Background. Omentin-1 (QM-1) — one of the most important anti-inflammatory adipocytokines produced by adipose tissue. It is known that its concentration is reduced in obese patients. However, the role of OM-\ in the pathogenesis of coronary heart disease (CHD), including acute coronary syndrome (ACS), is not fully determined.

The objective of the study — to assess the level of OM-1 in blood serum of patients with ACS without ST-segment elevation (ACSWEST) who underwent percutaneous coronary intervention (PCI) and patients with stable CHD.

Design and methods. Examined 104 patients with ACSWEST undergoing PCI. Comparison groups consisted of 38 patients without CHD according negative results of stress-echocardiography or coronary angiography, as well as 80 patients with stable CHD. All patients were evaluated anthropometric indicators: height, weight, waist circumference (WC), body mass index (BMI). Serum concentrations of OM-I were determined by enzyme immunoassay (DRG,USA), serum lipid profile was determined by enzymatic method.

Results. In patients with ACSWEST who underwent PCI, the concentration of OM-I in the blood is lower than in those examined without atherosclerotic lesions of the coronary arteries [7.53 (5.00-10.55) ng/ml and 12.56 (7.84-15.34) ng/ml, respectively; p < 0.001). The concentration of OM-1 in the blood in patients with ACSWEST and a stable CHD did not differ (p > 0.05). In patients with ACSWEST, the concentration of OM-1 blood with multivascular lesions of the coronary arteries is lower than with 1-2 vascular lesions [7.30 (3.91- 8.17) ng/ml and 9.44 (6.54-9.93) ng/ml, respectively; p < 0.001. Similar patterns were established in patients with a stable CHD (p < 0.001).

The concentration of OM-1 inthe blood in women with ACSWEST, with stable CHD and in those examined without CHD was higher than in men of the corresponding groups (p < 0.001).

In patients with ACSWEST and with a stable CHD with overweight and obesity (WHO, 1999), the concentration of OM-1 inblood serum is lower than in patients with CHD and normal BMI (p < 0.001). In patients with ACSWEST and AO, the level of OM-1 inthe blood is lower than in patients with ACSWEST without AO, both in men and women (p < 0.001). When conducting a regression analysis, it was found that the concentration of OM-1 inthe blood of patients with ACSWEST is determined by BMI (b = -0.30, beta = -0.23, p = 0.002) and patient gender (b = 2.21, beta = 0.16, p = 0.029); in patients with a stable CHD — BMI (b = -0.38, beta = -0.27, p = 0.029).

Conclusion. For patients with CHD, both with ACSWEST and with stable CHD, a low level of OM-1 in the blood is characteristic. The lowest OM-1 values were found in patients with multivascular coronary artery disease and obesity. The gender characteristics of the concentration of OM-1 in serum were established: the concentration of OM-1 in serum in women is higher than in men. A decrease in the concentration of OM-1 in the blood in patients with ACSWEST and with stable CHD is associated with BMI, the patient’s gender, and the severity of coronary atherosclerosis.

Background. Study of predictive need in the future hospitalizations still was not carried out though it can be useful for solution of both medical and social-economic issues of health care.

 Objective. Study of a possibility of forecasting of repeated hospitalizations in various terms after cardiac surgery on a set of characteristics of the patients in pre- and postoperative (hospital) periods.

Design and methods. Results of long regular postoperative follow up (in terms up to 12 years) for 114 patients (80 men and 34 women) with the infective endocarditis (IE) after valve replacement of various localizations are analysed. The initial database included 133 factors — demographic, clinical, laboratory and tool characteristics of patients. Frequency and the reasons of hospitalizations, symptoms of disease complications — the prosthesis depended and independent were considered. In order to solve the prognostic problem, there were used a symptom-syndrome approach, providing expansion of the factor space due to the most significant factor combinations and the method of projective classification of patients, which provides a reduction of the degree in predictive randomness.

Results. Three integrated factors, the most significant for forecasting of repeated hospitalizations are allocated. The first interpreted as “a factor of adequate treatment” included belonging to a male gender, maintaining working capacity and no need in postoperative use of cardiac glycosides (CG); the second one unites such variants as existence of either regular atrial fibrillation or need in implementation of temporary cardiostimulation in patients with HF III–IV (NYHA). The third integrated factor consisted of a combination of aortic valve prosthesis, nonphysical work and need in postsurgery inotrop support. Combination of two and more integrated factors resulted in high probability (the importance of distinction 0.000007) allocations of groups with low and high risk of repeated hospitalizations — 9.5 % (4 of 43 patients) and 58.1 % (18 patients from 31) correspondingly.

Conclusion. The proposed technique can be used for similar purposes in various categories of patients for advance planning of treatment, preventive, social and economic measures.

