidney  function survival analysis revealed a one-year survival in 87 %, 3 years – in 84 and 5 years – in 67 % of cases.

 It is known that with thyrotoxicosis and hyperthyroidism, changes in the functioning of the sympathoadrenal system can occur, but the question of the influence of subclinical hyperthyroidism on the activity of the mediator and hormonal  component of the sympathoadrenal system, as well as the activity of the cortical layer of the adrenals, is still controversial.  Patients with thyroid cancer receive suppressive therapy with levothyroxine according to vital indications, so this issue is  topical from the medical point of view. The aim of the study is to evaluate the catecholamine content in the urine and cortisol in the blood of patients with highly  differentiated thyroid cancer depending on the degree of suppression of the thyroid-stimulating hormone and the signs of the  developing cardiovascular pathology (tachycardia, high blood pressure) and the tone of the autonomic nervous system.  93 patients with a suppressed thyroid-stimulating hormone level (TTG < 0.5 mE/L) and 50 individuals of the control  group were examined. It is shown that patients differ from the control group by a significant decrease in the level of  normetanephrine (noradrenaline metabolite) in the urine. In patients with a predominance of the sympathetic tone of the autonomic nervous system, there was a decrease in the levels of metanephrine and dopamine in the urine, as compared with  healthy individuals with a similar tone of the autonomic nervous system. In patients with thyroid-stimulating hormone  supersuppression (TTG < 0.1 mE/L), there was a significant decrease in the median of the cortisol level in the blood as  compared to the control.  The obtained data demonstrate the presence of compensatory mechanisms of balance of the sympathoadrenal system in  subclinical hyperthyroidism, as well as the threat of development of hypocorticism in supersuppression of the thyroidstimulating hormone (TTG < 0.1 mE/L).

A prospective comparative study of the diagnostic efficiency of X-ray computed tomography (CT), ultrasound  (US), bone marrow biopsy, osteoscintigraphy and a new safe diagnostic method – whole body diffusion-weighted magnetic  resonance imaging (MRI-DWI) in staging lymphoma was conducted. We examined 158 adults including 68 with Hodgkin  lymphoma and 90 with non-Hodgkin lymphoma. MRI-DWI demonstrated the highest diagnostic efficiency of lymphoid and  bone marrow lesions. For the first time, indications for bone marrow biopsy in patients with lymphoma who underwent whole  body MRI-DWI were determined. A new highly effective and safe lymphoma staging algorithm has been developed, including  whole  body  MRI-DWI,  US  of  the  spleen,  bone  marrow  biopsy  (by  indications).  The  developed  algorithm  increases a lymphoma staging accuracy with respect to CT without intravenous contrast by 23 %, with respect to CT with intravenous  contrast by 17 %. The staging accuracy was 98 %. At the same time, X-ray and radioisotope radiation is not used, intravenous  administration of contrast agents and radioactive isotopes is not required, the number of bone marrow biopsies is reduced by  72 %, and a cost of patient examination is reduced.

The model studies on C6 glioma cells showed that the role of nicotinic acetylcholine receptors (nAChR) in the  regulation of the redox balance varies under different cultivation conditions. In a serum-free medium, the inhibitor of nAXP  alpha-cobratoxin alleviates the oxidative stress that is manifested in an increase in the activity of superoxide dismutase and  catalase, the level of reduced glutathione and in a decrease in the concentration of malonic dialdehyde.

The analysis of the long-term results of treatment of 1065 radically operated gastric cancer patients was carried out. 103 of them underwent combined operations. A statistically significant effect of the nature of the operation performed on the number of postoperative complications (4.9 % after combined operations, 1.1–3.4 % after standard operations)  and the incidence of disease progression (39.8 % after combined operations, 17.8–30.1 % after standard operations). Prevalence in the structure of the progression of peritoneal dissemination was noted, the 4-year cumulative incidence of which after  combined operations was 41.1 ± 0.3 % and after standard operations – from 13.26 ± 0.02 to 27.27 ± 0.07 %. The latter testifies  to a relative radical surgical treatment when a tumor leaves the gastric wall, which requires the use of adjuvant treatment  aimed at preventing the progression of gastric cancer, primarily with disseminated peritoneal lesions.

