According to the epidemiological studies, in patients with myocardial infarction acute kidney injury develops in the majority of cases. This combination of pathologies is prognostically unfavorable and requires an in-depth study.

The article presents the examination data of the structural and functional state of the cardiovascular system of 109 patients with acute ST-segment elevation myocardial infarction (STEMI). The studied patients were divided into two groups. The main group consisted of patients, whose myocardial infarction was complicated by the development of acute ischemic kidney injury (n = 65); the comparison group included patients with myocardial infarction and normal kidney function (n = 44). The results of electrocardiography, echocardiography and coronary angiography of the studied patients were analyzed. Patients with myocardial infarction and acute ischemic kidney injury were characterized by more pronounced ischemic changes according to electrocardiography, a more pronounced decrease in local and global contractility of the left ventricle, a larger size of the left ventricular cavity, a more frequent incidence of coronary artery multivascular lesions, a greater proportion of patients with thrombotic occlusion of the associated artery infarction and a more frequent localization of the lesion in the left anterior descending artery.

The information technology has been developed for detecting unstable states of the cardiovascular system based on dispersive bioelectric models and 4th generation electrocardiography. New equipment and software for assessing predictors of life-threatening arrhythmias have been created and certified. The reserves of cardiac activity adaptation from elite athletes to patients with myocardial infarction have been studied. A risk stratification model has been developed for patients with chronic heart failure, the forecast correctness was 94.7 %.

A comparative analysis of structural organization changes in skin microcirculatory vessels, serum level of leptin, diponectin, resistin in the ase of metabolic syndrome and doxorubicin intoxication was performed. It was shown that hypertrophy of the muscle fibers, perivascular space edema, and skin arteriole spasm in the metabolic syndrome accompanied by a structural reorganization of the organs and their vessels by the type of dystrophy. In the case of doxorubicin intoxication, the alteration processes were dominant. Changes in the level of hormones leptin adiponectin and resistin in the metabolic syndrome and doxorubicin intoxication were multidirectional.

Mechanisms of development of ischemic stroke are complex and have not been fully established. The aim of this study was to estimate the changes in the pool of free amino acids and biogenic animes in the brain cortex of rats with subtotal cerebral ischemia (SCI) and treated with L-NAME. Experiment was made on 18 rats: 12 animals were undergoing bilateral filament occlusion of arteries carotid, 6 of them were treated with L-NAME. The analyses of free amino acids levels in the blood plasma extracts were carried out by reversed phase HPLC.

Concentrations of several amino acids were elevated during SCI including aspartate, b-alanine, valine and leucine. In contrast, the levels of glutamate, asparagine, treonine, gamma-aminobutiric acid, tyrosine and 5-hydroxiindolylacetate were decreased. The administration of L-NAME partially prevented the imbalance of the amino acids pool due to SCI by normalizing the levels of aspartate, glutamate, asparagine, methionine, gamma-aminobutiric acid, b-alanine, 5-hydroxiindolylacetate. However, the administration of L-NAME has induced an additional imbalance in the amino acids pool in the brain cortex (decrease in the levels of glutamine, histidine, taurine, tryptophan, phenylalanine, tyrosine (in comparison to SCI) and decrease in the levels of treonine and arginine. The imbalance of the amino acids pool induced by the administration of L-NAME during SCI is more severe than the imbalance caused by SCI.

 In experiments on 60 white outbred male rats, the effect of the stress of “deficiency of time” on somatic (relative masses of the adrenal glands, thymus and spleen, gastric mucosa, consentrations of corticosteroids and insulin in the blood) and behavioral (vertical and horizontal motor activity) indicators of stress-reactions, physical endurance of animals, thyroid function (serum concentration of total and free fractions of triiodothyronine and thyroxine, thyrotropic hormone) is considered.

As a result of the study, it was found that the stress of “deficiency of time” causes an increase in the relative mass of the adrenal glands (by 31 %), a decrease in relative masses of the thymus and spleen (by 26 and 14 %), damage to the gastric mucosa (in 80 % rats with a severity 1 point in 20 % rats, 2 or 3 points in the remaining 60 % in the 1:1 ratio; a multiplicity of 2 hemorrhages per animal in 30 %, 3 in 40 % and 4 in 10 % rats, damage index is 4.7), changes in the serum concentration of corticosteroids (increase by 43 %) and insulin (decrease by 19 %) and leads to the activation of thyroid function (age concentration of total and free triiodothyronine and thyroxin increased by 18–32 %). Under the stress of “deficiency of time”, the horizontal locomotor activity and the physical endurance of animals increase, while their vertical locomotor and exploratory activity decreases. The proposed model allows studying the mechanisms of development of stress damage in order to develop new ways to limit the negative effects of emotional stress on human health.