Background. In 30 % of cases with epilepsy, it qualifies as medically intractable and requires surgical treatment. The need for improvement of epilepsy surgery effectiveness demands updating of the preoperative assessment protocols. Intraoperative wide-range electrocorticography is a novel technique for defining resection volume in focal structural epilepsy. Combined analysis of high-frequency and epileptiform activity provides additional information and allows prognosticating of surgery outcome. However, consistent evaluation of intraoperative monitoring results is only possible when general anesthetic effect on brain electrical activity is taken into account.

Objective. This study was aimed at evaluation of anesthetic gas sevoflurane effect on high-frequency brain electrical activity, recorded directly from the cortex or deep brain structures.

Design and methods. Eight patients were included in this study (2 females, 6 males), aged 19 to 47, with a long-term epilepsy (disease duration 15 to 38 years). Prolonged electrocorticographic monitoring was indicated to these patients, combined with eloquent zones mapping in some cases. Patients were implanted with grid electrodes on frontal and temporal cortex, and deep brain Spencer electrodes into the mesial temporal lobe. Wide-range electrocorticography was recorded during slow-wave sleep and intraoperatively under sevoflurane anesthesia. Pathological high-frequency oscillations (pHFOs) rate was counted.

Results. In seven patients pHFOs were recorded extraoperatively. Pathological HFO rate varied between 13 and 30 % (mean — 19 %). Distribution of pHFO did not change due to anesthesia effects. Mean background noise amplitude was significantly decreased intraoperatively (z = 2.45; p = 0.014). This effect facilitated visual marking of pHFOs. There were no trends in comparison between extraoperative and intraoperative pHFO rate.

Conclusion. Well-controlled levels of general anesthesia obtained with sevoflurane (0,9-1,1 MAC) showed minimal effect on high-frequency brain electrical activity. This allows thorough analysis of wide-range electrocorticogiaphy without waking the patient and provides more information about the extension of the epileptogenic zone and its resection rate intraoperatively.

Background. Currently in developed countries, up to 4 % of pregnant women have cardiovascular diseases, which are one of the leading causes of maternal mortality. Anesthesia method have an important role in the abdominal delivery in this category of patients.

 Objective. To summarize the experience of different anesthesia approaches to abdominal delivery in pregnant women with cardiovascular diseases.

Materials and methods. A retrospective analysis of the use of various methods of anesthesia during abdominal delivery of pregnant women with cardiovascular diseases was performed.

Results. In “Maternity Hospital № 13” and the Almazov National Medical Research Centre for the period from 2014 to 2018 2140 abdominal deliveries were carried out in pregnant women with heart diseases (1450 and 690, respectively). In the Maternity Hospital №13 1374 (94.8 %) of abdominal deliveries were performed under regional anesthesia, 76 (5.2 %) under general anesthesia. In Almazov National Medical Research Centre 513 (74.3 %) of abdominal deliveries were performed under regional anesthesia, 177 (25.7 %) under general anesthesia. The features of the hemodynamic profile of general and regional anesthesia in pregnant women with various heart disease are presented.

Conclusion. In pregnant women with heart disease, up to 88 % of cesarean section are performed under regional anesthesia. General anesthesia is used for contraindications to regional anesthesia, as well as for obstetric indications. The use of advanced monitoring, methods of slow titration of local anesthetic dose and the use of vasopressors allow to avoid hemodynamic disorders in patients with concomitant heart disease.

Endometriosis is one of the most common gynecological diseases, which has a negative effect on the women’s life quality and is one of the main causes of infertility. The early and preсise desease detection is essential to prevent the possibility of sequelae. From instrumental methods for the diagnosis of endometriosis ultrasound, magnetic resonance imaging and laparoscopy are currently used. MRI is the most informative non-invasive method in instrumental diagnosis of various forms of endometriosis. MRI of the pelvic organs has a high accuracy in the diagnosis of endometriosis and allows visualization of most endometriotic foci, including extraperitoneal, that allows you to properly plan treatment and prevent complications of the disease.

Hereditary spherocytosis (HS) is the most common cause of hemolytic anemia of varying severity can lead to complications such as cholelithiasis, sepsis, etc. Difficulties in diagnosis are asymptomatic and atypical cases HS. It is important to search methods that can detect microspherocytic anemia.

The article describes the technique of acidified glycerol lysis test (AGLT), the results and analytical characteristics of the method. Presents a refined acidified glycerol lysis test (AGLT) with incubated blood performed on the automatic biochemical analyzer with a graphical check of the lysis of erythrocytes is a sensitive, fast and reliable method of identification of HS and can be used in clinical diagnostic laboratories.