Background. A significant role in solving the problem of renal replacement therapy should be played by kidney transplantation, which is now widely regarded as the optimal method for treating end-stage renal failure. An important problem remains the survival of the graft, and therefore it is necessary to find the most optimal method for diagnosing the earliest lesion of the graft.
Objective. Examine the possibility of using glomerular filtration rate calculated by the Cockcroft–Gault (C&G) and EPI formulas to assess renal allograft function.
Design and methods. 216 patients with functioning renal allograft were examined, among them 92 women and 124 men, the average age was 56.8 ± 12.8 years. All patients completed: determination of serum creatinine level (Cr) (mmol/l), determination of the level of daily proteinuria (g/day), calculation of glomerular filtration rate using the formula EPI (ml/min) and Cockcroft–Gault formula (ml/min). All patients received immunosuppressive therapy.
Results. We divided patients into 4 groups: 1 — patients without daily proteinuria with serum creatinine (Cr) < 0.110 mmol/l, 2 — patients without daily proteinuria with Cr > 0.110 mmol/l, 3 — patients with daily proteinuria less than 0.15 g/day with Cr < 0.110 mmol/l, 4 — patients with daily proteinuria more than 0.15 g/day with Cr > 0.110 mmol/l. The average Cr level was in the group 1 — 0.093 ± 0.001 mmol/l, in 2 — 0.162 ± 0.005 mmol/l, and 0.081 ± 0.002 mmol/l, and 0.135 ± 0.012 mmol/l in 3 and 4 groups, respectively. Glomerular filtration rate Cockcroft–Gault and EPI, respectively, in group 1 — 82.1 ± 4.4 ml/min and 74.9 ± 3.7 ml/min, in 2 — 55.3 ± 2.9 ml/min and 46.8 ± 2.4 ml/min, at 3 — 79.4 ± 2.8 ml/min and 71.1 ± 2.5 ml/min, at 4 — 51.2 ± 1.6 ml/min and 42.5 ± 1.2 ml/min. Сr level is not a sufficiently accurate indicator of allograft dysfunction, as in group 1 it was significantly higher than in group 3 (p < 0.01), exactly the same picture was observed when comparing groups 2 and 4. At the same time, glomerular filtration rate using the Cockcroft–Gault formula and EPI formula was slightly higher in group 3 and 4 compared with group 1 and 2.
Conclusion. Calculating glomerular filtration rate using the Cockcroft–Gault formula and EPI formula is a more sensitive method for assessing renal allograft dysfunction. 

 This review article deals with the comparison of different modes of anticoagulant therapy, taking into account the risk profile and the individual characteristics of patients with atrial fibrillation. This paper analyzes the efficacy and safety of direct oral anticoagulants in different clinical situations. Modifiable and unmodifiable bleeding risk factors are evaluated based on the hemorrhagic complication risk assessment scales for patients taking anticoagulants. The evidence base for anticoagulant therapy in the presence of a single episode of atrial fibrillation is represented. Regimens and terms of initiation of anticoagulant therapy after a cardioembolic stroke or transient ischemic attack are considered. In addition, great attention is paid to the problem of early prescription of anticoagulants after intracranial hemorrhage. For patients at high risk of gastrointestinal bleeding or impaired renal function, an optimal strategy for reducing thromboembolic complications is evaluated. Anticoagulant therapy is also evaluated in patients with stable coronary heart disease, including after coronary stenting.