The search for new effective methods of preventing or reducing ischemic myocardial injury and its mechanisms of realization is an actual problem of modern experimental and clinical medicine. The aim of the study was to determine the reproducibility of antiischemic and antiarrhythmic effects of the remote ischemic preconditioning myocardium of rats with dysrlipidemia (DLE). It was found that remote ischemic preconditioning is not  effective in terms of necrosis zone size limits in the left ventricle during ischemia-reperfusion in rats with DLE. At the same  time, after the reproduction of remote ischemic preconditioning in rats with DLE, a pronounced antiarrhythmic effect takes  place, as evidenced the decrease in the duration of ischemic heart rhythm disturbances by 85 % (p < 0.05). The findings  indicate the need for a differentiated approach to the appointment of remote ischemic preconditioning in patients with acute  myocardial infarction. The existence of such a risk factor for cardiovascular diseases such as DLE can be a criterion for  exclusion remote ischemic preconditioning as a way of reducing ischemic and reperfusion injury of the myocardium in  patients with acute myocardial infarction.

An electron microscopic method for analyzing the cells of the stromal component of colon cancer has been applied. During the study, cells of hematogenous and mesenchymal origin with altered ultrastructures were found.

Antiphospholipid syndrome (APS) is an important multidisciplinary problem, especially in obstetrics. The assessment of the health status of children born by mothers with APS is no less significant. Based on the analysis and the systematization of literature from 1987 to 2017, the modern aspects of pathogenesis and diagnostic criteria are presented; both  immediate and long-term consequences of mothers’ APS influence on their offspring are considered. APS during pregnancy  can lead to an increase in the incidence of pregnancy and passive transmission of antibodies to the fetus, which increases the  risk of prematurity, intrauterine growth retardation (IUGR), thrombocytopenia. Antiphospholipid antibodies can influence  the nervous system during the embryonic period. Circulation of antibodies in newborns is rarely able to lead to thrombosis,  usually against the background of an infectious process and/or hereditary thrombophilia. The health status of newborns, born  by mothers with APS, depends on the gestational age, the level of physical development, the interest of brain structures. Further, a long-term follow-up is needed to assess the health status of children in different age periods.

Highly differentiated carcinoma is becoming more generalized and socially significant disease. Being spread among the highly prevalent benign thyroid nodules, this pathology creates additional requirements for early diagnostics. Detection of certain mutations, like BRAF, RAS, PIK3CA, AKT1, PTEN, ТР53, TERT, RET/PTC, PAX8-PPARγ, CTNNB1 in the fine needle aspiration material of papillary, follicular, medullar and anaplastic thyroid carcinoma or follicular  adenoma of the thyroid is used for the improved diagnostics and correct treatment of this conditions. Authors consider, that combination of two biomarkers and more in a single test-panel will provide a diagnostically significant result for the detection and prognosis of the development of the carcinoma, what is important for the  creation of the patient’s follow up plan. As for the diagnostics of follicular neoplasias a diagnostic panel of 7 genes was proposed: BRAF, KRAS, HRAS, NRAS, RET/PTC1, RET/PTC3, PAX8/PPARγ with a sensitivity 57–75 % and specificity 97–98 %. In case of cytological result of “atipia of non identified malignancy potential” or “follicular lesion of non identified significance” usage of this panel will be highly effective. In case of papillary thyroid carcinoma suspicion a BRAF gene (sensitivity – 36 %, specificity – 98 %) or a gene-panel of BRAF, RAS, RET/PTC, PAX8/PPARγ (sensitivity – 50–68 %, specificity – 86–96 %) should be analyzed. Test-panels ThyroSeq (versions 1 and 2), ThyGenX, RosettaGXReveal and ThyroidPrintThyr with the sensitivity of about 90 % substantially increase the quality of diagnostics, however their cost and complexity in implication of this tests prevent their usage as routine methods.