Krasnoyarsk State Medical University

Introduction. The combination of esophageal pathology and bronchial asthma is frequently encountered in clinical practice, but in some cases it may remain unrecognized due to diagnostic difficulties and a lack of clinical suspicion. Aim. To evaluate the structural, functional, and laboratory abnormalities detected in patients with bronchial asthma combined with esophageal pathology. Materials and methods. The study was conducted at the Allergology Department of the Krasnoyarsk Regional Clinical Hospital. Sixty-nine patients admitted for inpatient treatment with a diagnosis of bronchial asthma were examined. Based on clinical and anamnestic data, the patients were divided into two groups: those with bronchial asthma without esophageal pathology (Group 1: 38 patients (55.07%)) and those with bronchial asthma combined with esophageal pathology (Group 2: 31 patients (44.93%)). The examination methods included: anamnestic analysis, physical examination, completion of the ACQ-5, ACT, GERDQ, and dysphagia questionnaires, instrumental tests (spirography with a bronchodilator, fibrogastroduodenoscopy), laboratory tests, and esophageal morphological examination. Results. Patients with asthma combined with esophageal pathology had a significantly higher number of daytime and night-time attacks and, consequently, a higher need for SABA. According to spirometry data, fixed airway obstruction was significantly more common among patients in Group 2. Immune status showed a significant decrease in NKT cells in Group 2 patients. A decrease in NKT cells in patients with bronchial asthma combined with esophageal pathology, as well as a negative association with fungal esophagitis, may indirectly indicate a decrease in epithelial barrier function and, consequently, a greater vulnerability to environmental factors, as also confirmed by the AQLQ questionnaire scores in the “environment” domain. Conclusions. The obtained data confirm the aggravating effect of esophageal pathology on the course of bronchial asthma and also indirectly indicate changes in the mucosal immune system, which may lead to combined damage to the mucous membranes of the esophagus and respiratory tract.

Objective — to analyze current data on anesthetic management techniques for abdominal delivery in pregnant women with morbid obesity. The review was conducted by searching PubMed, Google Scholar, and eLibrary databases from January 1, 2000, to August 31, 2024, using the keywords: pregnancy, obesity, body mass index, cesarean section, anesthesia, and complications. The search yielded 724 references. 655 references were excluded from the review due to their description of pregnancy management and spontaneous labor in obese patients. The literature review included 69 references. Inclusion criteria: design (clinical studies in all peer-reviewed journals without language or national restrictions); subjects (pregnant women with obesity grade II or higher). This review examines anesthesia techniques for cesarean section in pregnant women depending on the severity of obesity. The analysis revealed a wide range of neuraxial and general anesthesia techniques, each with its own advantages and disadvantages, and none is “perfect.” Anesthetic management of abdominal delivery in pregnant and postpartum women with morbid obesity requires a personalized, multidisciplinary approach. The review data suggest that further research is needed to personalize anesthesia for cesarean section in obese patients.

