Background. Recently, clinical benefits among COVID-19 patients, received vitamin D were demonstrated. Features of vitamin D metabolism in the acute period of COVID-19 remain unclear.

Objective. To assess the level of 25(OH)D and 1,25(OH)2D in hospitalized COVID-19 patients and cholecalciferol effect on the vitamin D metabolites dynamic.

Materials and methods. Group 1 (n = 22) patients received cholecalciferol bolus therapy at a total dose of 100,000 IU. Group 2 patients (n = 22) did not receive cholecalciferol supplementation. Serum 25(OH)D and 1,25(OH)2D levels were estimated for each group on the first and the ninth day of hospitalization.

Results. On the ninth day of hospitalization 25(OH)D serum level demonstrated the 45.8 % rise in the Group 1, while in the Group 2 there was a decrease in the 25(OH)D level by 17.9%. At the same time, dynamic evaluation of the 1.25(OH)2D level did not show any differences between the groups, while pairwise comparison on the first and on the ninth days of hospitalization revealed an increase in the active metabolite concentration (p < 0.001) in both groups.

Conclusion. Such vitamin D metabolism parameters in the acute period of COVID-19 may be associated with a 1α-hydroxylase activity alteration. Thus, 1.25(OH)2D serum level increase regardless of vitamin D status during the hospitalization could be explained by the COVID-19 course or concomitant corticosteroid medication.

Background. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 10-15% of women of reproductive age. PCOS is often associated with metabolic disorders, type 2 diabetes, cardiovascular disease, and other complications. In recent years, angiogenesis has been widely discussed as an important factor in the pathogenesis of PCOS.

Objective. To identify growth factors in women with PCOS compared with healthy women in normal and overweight subgroups.

Design and methods. This case-control study carried out at the Almazov National Medical Research Centre (ANMRC) included 45 patients with PCOS (22 women with a body mass index (BMI) < 25 kg/m² and 23 women with a BMI > 25 kg/m²) and 45 women with normal ovulation (22 women with a BMI < 25 kg/m² and 23 women with a BMI > 25 kg/m²). Seven growth factors were analyzed in the plasma of patients.

Results. Compared to the control group, normal weight women with PCOS had higher plasma levels of EGF (medians were 5.57 and 0 pg/ml, p = 0.040) and FLT3L (medians were 5.0 and 2.25 pg/ml, p = 0.018). Growth factors FGF 2 and TGF alpha were increased in women with PCOS both in overweight and normal weight subgroups (p<0.001).

Conclusion. In both overweight and non-overweight groups, women with PCOS show an increase in growth factors.

Background. Topical diagnosis of primary hyperparathyroidism (PHPT) remains an urgent problem due to the high incidence of persistence and recurrence after surgical treatment. At the preoperative stage, a search for the parathyroid hormone hyperproduction source is performed using instrumental methods: ultrasound, scintigraphy of the parathyroid glands (PTG) and multislice computed tomography (MSCT). The cause of PHPT persistence and recurrence after parathyroidectomy may be the multiple nature of PTG lesions or their ectopic location. Additional methods of visualization of PTG adenomas can be used to improve diagnosis (PET/CT).

Objective. To compare the sensitivity and specificity of PET/CT with 11C-choline with the traditional visualization techniques.

Design and methods. 16 PHPT patients were analyzed. All patients underwent US, subtraction scintigraphy with 99mTc-technetril/99mTc-pertechnitate and CT were performed in 12 and 16 patients, respectively. 11C-choline PET/CT was used for all patients. Imaging results’ coincidence of two methods were labeled as the true one.

Results. The sensitivity of PET/CT with 11C-choline was 94 %, CT, subtraction scintigraphy with 99mTc-technetril/99mTc-pertechnitate and US — 75 %, 69 % and 63 %, respectively. The specificity of PET/CT with 11C-choline, CT, scintigraphy with 99mTc-technetril/99mTc-pertechnitate, and US was 100 %, 84 %, 76 %, and 68 %, respectively.

Conclusion. PET/CT with 11C-choline demonstrated best sensitivity and specificity among all methods and can become an alternative in PHPT diagnostics in case of negative or inconvclusive results of previous visualization.

Oxygen is the main participant in redox reactions in the body and its deficiency can lead to organ dysfunction. Thus, a decrease in blood flow in a certain region of the myocardium in patients with coronary heart disease can cause a heart attack. According to experimental studies, early reperfusion reduces infarct size, and clinical studies have shown that early effective reperfusion of the affected artery and prevention of re-occlusion is the basis for minimizing infarct size and mortality.

