Background. Platelets play a key role in the pathogenesis of acute coronary syndrome (ACS). In recent years, the amount of data on the advisability of using the platelet function test (PFT) in the appointment of antithrombotic therapy has been growing.

Objective. To access PFT in patients with unstable angina and various comorbidities.

Design and methods. The study involved 74 patients with the diagnosis of unstable angina. All patients underwent standard clinical examination, PFT (impedance aggregometry with ADP and collagen), assessment of Charlson comorbidity index.

Results. The most frequent comorbidities were: hypertension (95 %), type 2 diabetes mellitus (30 %), excessive body weight (35 %), multifocal atherosclerosis (22 %), smoking (24 %). Half of the patients (n = 36) had high level of comorbidity. Patients with a comorbidity index of 5 or more had high platelet aggregation on the 3rd day of hospitalization. Elderly patients, smokers, as well as patients with diabetes mellitus type 2 and multifocal atherosclerosis also had higher values of platelet activity, which may be associated with unfavorable prognosis and risk of recurrent events.

Conclusion. We revealed association between PFT and comorbidities both with risk factors or diseases alone and in its integral assessment using the Charlson comorbidity index. Among the individual risk factors, smoking, diabetes mellitus and multifocal atherosclerosis were the most important, which confirms their direct role in the pathogenesis of thrombotic complications.

Background. The 2019 novel coronavirus pandemic has had a significant impact on the prognosis and outcomes of patients with acute coronary syndrome (ACS).

Objective. Study of the impact of a new coronavirus infection (NCI) on the nature of the course and outcomes of the disease in patients with ACS.

Materials and methods. The study included patients with ACS and a positive test for COVID-19 upon admission to the hospital in the period from April 2020 to August 2021.

Results. The study included 107 patients. Among patients with and without ST elevation with more than 50 % lesions (n = 10; n = 10), 8 patients died, which was 80 % in each group. In the group with and without ST elevation with less than 50 % involvement (n = 20; n = 67), 5 and 8 patients died, accounting for 25 % and 11.9 %, respectively. The role of the influence of the levels of Il-6 (interleukin-6), troponin T and creatinine on the course and outcomes of the patients’ disease was analyzed.

Conclusion. COVID-19 infection, namely the degree of damage to the lung tissue, significantly worsens the course and outcomes in patients with both NSTE-ACS and STE-ACS. Further accumulation of clinical experience in endovascular treatment of ACS and the development of algorithms for providing medical care to patients with ACS in the context of COVID-19 is required.

Carotid artery stenosis is one of the leading causes of ischemic strokes and accounts for about 20 % of all strokes. The widespread use of radiological diagnostic methods and recommendations for the carotid artery stenosis patients management led to the identification of atypical forms of damage to the brachiocephalic arteries — a combination of multi-level stenoses of extra and intracranial localization. Multilevel lesion of brachiocephalic arteries is characterized by a combination of hemodynamically significant stenosis of the internal carotid artery in combination with stenosis of the common carotid artery or brachiocephalic trunk. The prevalence of tandem lesions varies from 0.5 to 6.4 %. Despite the rarity of this pathology, the risk of ischemic complications against the background of tandem stenosis of the brachiocephalic arteries is higher than with a single-level lesion. The surgical intervention strategy should provide for the correction of both stenosis, which can be achieved in three ways: endovascular method, open prosthetics and hybrid method. The essence of the hybrid technique is the simultaneous correction of the distal and proximal zones of stenosis by one surgical team in a hybrid operating room. The aim of the study is to review the available literature data and to demonstrate the developed hybrid intervention technique with a detailed description of the technical aspects of all stages of the surgery.

Epilepsy is one of the oldest known nervous system disorders and imposes enormous physical, psychological, social and economic burden on individuals, families and countries due to misunderstanding and stigmatization. These problems are most relevant for developing countries, where up to 85 % of epilepsy patients live. Despite the fact that it is a treatable and preventable disorder, there is a lack of adequate public awareness and understanding of the problems of epilepsy. This article is devoted to the Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) 2022–2031, adopted on 27 May 2022 at the 150th session of WHO’s Executive Board. It provides data on the public and medical importance of epilepsy, the history of the joint initiatives of WHO, the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) aimed at reducing the burden of epilepsy on society and improving public knowledge about neurological disorders. The key provisions of the Intersectoral Global Action Plan on epilepsy and other neurological disorders 2022–2031 are announced. The Epilepsy 90–80–70 cascade target, launched by ILAE and IBE, is presented to inspire decades of action and significantly improve care and treatment for all people living with epilepsy worldwide. The final section is devoted to the evolution of epileptology at Almazov National Medical Research Centre, its present and its prospects.

Background. Children living in the Far North and areas equated to it are exposed to the climate with insufficient insolation and unstable weather. The lifestyle in the North also contributes to the health, which leads to a high incidence and disablement.