Epileptogenesis is commonly defined by the emergence of spontaneous seizures after an initial insult; however, convergent experimental and clinical evidence indicates that the underlying disease process begins well before seizures become clinically detectable. During this pre-seizure phase, persistent molecular cascades remodel synaptic plasticity, circuit architecture, and glial-immune signaling. These processes are associated with trait-like alterations in cognition, affect, and behavior. Despite their clinical relevance, these neurobehavioral signatures remain poorly integrated into molecular models of epileptogenesis and are rarely considered as translational biomarkers of disease progression. This review synthesizes evidence linking core epileptogenic molecular cascades-maladaptive synaptic plasticity, glial-immune signaling, oxidative-metabolic stress, and activity-dependent gene regulation-to reproducible alterations in executive control, cognitive flexibility, emotional regulation, and motivational-social behavior. We outline an integrative framework in which these phenotypes are conceptualized as system-level readouts of progressive network reconfiguration rather than nonspecific "comorbidities" or mere consequences of recurrent seizures. Within this perspective, neurobehavioral markers can complement electrophysiological and molecular measures by capturing disease-relevant changes during windows when anti-epileptogenic interventions would be most effective. To increase mechanistic specificity, we provide representative pathway and gene-level anchors across epileptogenesis stages, a structured molecular-to-neurobehavioral mapping, and an operational biomarker panel specifying confounders and minimal controls. These anchors are included to ground the framework in experimentally documented molecular nodes with stage-dependent relevance; examples are representative rather than exhaustive, and evidence strength is indicated as preclinical mechanistic versus associative human observations. Finally, we discuss methodological requirements for biomarker validity (specificity, temporal anchoring, and cross-model consistency) and outline how integrating molecular and neurobehavioral trajectories may refine target discovery and improve the translation of anti-epileptogenic strategies. Conceptualizing epileptogenesis as a progressive disease process with measurable pre-seizure neurobehavioral signatures may broaden biomarker strategies beyond seizure occurrence and support the development of disease-modifying interventions.

509 Background: Venous tumor thrombus (VTT) in patients with renal cell carcinoma (RCC) represents an aggressive disease feature associated with poor prognosis and management challenges. The efficacy of immunotherapy-based combinations in this subgroup remains insufficiently characterized. Methods: The PELET trial is an ambispective study enrolling adult patients with histologically confirmed advanced RCC and unresected VTT. Patients received lenvatinib 20 mg orally once daily in combination with pembrolizumab 200 mg intravenously every 3 weeks. The primary endpoint was a ≥30% reduction in thrombus size. Secondary endpoints included changes in thrombus level, progression-free survival (PFS), and safety. Results: Twenty patients were included, predominantly male (85%), with a median age of 58.5 years. Most had clear cell histology (90%) and no sarcomatoid features. The median baseline thrombus size was 6.55 cm, which decreased to 3.0 cm after at least 12 weeks of therapy (p < 0.001). A ≥30% reduction in thrombus size was achieved in 45% of patients, meeting the primary endpoint. Moreover, 35% experienced a reduction in thrombus length > 50%, and 45% demonstrated a decrease in thrombus level by at least one level. Thrombus response was not correlated with baseline thrombus size. Median PFS was not reached at the time of analysis. Grade ≥3 adverse events occurred in 15% of patients. Conclusions: Twenty patients were included, predominantly male (85%), with a median age of 58.5 years. Most had clear cell histology (90%) and no sarcomatoid features. The median baseline thrombus size was 6.55 cm, which decreased to 3.0 cm after at least 12 weeks of therapy (p < 0.001). A ≥30% reduction in thrombus size was achieved in 45% of patients, meeting the primary endpoint. Moreover, 35% experienced a reduction in thrombus length > 50%, and 45% demonstrated a decrease in thrombus level by at least one level. Thrombus response was not correlated with baseline thrombus size. Median PFS was not reached at the time of analysis. Grade ≥3 adverse events occurred in 15% of patients. Clinical trial information: KCRB-092025-01.