Timely performed percutaneous intervention in patients with acute myocardial infarction significantly reduced the mortality rate and the risk of heart failure. Despite the endovascular treatment effectiveness, there is still a need for additional methods of cardioprotection, reducing the area of myocardial infarction and preventing the development of heart failure and adverse left ventricular remodeling. Blood oxygen supersaturation (SSO₂ therapy) is one of the adjuvant methods of cardioprotection in the treatment of patients with acute myocardial ischemia.

This review describes possible mechanisms for implementing the cardioprotective effects of SSO2 therapy, technology and equipment necessary for the application of this technique. In addition, the results of experimental and clinical studies on SSO₂ therapy are consecrated. Of note, only one multicentre prospective randomized controlled trial with uniform randomization was performed. Thus, the use of this technology is limited by the use a commercial equipment.

Background. Diagnosis of acute myocardial infarction (AMI) in pubertal patients is a diagnostic challenge, as individuals of such a young age usually do not have traditional risk factors for coronary heart disease (CHD) and, as a result, are at increased risk of misdiagnosis.

Objective. To describe a clinical case of AMI in a 16-yearold patient against the background of complete well-being.

Design and methods. A 16-year-old patient, against the background of complete well-being, developed pressing pains in the chest, which stopped on their own after a few hours. During hospitalization, in addition to an increase in the level of troponin, the results of other laboratory and instrumental studies did not confirm the version of AMI, as a result of which other cardiac and non-cardiac causes of the development of chest pain formed the basis of the diagnostic search. This was the reason for the delayed diagnosis and endovascular treatment of thrombotic occlusion of the right coronary artery, and, as a result, the formation of an area of persistent hypokinesia of the lower parts of the left ventricle. Further search for possible causes of AMI, including the analysis of genetically associated conditions, did not yield results.

Results. This publication describes a case of acute inferior myocardial infarction with ST segment elevation and thrombotic occlusion of the right coronary artery in a 16-year-old adolescent and the impact of an irrational diagnostic process on long-term prognosis.

Conclusion. The presented clinical case demonstrates the importance of including the diagnosis of AMI in the process of differential diagnosis of acute chest pain, even in adolescent patients.

Background. Atrial fibrillation (AF) is the most common stable arrhythmia in the population. The interaction of AF and cardiorenal syndrome is poorly understood, despite the fact that the proportion of such patients with combined heart and kidney damage reaches 60% among people with chronic heart failure (CHF). Data on the long-term prognosis in patients with cardiorenal syndrome depending on the form of AF is not enough.

Objective. To assess the prognosis in patients with cardiorenal syndrome depending on the clinical form of AF.

Design and methods. 126 patients with verified cardiorenal syndrome and various forms of AF were included. An observational study was performed with the fixation of hospitalizations for CHF and other cardiovascular events, including deaths.

Results. The rate of onset of the first end point is higher in patients with permanent AF (8.5 [3.0; 18.5] months and 15.0 [5.0; 24.0] months, p < 0.001). Analysis of survival curves shows a worse prognosis in patients with permanent AF.

Conclusion. In patients with cardiorenal syndrome in combination with AF, its clinical form has a significant impact on the long-term prognosis. Permanent AF, to a greater extent than paroxysmal/persistent AF, in conditions of cardiorenal syndrome is associated with faster and more frequent development of new cardiovascular events, including hospitalizations for decompensated CHF and deaths.

Background. Fetal and extra fetal diagnostics is currently performed using 3 Tesla magnetic-resonance imaging scanners. Examination is more informative during the third trimester of pregnancy, when fetal movements are less significant. 3 Tesla MR-images demonstrate better characteristics than 1,5 Tesla ones, however, there is a risk of heating the patient during scanning, which is especially dangerous for pregnant women.

Objective. The aim of the study is to improve fetal and extrafetal structures visualization by means of developed metamaterial pad (metadevice).

Design and methods. In the study, a metadevice was considered to improve fetal and extrafetal imaging in a field with magnetic induction of 3 T. 12 pregnant women between 29 and 39 weeks gestation (33,4 ± 4,8 weeks) were examined, standart magnetic resonance images of Single Shot Turbo (SST)/Fast Spin Echo(FSE)) were obtained. Standart abdomen coil was used to receive examination data. Metadevice and the coil were placed on the center of the examined area. The images were evaluated by radiologists on a 5-point Likert scale.

Results of metadevice testing showed diagnostic quality improvement, increase in radio-frequency magnetic field homogeneity, decreased SAR value and reduction in body heating effect during MR-scanning.

Conclusion. Metadevice-assisted MRI can lower heating risks, reduce dielectric artifacts and improve imaging quality of the fetus and extrafetal structures.