The objective was to study the effect of drug «Oxyphtem»1 on liver morphometric parameters in a systemic inflammatory response.Materials and methods. The experimental study was carried out on male Wistar rats (n = 26). The rats of the experimental group were injected with drug «Oxyphtem» intravenously once. Daily observation was carried out during14 days. Rats were taken out of the experiment on the 15th day under light ether anesthesia. Liver samples were fixed in 10 % neutral formalin in phosphate buffer for 24 hours. Histological preparations were studied using the Measure Pixels image analysis computer program based on a Leica 2000 light microscope.Results. In the intact group of rats, no violations of the liver parenchyma were detected: hepatocytes had clear boundaries, the lamellar structure was preserved and sinusoidal capillaries were not dilated. With the development of the systemic inflammatory response in the liver of rats of the control group, expansion and blood filling of the central veins and sinusoids, violation of the structure of the liver plates, and perinuclear edema of hepatocytes were noted. In the experimental group of rats with the use of drug «Oxyphtem», the preservation of the structure of the liver plates was observed, binuclear hepatocytes were found, and the sinusoids were not expanded. We hypothesize that hepatocyte proliferation and the increase in binuclear hepatic cells were indicative of the regenerative response to systemic inflammatory damage and metabolic demand.Conclusion. The use of drug «Oxyphtem» under conditions of the experimental systemic inflammatory response increases reparative regeneration and adaptation of the liver.

We examined 75 patients with T2DM: the control group - patients without CKD (n=10) and the main group - patients with CKD (n=65). The main group was also divided into 2 groups according to estimated GFR (eGFR; in mL/min/1.73m2) by the CKD-EPI: eGFR≥60 (n=45) and eGFR<60 (n=20).MP imaging was performed using SPECT - AnyScan® SC - Mediso with technetium-99m sestamibi. The following scale was used to determine the SRS measure: 0 points - 70% or more, 1 point - 69-50%, 2 points - 49-30%, 3 points - 29-10%, 4 points - 9% and below in 17 segments of the polar map.The average age of patients in the control group was 54.3±9.14, and 30% were men. In the main group, the average age was 58.05±8.0, and 41.5% were men, and their average eGFR was 74.5±26.39 mL/min/1.73m2.70% of patients in the control group had SRS=0, i.e. normal myocardial perfusion at rest. The remaining 30% of patients had a minimally abnormal results (SRS=1-2). The number of patients with normal MP observed decreases when CKD occurs: 46.7% in the group with eGFR>60ml/min and 35% in patients with eGFR<60ml/min. In patients with CKD, not only the number of patients with decreased MP increases, we can observe that its severity also increases: the percentage of patients with the SRS=1-2 is 35.5% and 35%, SRS=3-4 in 15.6% and 10%, and SRS≥5 were 2.22% and 20%, in the groups of GFR>60 and GFR<60 respectively (p=0.041).

The European Renal Association (ERA) Registry collects data on kidney replacement therapy (KRT) in patients with end-stage kidney disease (ESKD). This paper is a summary of the ERA Registry Annual Report 2021, including a comparison across treatment modalities. Data was collected from 54 national and regional registries from 36 countries, of which 35 registries from 18 countries contributed individual patient data and 19 registries from 19 countries contributed aggregated data. Using this data, incidence and prevalence of KRT, kidney transplantation rates, survival probabilities and expected remaining lifetimes were calculated. In 2021, 533.2 million people in the general population were covered by the ERA Registry. The incidence of KRT was 145 per million population (pmp). In incident patients, 55% were 65 years or older, 64% were male, and the most common primary renal disease (PRD) was diabetes (22%). The prevalence of KRT was 1040pmp. In prevalent patients, 47% were 65 years or older, 62% were male, and the most common PRDs were diabetes and glomerulonephritis/sclerosis (both 16%). On 31 December 2021, 56% of patients received haemodialysis, 5% received peritoneal dialysis, and 39% were living with a functioning graft. The kidney transplantation rate in 2021 was 37 pmp, a majority coming from deceased donors (66%). For patients initiating KRT between 2012-2016, 5-year survival probability was 52%. Compared to the general population, life expectancy was 65% and 68% shorter for males and females receiving dialysis, and 40% and 43% shorter for males and females living with a functioning graft.

The relationship between the content of metallothioneins, copper and zinc ions in peripheral blood plasma in chronic lymphocytic leukemia (CLL) depending on the disease progression was studied. It was shown that in patients with CLL in blood plasma with a progressive disease, partial and complete remission, the values of the zinc-to-copper ratios significantly decreased in comparison to similar indicators of practically healthy donors. It was established that in patients with CLL, the level of metallothioneins in blood plasma decreases with the disease progression compared to other studied groups, which indicates a reduced function of cysteine-containing metallothionein proteins. Based on the obtained data, it can be concluded that the zinc-to-copper concentration ratio and the level of metallothionenins in peripheral blood plasma are potential diagnostic and prognostic markers in chronic leukemia.