The aim: identifying the role of single nucleotide polymorphism (SNP) carrier rs1800795 (-174G/C) of the interleukin-6 IL6 gene and rs5275 (+ 8473T/C) of the cyclooxygenase-2 PTGS2 gene in the development of acute pancreatitis. Materials and methods: The case-control study involved 296 people diagnosed with acute pancreatitis (OP). There were 124 (41.89%) males and 172 (58.11%) females. By age, patients ranged from 24 to 83 years old, the average age was 44,3±12,6 years. Patients with mild severity OP - 103 (34.79%) people, moderate severity OP - 110 (37.16%) people, severe severity OP - 83 (28.05%) people. The control group amounted to 78 people. In real time determined by the PCR method the frequency of occurrence of ONP rs1800795 (-174G/C) a gene of IL6 and ONP rs5275 interleukin-6 (+ 8473T/C) a gene of PTGS2 cyclooxygenase-2 at sick OP with varying severity. Statistical data processing was carried out using the MS Excel for Windows program and the STATISTICA 10.0 software package. Results: When comparing alleles in patients of all grades with the control group, carriage as a risky variant allele G (rs1800795 (-174G/C) rs1800795 (interleukin-6 IL6 gene) (OR 2,334; 95% CI 1,611-3.381; p < 0.001) and homozygous GG (OR 6.713; 95% CI 2,957-15,242; p < 0.001) genotypes can be considered as a risk factor for the development of acute pancreatitis. Comparison of alleles in patients with severe OP severity and control group allowed to establish that carriage as a risky variant allele of G (rs1800795 (-174G/C) rs1800795 (IL-6) gene (OR 2.320; 95% CI 1.435-3.750; p < 0.001) and homozygous GG (OR 7.607; 95% CI 3.023-19.146; p < 0.001) of the genotype can be considered as a risk factor for the development of severe acute pancreatitis. When comparing alleles in patients of all grades with control, carrying a risky variant G allele of the PTGS2 gene (COX-2) (OR 1.588; 95% CI 1.063-2.282; p = 0.023), is a risk factor for the development of OP. When comparing alleles in patients with severe severity of OP and control group: carrying a risky variant allele G (OR 1.813; 95% CI 1.117-2.942; p = 0.016), can be considered as a risk factor for the development of a severe course of acute pancreatitis. Conclusion: Thus, in residents of Krasnoyarsk, the carriage of both the rs1800795 (-174G/C) IL6 gene and the rs5275 (+ 8473T/C) PTGS2 gene can serve as a predictor of the development of OP and severe disease

Highlights In the analytical review, the main pathophysiological mechanisms of myocardial infarction development are presented, including complex molecular processes that lead to ischemia and necrosis of the heart muscle. Historically, understanding of this condition has come a long way from its first descriptions to modern diagnostic and treatment methods, which have significantly improved the prognosis for patients with MI. Understanding the history and pathophysiology of myocardial infarction is key to medical practice, research, and patient education. This knowledge contributes to improved diagnosis, treatment, and prevention, which ultimately leads to improved quality of life for patients and a reduced burden of cardiovascular disease at the societal level. Abstract Understanding the historical aspects and pathophysiology of myocardial infarction is important for both medical professionals and patients. Knowledge of the mechanisms of myocardial infarction development allows physicians to more accurately assess the patient’s condition and choose optimal treatment methods, including drug therapy and interventional procedures. An analysis of scientific literature and articles published over the past decade was conducted using the resources of the PubMed and eLibrary search engines using the following keywords: atherosclerosis, history of myocardial infarction, pathophysiology of myocardial infarction, ischemic heart disease, pathogenesis of atherothrombosis, endothelium, inflammation. In the selection, preference was given to systematic reviews and meta-analyses as sources with the highest level of evidence, as well as randomized controlled trials (RCTs), large cohort studies and authoritative clinical guidelines.

The article provides an overview of studies on the use of topical glucocorticosteroids (TGCS) in psoriasis. It is noted that TGCS have anti-inflammatory, antipruritic, immunosuppressive, vasoconstrictive and antiproliferative effects, which is important in the treatment of psoriasis. Most studies have shown that TGCS such as betamethasone, mometasone, alclomethasone and clobetazol shampoo are the first-line drugs for the treatment of mild to moderate psoriasis. It has been established that currently, for the treatment of psoriasis, it is preferable to use combined drugs betamethasone + calcipotriol, which allow for long-term control of the disease while following strict recommendations for their use. Salicylic acid and zinc pyrithione may be recommended to accelerate the regression of psoriasis. Nanotechnologies of the TGCS delivery system are being developed in order to increase their bioavailability