Background. The search for new markers of the epileptogenic zone (EZ) for the surgical treatment of epilepsy is currently of relevance. Pathological high-frequency oscillations (pHFO) are considered to be a potential marker for EZ. Papers devoted to this topic are few and insufficiently systematized, mostly due to a small quantity of patients.
Objective. This study was aimed to determine the diagnostic efficacy of high-frequency electrocorticography (HF ECoG) based on the epilepsy surgery outcomes.
Design and methods. This is an original retrospective study of high-frequency bioelectrical activity parameters in 114 patients who underwent surgical treatment in the Polenov Neurosurgical Institute Clinic during 2017–2018. In the subgroup of patients with pharmacoresistant course of structural epilepsy (21 patients) on the preresective electrocorticogram, the pHFO index was higher than in the subgroup with intracerebral neoplasms (11 patients), which may be associated with a longer history and severity of the disease.
Results. Through the analysis of the high-frequency component of the post-resective HF ECoG, it was shown that the presence or absence of pHFO in the range of 250–500 Hz does not affect the seizure outcome. The dynamics of the high-frequency activity index before and after the resection are statistically significant for the seizure outcome prediction for structural epilepsy surgery. In this study, the specificity of the pHFO dynamics analysis technique was 85.71 % and sensitivity equaled 58.33 %.
Conclusion. Thus, the HF ECoG and the assessment of the dynamics of the pHFO index in the range of 250–500 Hz can complement the traditional method of intraoperative ECoG in the range of up to 70 Hz, including the prediction of the results of surgical treatment. 

In this article we wrote about main immunologic disorders in Helicobacter pylori infected patients (changes of local, cell and humoral immunity). We have our own data about changes of interleukins 1β, 4 and 8 level in cagA(+) and cagA(−) Helicobacter pylori strains infected patients: we saw that level of proinflammatory interleukin-1β and unterleukin-8 are higher and level of anti-inflammatory interleukin-4 are lower in patients infected cagA(+) strains of Helicobacter pylori. We demonstrated results of different studies about efficacy of anti-Helicobacter pylori vaccines as immunologic prophylaxis of this microorganism invasion: usage of mucosal adjuvants and usage of immunostimulating probiotics during vaccination have promising results.

Background. The wide spread of cellular technologies will sooner or later lead inevitably to the introduction of MMSC or their exosomes to patients who have implanted artificial materials in their organism. The engraftment of foreign bodies is accompanied first by acute and then chronic inflammation, very often acquiring a granulomatous character. A decrease in the activity of the inflammatory response can theoretically improve the results of implantation.
Objective. To study the results of the influence of autologous MMSC of bone marrow origin (AMMSCBMO) adsorbed on silicone, on the inflammatory process that accompanies the implantation of this polymer in theexperiment. Design and methods. In different times, the condition of tissues around the implanted silicone with adsorbed AMMSCBMO was studied by method of light microscopy.

Results. After the implantation of silicone with adsorbed AMMSCBMO, as compared with the results of the introduction of this material without use of cellular technologies, a smaller volume of  loose fibrous connective tissue is formed around the encapsulated polymer. In this connective tissue after AMMSCBMO use the absolute number of all cells is lower in 2 weeks, and the percentage and numerical density of neutrophils — within 1–2 weeks. On the contrary, the relative number of erythrocytes within 1–2 weeks and macrophages at 1–3 weeks under the conditions of AMMSCBMO use were greater.
Conclusion. A smaller volume of loose fibrous connective tissue and a decrease in the severity of cellular infiltration, in particular, the number of neutrophils, around the implanted silicone with  AMMSCBMO indicates a decrease in the activity of the inflammatory reaction as a result of the use of cellular technologies, more rapid cleansing of postoperative wound from debris, the success of reparative processes and the creation of conditions for the integration of a foreign bodies into the organism.

Takayasu’s disease (non-specific aorto-arteritis) is a chronic, idiopathic, inflammatory disease that primarily affects large vessels, such as the aorta and its major branches, including the pulmonary and coronary arteries. It often develops in women under the age of 50 years. Accurate and early diagnosis plays an important role in the prognosis of life in patients with this pathology. Complaints of  patients with lesions of the aorta and its branches are non-specific in nature and are characterized by fever, night sweats, malaise and arthralgia, passing under the “mask” of other diseases. With the progression of the disease, stenoses or aneurysms occur in the arteries, which leads to ischemia of the limbs and internal organs, manifested by the corresponding clinical manifestations.
The article presents the observation of aorto-arteritis Takayasu type V (generalized variant) in the woman of 26 years.