Autoimmune encephalitis associated with anti-LGI-1 antibodies is a new type of autoimmune neurological disease.We present a description of a clinical case — this disease in a patient who was hospitalized at the Republican Scienti fi c and Practical Center for Neurology and Neurosurgery. During the analysis of blood and cerebrospinal fl uid for the presence of antibodies to autoimmune encephalitis, antibodies — IgG to anti-LGI-1 in the blood and cerebrospinal fl uid were detected. Conducted immune therapy, including intravenous administration of glucocorticosteroids, plasmapheresis and intravenous immunoglobulin led to a pronounced positive dynamics in the patient’s condition. Follow-up data indicate that the patient returned to her previous work after a course of therapy.

When analyzing pharmacoeconomic studies of the skin melanoma treatment conducted in various countries, the combinations of vemurafenib + cobimetinib and encorafenib + binimetinib are the most acceptable therapy options in terms of increasing life expectancy with adjustments for quality, but, according to the clinical guidelines of the National Joint Oncology Network (NCCN), USA, version 2.2023 – “Melanoma: Cutaneous”, not for adjuvant therapy. At the same time, social networks can be a valuable asset of information about patient’s quality of the life. For the patients with advanced melanoma with a BRAF mutation, the combination of atezolizumab + vemurafenib + cobimetinib indicated the highest clinical effectiveness and can be recommended for pharmacotherapy under condition of drug price reduction.Comparison various drugs combinations with monotherapy for patients with unresectable or metastatic melanoma with a positive BRAF V600 mutation indicated that nivolumab + ipilimumab therapy is not cost-effective in comparison with nivolumab monotherapy, but combination of dabrafenib + trametinib, on the contrary, increases the patient's life expectancy compared to vemurafenib and it’s more cost-effective. It was shown that Pembrolizumab to increase life expectancy but it’s associated with increased costs compared to ipilimumab when comparing different monotherapy options. The assumed additional cost-effectiveness factor is acceptable for most European countries, because it does not exceed the “willingness to pay” threshold. It is necessary to conduct large-scale pharma-economic studies in order to identify the most cost-effective treatment for Russia for various variants of the course of melanoma, both of various combined regimens with each other, and their comparison with monotherapy. It is important to take into account also the costs of correcting undesirable adverse drug reactions, since they have a significant impact to the structure of direct costs. The development of innovative drugs for the treatment of melanoma is proceeding rapidly, however, access to these drugs is limited due to their high cost. Patient-centred drug development and reimbursement options need to be found.

Aim. To conduct a systems analysis of clinical and epidemiological risk factors of bacterial complications associated with liver transplantation, to evaluate the effectiveness of their prevention algorithm.Materials and methods. The authors analyzed the treatment outcomes of 1000 recipients who underwent liver transplantation from April 2008 to April 2023. The study involved analysis of correlation between infections associated with health care and main risk factors, including contamination of different loci and preservation solution.Results. The incidence of healthcare-associated infections accounted for 22.2%. The cumulative incidence of donor organ and recipient contamination was 9.85%. Transmission of infection occurred in 29% of cases. Sepsis developed in 8% of all recipients with healthcare-associated infection. The mortality rate was 70% in cases of sepsis. After liver transplantation, in-hospital mortality was 9.3%. Urgent transplantation was required in 10.7% of observations. Univariate regression analysis shows the highest risk contribution to healthcare-associated infection for the MELD score, contamination of preservation solution with multidrug-resistant flora, severe early graft dysfunction, blood loss, and warm ischemia time.Conclusion. Contamination of preservation solution increases the risk of bacterial complications associated with liver transplantation. The resistance profile affects the development time, structure and outcome of these complications. Timely diagnosis and infection control measures are fundamental to preventing the infectious complications.

AbstractPolytetrafluoroethylene (PTFE), octenidine dihydrochloride (OCT), and zinc oxide (ZnO) were used to modify the polypropylene nonwoven material by the methods of “wet chemistry” and low‐energy electron beam deposition (EBD). The influence of nonwoven material modification on the morphology, chemical composition, filtration, and antibacterial properties was established. The modified material has antibacterial activity against the gram‐positive strain Staphylococcus aureus and against gram‐negative strains of Escherichia coli and Klebsiella pneumoniae (suppression of bacterial growth for materials with OCT was 100%, with ZnO—70%). PTFE application to Aquaspun leads to a significant increase in the contact angle (from 141.3° to 152.7°) and air filtration efficiency (from 78.3% to 83.4%), which provides the barrier properties of the material. It was established that the material obtained using low‐energy EBD demonstrated a more pronounced antimicrobial potential against the tested strains of St. aureus.Highlights The influence of polypropylene nonwoven materials surface modification methods is systematically investigated. Low‐energy electron beam deposition increases antibacterial and filtration properties of nonwoven materials. Surface modification methods increase barrier properties of polypropylene nonwoven materials.