Objective. To analyze the incidence of the children aged 0–14 years in the Komi Republic from 2013 to 2021.

Design and methods. The research material was the database of the “Republican Medical Information and Analytical Center” and the Federal State Statistics Service from 2013 to 2021. A trend line is used to illustrate trends. The value of the approximation reliability R2 is calculated, the values of which indicate the degree of coincidence of the calculated line with the data.

Results. The leading place in the structure of childhood morbidity in the Komi Republic is occupied by respiratory diseases, injuries, poisoning, diseases of the skin, infectious and parasitic diseases. In all cases the rate of primary disease incidence, infant mortality and disability in the Komi Republic exceeded that in Russia.

Conclusion. Severe climatic conditions in Komi Republic are one of the risk factors for the deterioration of children’s health in almost all nosologies.

Diagnosis of a combined genetic pathology that occurs with jaundice syndrome is a difficult task, because of common clinical manifestations for several diseases having different genesis and requiring specific diagnosis and treatment tactics. Icteric staining of the skin due to hyperbilirubinemia at any age requires immediate examination to establish its genesis and differential diagnosis between infectious and non-infectious diseases. The spectrum of diseases accompanied by jaundice syndrome includes more than 50 different diseases. The main mechanisms of suprahepatic jaundice are: firstly, a violation of the capture and glucuronidation of bilirubin in the liver, and secondly, an increased destruction of red blood cells due to hemolysis or during the disposal of blood during internal bleeding. The first mechanism is realized in Gilbert’s syndrome, while the second mechanism of suprahepatic jaundice is often due to hemolytic anemia.

In presented clinical case, the implementation of two pathogenetic forms of jaundice in one patient is shown — suprahepatic, caused by type 2 hereditary stomatocytosis and Gilbert’s syndrome, as well as obstructive jaundice, caused by cholelithiasis. The special attention should be paid to precise patient examination, if disease manifestations are not consistent with classical clinical picture. The use of a new generation sequencing method, along with traditional diagnostics methods, made it possible to establish an accurate diagnosis and determine the tactics of patient management.

Background. In the age of modern technologies, the relevance of preventive and personalized medicine is growing, therefore, the identification of preclinical markers of the disease is a priority.

Objective. Checking the power of a mathematical model with a computer support program to determine the probability of developing congenital pneumonia in premature newborns with very low and extremely low birth weight.

Design and methods. Based on the results of a comprehensive examination of 113 premature newborns with very low and extremely low birth weight, a mathematical model was developed (z = –4.59+2.54RFIII+2.40CVAF+1.83HCDH+ 1.81Asphyxia+1.66CCLP+0.86TP+0.74CRP+0.48CPIN)) with a computer support program to determine the likelihood of developing congenital pneumonia (http://pneu.bsmu.by ; https://www.bsmu.by in the Doctor menu/Pharmacist: “Diagnosis of congenital pneumonia”). The power test was carried out with an additional set of 58 premature newborns with very low and extremely low birth weight, not included in the resulting model.

Results. The following data were obtained: sensitivity equal to 0.95, specificity — 0.90, prognostic significance of a positive test result — 0.95, prognostic significance of a negative test result — 0.90, likelihood ratio — 9.93.

Conclusion. The results of external validation indicate the high power of the proposed model with a computer support program for determining the likelihood of developing congenital pneumonia in premature newborns with very low and extremely low birth weight.

Mirror syndrome (Ballantyne syndrome) is a rare complication of pregnancy that develops on the background of fetal edema of immune or non-immune origin, in which a pregnant woman develops a clinical symptomocomplex similar to severe preeclampsia. The purpose of this review is to present a modern view on the etiopathogenesis, diagnosis and management of pregnancy, complicated by mirror syndrome. Perinatal losses in Ballantyne syndrome reach 56–67 %. The triggering factor in the development of mirror syndrome are conditions in which generalized edema of the fetus and placenta develops, which leads to the development of dropsy of the mother. Correction of the cause of fetal edema leads to regression of clinical symptoms in a pregnant woman. Specialists in the field of fetal surgery should be aware of the possibility of developing this condition during intrauterine correction of twin-to-twin transfusion syndrome.

Genetic testing plays an increasing role in the diagnosis of various diseases every year. Special attention is paid to genes with an increased risk of cancer in case of mutation. Hereditary prostate cancer is usually more aggressive and is most often associated with mutations in DNA repair genes. These mutations carriers have an increased risk of metastasis and a shorter life expectancy. The study of mutations in the BRCA1/BRCA2 genes is most often used in clinical practice, while there are many other genes responsible for DNA repair processes that have not been sufficiently studied. In this paper, we report a review of literature sources studying the cellular mechanisms of functioning of DNA repair genes, the effect of such mutations on the disease state and oncological outcomes.