The effectiveness of the colonic esophagoplasty planning method for surgical treatment of esophageal and gastroesophageal junction carcinomas is evaluated by analyzing factors that affect the mortality risk from respiratory complications and other causes.

Colonic esophagoplasty in cases of non-transplanted stomach was performed in 109 patients with esophageal carcinomas – 66.1 % (72/109) and gastroesophageal junction carcinomas – 33.9 % (37/109). Esophagoplasty was performed using the planning method (selective angiography and trial clamping of vessels) which was applied in 40.4 % (44/109) patients. The method effectiveness was evaluated by determining the effect of mortality risks (hazard ratio – HR) from respiratory complications (aspiration pneumonia and adult respiratory distress syndrome) and other causes.

Postoperative morbidity was determined in 66.8 % (73/109) observations. Graft necrosis was diagnosed in 7.3 % patients (8/109), esophageal anastomosis leakage without graft necrosis – in 5.5 % patients (6/109), pneumonia – 14.7 % patients (16/109) patients, pulmonary and heart failure – in 5.5 % patients (6/109), pulmonary artery thromboembolism – in 0.9 % patients (1/109). The use of the planning method reduced the mortality risk from respiratory complications and from other causes (HR 0.46 [95 % CI 0.24–0.89], p_Cox = 0.021 and HR 0.52 [95 % CI 0.29–0.95], p_Cox = 0.034, respectively).

The planning method allows selecting the most suitable colonic segment, planning in advance the levels of feeding vessels intersection and forming a graft by subtotal colon mobilization. Adverse factors in relation to the mortality risk from respiratory complications and from other causes are the fact of graft necrosis development, the presence of long-existing cervical fistula in conditions of wound infection and the presence of bile reflux, stage III and IV of malignant tumors.

The aim of the study was to evaluate relations between the deposition of IgA, IgG, IgM, C3, C1q and baseline clinical features and pathological findings.

According to exclusion criteria, 72 patients with diagnosed primary IgAN who were biopsied from 2015 to 2017 in the district of the Minsk city, Belarus were included for retrospective analysis. All biopsy had to be reviewed according to the Oxford classification (MEST-C). We examined the immunofluorescence staining with antibodies against IgG, IgA, IgM, C3, C1q.

Mean age was 32 (26; 42.5) years, 72.2% was men, 48.6% of the patients had arterial hypertension. Median of proteinuria was 870 (355; 1420) mg/day, 8.4% of the patients had isolated hematuria, serum creatinine – 104 (89; 126.5) µmol/l.

The patients with 3+ IgA deposits showed a significantly higher percentage of crescents (C1-2) than those with 2+ IgA deposits (p = 0.028). The presence of C3 deposits showed a gradual increase in the percentage of endothelial proliferation (E1) (p = 0.007). The degree of IgA deposits showed a significant negative relation to the IgM deposits (p = 0.01) and a positive relation to the C3 deposits (p = 0.001).

We found that the intensity of IgA and C3 deposits is associated with histopathology markers of the acute reaction (C1-2 and E1) according to the Oxford classification. At the same time, the appearance of the IgM deposits testifies the acute phase of the disease as well as the advanced sclerotic stage in some patients.

The aim of the study was to establish the diagnostic significance of biochemical parameters, considered as markers of epileptic seizures in patients with arterial aneurysms (AA). 82 patients with AA (50.4 ± 11.5 year-old) with epileptic seizures (35 persons) and without them (47 persons) were examined. Before treatment, the following biochemical parameters were determined in plasma of patients: lactate, pyruvate, products reacting with thiobarbituric acid (TBA-P), antioxidant activity of the serum, activity of superoxidedismutase and catalase, tumor necrosis factor-alpha (TNF-ά). To characterize the diagnostic significance of the results, the diagnostic sensitivity and the diagnostic efficacy were determined. The complex of biochemical tests with high diagnostic significance, consisting of lactate, lactate/pyruvateindex, catalase activity, TBA-P and TNF-α, was established in patients with AA with epileptic seizures. It allows considering these parameters as markers of epileptic seizures development in patients with AA. Among the most diagnostically significant tests for detection of epileptic seizures in patients with AA should be considered the concentration of TNF-ά with diagnostic sensitivity of 73%, the diagnostic specificity of 79% and the diagnostic efficacy of 75%.

The results of assessing the survival rate of probiotic microorganisms on media containing sodium glutamate, tartrazine and sodium benzoate in the concentration range of 10^–4 –10^–7 M in vitro are presented. It is shown that the effect of glutamate, sodium benzoate and tartrazine on different strains manifests itself both in a sharp inhibition of the viability of cultures and a stimulation of their growth. In the Lactobacillus acidophilus with tartrazine of 10^–4 M and 10^–5 M, the survival rate of the strain ranged from 10.5 to 45.62% as compared to the control. The survival rate of the Enterococcus faecium SF 68 strain with nutritional supplements of 10^–5 M and 10^–6 M was 15.29 and 35.6%, respectively, and Escherichia coli M 17 strain ranged from 49.1 to 58.29% as compared to the control.