Acute myocardial infarction (AMI) remains a major public health concern worldwide. The aim of this narrative review was to identify and summarize the results of epidemiological studies on AMI incidence in Russia and abroad. Russian and international publications were searched in the databases eLibrary, PubMed, and Google Scholar. The search covered the previous 5 years. The analysis showed that the incidence rate of AMI in the Russian population during the study period remained high, reaching 140.8 cases per 100,000 population by 2022. This rate was lower compared with some CIS countries (Belarus, 174.5 cases) and European countries (Sweden, 288.0 cases; United Kingdom, 288.0 cases; France, 180.2 cases; Hungary, 177.5 cases; Spain, 169.0 cases; Cyprus, 160.0 cases), as well as New Zealand (536.0 cases), the United States (439.9 cases), Japan (389.7 cases), Australia (352.0 cases), Iran (343.0 cases), China (231.6 cases), and Tanzania (172.0 cases). These findings indicate that the incidence of AMI remains high both in Russia and globally, with an upward trend among middle-aged individuals. This highlights the need for future multicenter epidemiological studies of AMI incidence in Russia, particularly among adults aged 45–59 years, to support the development of new diagnostic and therapeutic strategies.

The SARS-CoV-2 spike (S) protein, crucial for viral entry, remains a key target for diagnostics and therapeutics amid evolving variants. Here, we describe the selection and characterization of novel DNA aptamers targeting the S1 subunit, including the Omicron strain, via systematic evolution of ligands by exponential enrichment (SELEX) and biolayer interferometry (BLI). Three aptamers—AptS1-tSP4, AptS1-tSP10, and AptS1-tSP11—exhibited nanomolar dissociation constants (14–59 nM), with AptS1-tSP10 demonstrating good selectivity over MERS-CoV and robust binding in human saliva and pseudovirus samples. Integration with proximity ligation assay and qPCR (PLA-qPCR) achieved a detection limit of 3 pM, surpassing many antibody-based methods. Mass spectrometry-based epitope mapping identified the receptor-binding domain (RBD) peptide VGGNYNYLYR as the primary binding site for AptS1-tSP10. Molecular dynamics and quantum mechanics simulations revealed stable interactions through hydrogen bonding and π-π stacking with neutral residues in both open and closed spike conformations, independent of variant mutations. These multifunctional aptamers offer a versatile platform for ultrasensitive, epitope-specific SARS-CoV-2 detection and pave the way for nucleic acid-based therapeutics to combat viral infections.

Background/Objectives: Medication non-adherence and incomplete seizure documentation remain major challenges in epilepsy care, particularly in drug-resistant forms. Digital health tools may improve self-management by integrating seizure tracking, adherence support, and patient–clinician communication. This narrative review summarizes current mobile applications for seizure monitoring and adherence and outlines opportunities and gaps in clinical translation. Methods: A narrative synthesis (PubMed, Scopus, Google Scholar; 2019–2025; English) summarized functionality, usability, clinical validation, and limitations of epilepsy-focused mobile/wearable applications; no systematic methods or meta-analysis were applied. Results: Existing tools cluster into seizure diary apps, smartwatch-based monitoring systems, and adherence-focused applications. While they improve documentation and treatment regularity, most lack adaptive personalization, language localization and therapeutically active components. Comprehensive platforms combining tracking, adherence analytics and telehealth remain unevenly validated. Validated wearable detectors for generalized tonic–clonic seizures typically report sensitivity in the 80–95% range in real-world or simulated-real-world studies, alongside variable specificity and false-alarm rates, underscoring the need for individualized deployment and calibration. Conclusions: Mobile and wearable applications are promising adjuncts to routine epilepsy care. The field is gradually shifting from passive monitoring toward integrated, user-centered platforms that blend monitoring, predictive analytics and neuromodulation. This review also briefly outlines a conceptual example of an integrated mobile platform that combines seizure documentation, adherence support and patient-initiated rhythmic cueing; this example is presented at a purely exploratory level and requires further clinical validation.