The number of patients with epilepsy and completed attempt at suicide is 5 times higher than in the general population and ranks third among the causes of death in this group. Studying the psychopathological characteristics of patients with epilepsy brings us closer to an understanding of the possible suicidal behavior in this group of patients. Of particular interest are patients with pharmacoresistant form in the postoperative period. The long course of the disease and the presence of a “crisis situation”, as an awareness of the fact of operative treatment, can deform the internal picture of the disease and, against the background of personality changes in the postoperative period, lead to social disadaptation, worsening the prognosis of the disease, up to the occurrence of suicidal intentions. Given the clinical significance of the disease and the high incidence of mental disorders during epilepsy, including those that occur after surgery, a better understanding of possible suicidal intentions can help in optimizing the social adaptation of patients and the prevention of suicides.

Over the past decade, there has been a significant improvement in neuroimaging techniques to improve the early diagnosis of acute stroke. Computed tomography and magnetic resonance imaging are often used in intracerebral hemorrhage or to evaluate contraindications to thrombolysis, to detect the localization of the ischemic area and to estimate the time of stroke. With the availability of fast and advanced imaging techniques, there is a growing interest in their application to predict success and eliminate the risks of specific therapy.

This review examines the existing methods of neuroimaging in acute strokes. To interpret the results of neuroimaging, it is important to know the clinical picture. In addition, the time factor, from the onset of stroke to collateral blood supply, should be incorporated into existing imaging-based therapeutic strategies.

Radiological diagnosis of respiratory distress syndrome of newborns (RDS) is an urgent task. The article presents clinical and radiological parallels of respiratory distress syndrome in newborns. X-ray criteria determining the degree of severity of RDS, allowing to improve early x-ray diagnosis, are identified. Taking into account the tasks in the Perinatal Center of Almazov National Medical Research Center 143 radiographs of newborns for 2017 with established diagnosis of RDS (boys n = 66, 46.2 %, girls n = 77, 53.8 %) were analyzed. The gestational age of newborns was 100 (69.9 %) children at the gestational age up to 32 weeks, and 43 (30.1 %) children at the age of 32 weeks. The body weight of the newborns was 1190 ± 510 g. The severity of neonates with RDS due to the severity of acute respiratory failure that determines the conduct of radiographic studies in the first 1-3 hours of a child’s life to solve the question about the choice of respiratory support and treatment with surfactants.

Visfatin, also called the pre-B cell colony enhancing factor, is produced mainly by the visceral fat and in the target cells activates the 3-phosphoinositide pathway, the cascade of mitogen-activated protein kinases and a number of the other effector systems. In the recent years, evidence has been obtained that visfatin regulates the functional activity of the hypothalamic-pituitary-gonad axis. Visfatin controls the synthesis and secretion of both gonadoliberin by the hypothalamic neurons and gonadotropins by the pituitary gonadotrophs, and also affects the steroidogenesis and folliculogenesis, acting on the reproductive tissues. One of the mechanisms of the steroidogenic action of visfatin is the potentiation of the stimulating effect of insulin-like growth factor-1 on the synthesis of sex steroid hormones. Since the production of visfatin and the activity of its signaling system vary significantly in the conditions of diabetes mellitus and metabolic syndrome, this directly affects its regulation of the reproductive functions in these metabolic disorders. Visfatin plays an important role in maintaining the functional activity of the ovaries and the normal quality of oocytes during aging. The review is devoted to the problem of the structural and functional organization of visfatin and its signaling system, the role of visfatin in the regulation of the female and male reproductive systems, and the mechanisms of visfatin action on the hypothalamic-pituitary-gonad axis.

Background. Despite invasive technologies and the advancement of modern pharmacotherapy in the treatment of coronary artery disease (CAD), patients still have risks of complications. There is a special group of patients with CAD with a prior myocardial infarction (MI). As demonstrated, a prior MI increases risk of recurring cardiovascular events. Thus, there was a decrease in the frequency of such events to a greater extent than that with aspirin monotherapy in the clinical study on combined antiplatelet and anticoagulant therapy in this group. By contrast, there was an increase in the frequency of large bleeding, which is a significant limitation of the combined therapy. Therefore, it is relevant to identify subjects with CAD and high thrombotic risk for individualization of therapy. In this study, the activity of thrombin formation was assessed with help of an integral hemostasis assessment method — a thrombin generation test (TGT) in patients with CAD regarding the presence or absence of MI in anamnesis.

Objective. Investigation of the thrombogenic activity with the help of TGT in patients with CAD with a prior MI.

Materials and methods. A total of 59 patients with a diagnosis of stable CAD hospitalized for myocardial revascularization were examined. Of these, 28 patients who had a history of MI (group 1), and 31 patients without previous MI (group 2). The control group consisted of 31 people without clinical manifestations of atherosclerosis. In vitro thrombin generation in platelet-poor plasma was measured by means of the calibrated automated thrombogram method (Thrombinoscope BV, Maastricht, the Netherlands). Four parameters were derived from the thrombin generation curves: LT (lag time — initiation phase of coagulation, min), Peakthr (peak thrombin concentration, nmol), ttPeak (time to peak concentration, min), ETP (endogenous thrombin potential — area under the thrombin generation curve), and VI (velocity index of thrombin generation, nmol/min).

Results. A significant increase in TGT parameters was revealed in Group 1 compared to Group 2 and control group: the peak height of thrombin (304.09 [279.97-353.91] nmol vs 283.38 [209.07-313, 54] and 258.86 [211.28-299.50] nmol, respectively (p < 0.01)) and the VI thrombin (131.78 [111.98-158.38] nmol/min vs 100.64 [56.33-122.19] and 77.96 [62.45-122,54,] nmol/min, respectively, (p < 0.001)). There was a significant positive correlation between ETP and total cholesterol level (r = 0.35, p = 0.01), LDL (r = 0.32, p = 0.02) in the general group of patients with CAD.

Conclusion. In patients with CAD and prior MI, a higher quantity and rate of thrombin formation were found by TGT, determining the test perspectivity for assessment of thrombotic risk in order to isolate subjects with an indication for more strong antithrombotic therapy.

The purpose of the study is on the model of vasorenal hypertension (2 kidney, 1 clamp) to study the dynamics of heart rate variability (HRV) spectrum components depending on stability of hypertension, developed after renal artery clamping. Experiments were put on Wistar male rats. During experiments in awake animals conducted registration systolic blood pressure (SBP), beat-to-beat interval (RR), spectral analysis of HRV. 1-3 weeks after the clipping of the renal artery, an elevation of MAP was observed in 21 of 33 rats. However, by week 8 of observations, the level of SBP was normalized in 11 animals. Analysis of the parameters studied in animals in which, after applying a clamp to the renal artery, an unstable elevation in the SBP was registered, showed a decrease in the high-frequency component (HF) of the HRV spectrum with an increase in the SBP. Normalization of SBP occurred within 1-5 weeks and was accompanied by restoration of HF and an increase in the length of RR. It was concluded that with unilateral ischemia of the kidneys, including mechanisms that positively affect the tone of the vagus, which counteracts the rise in blood pressure and promotes the normalization of its level, are activated.