Enteroviruses are widespread human pathogens characterized by a high level of a genetic diversity. They cause different clinical forms of infection. The aim of the present study was to analyze the molecular epidemiology of enterovirus infection in the application to the structure of its clinical forms in 2016–2017.

ECHO viruses predominated among patients with aseptic meningitis and were prevailing group of enteroviruses in 2016 (all ECHO viruses – 58%, including ECHO 9 – 26%, ECHO 6 –14%, ECHO 16 – 10%). In 2017, Coxsackieviruses prevailed (68%), that were including Coxsackievirus B5 (31%), Coxsackievirus B1, Coxsackievirus B4 and Coxsackievirus A6 (9% of each serotype). Coxsackieviruses were detected more frequently in patients with vesicular pharyngitis and unspecified enterovirus infection. The results of the molecular epidemiological analysis indicated that the prevalence of ECHO viruses in 2016 and Coxsackieviruses B in 2017 was due to the emergence of numerous new genovariants of these viruses.

Hereditary angioedema due to the C1-inhibitor deficiency (Type I) or the dysfunction (Type II) is a rare genetic condition characterized by recurrent episodes of edema with an estimated frequency of 1:10 000 and 1:50 000 in the global population without racial or gender differences. HAE Type III is even less common, and unlike Types I and II, it does not appear to be connected with the levels of the C1-inhibitor. For 45 patients (64.44% female; 35.56% male) from 19 unrelated families C1-INH-HAE was confirmed. A series of 19 different mutations in the SERPING1 gene was identified: 17 splicing (37.7%), 15 missense (33.3%), 8 frameshift (17.8%), 3 large del (6.7%), 2 nonsense (4.5%) mutations were found. De novo mutations were detected in 8 patients (17.78%). For 6 patients, the HAE diagnosis was determined at the pre-symptom stage. 9 C1NH mutations had not been previously described. The number of different mutations identified highlights the heterogeneity of the C1 inhibitor deficiency.

Vulvar lichen sclerosus (LS) is a common chronic mucocutaneous disease, which is usually underdiagnosed and tend to progress without adequate treatment.

Morphological characteristics of vulvar LS with unusual histological features.

Vulvar biopsy material (n = 83) with morphologically diagnosed LS was examined histologically and statistically.

Often saw-toothed modification of the epithelium, fibrinoid necrosis, cytoid bodies, satellite cell necrosis, hemorrhages, papillomatosis, milia, predominantly plasma cell inflammatory infiltrate, lymphoid follicles, elastosis, angiokeratoma-like vasculare change were found on the background vulvar LS.

Saw-tooth epidermal change, multiple cytoid bodies and satellite cell necrosis are histological features of LS described for the first time in this study, the former being a frequent presentation of vulvar LS. The mentioned above histological changes cannot appear as features in favor of lichen planus in the differential diagnosis of these diseases.

The influence of melatonin on the prooxidant–antioxidant balance in 18 to 21 year-old males with a low-level physical state at submaximal physical exertion is considered. The studied group took melatonin 3 mg once a day for 2 months. As a result of taking melatonin after physical exertion, there is a decrease in the activity of processes of peroxide oxidation of lipids and a high level of antioxidant protection in the blood plasma and erythrocytes, which diminishes the manifestations of the oxidative stress and maintains the prooxidant–antioxidant balance of an organism.

34 cases of craniocervical junction region meningiomas are analyzed. It was about 1.6% of the general number of patients with primary symptomatic intracranial meningiomas. Lateral or anterolateral meningiomas were in 31 cases (91.2%), posterior – in 2 cases (5.9%), anterior without lateralization – in 1 case (2.9%). 27 patients (79.4%) are operated on through the suboccipital approach, 7 patients (20.6%) – through the far-lateral suboccipital (transcondyllar) approach. Total removal of tumors was made in 24 cases (70.6%), subtotal removal – in 6 cases (17.6%), partial removal – in 4 cases (11.8%). Mortality was not observed. Intraoperative monitoring significantly improved the preservation of neurological functions. There were no cases of tumors recidivating during a long-term observation.

The suboccipital lateralized approach with laminectomy till the level of the lower pole of the tumor was sufficient to provide an adequate microsurgical removal of meningiomas of the craniocervical junction without resection of an atlantooccipital joint. The approach to the neoplasm matrix should be carried out after partial tumor resection without traction of brain stem parts. The use of intraoperative neuromonitoring supervised the stem functions at all stages of tumor removal and during the vertebral artery allocation.