I n t r o d u c t i o n . In the context of a steady decline in the tuberculosis morbidity and mortality, the need to improve the effectiveness of treatment of newly diagnosed patients is of particular importance, which is ensured not only by a rational choice of standard anti-tuberculosis chemotherapy regimens, but also by the appropriate use of pharmaceutical adjuvants.

A i m . Evaluation of the features of NET-forming (NETs – neutrophil extracellular traps) function of neutrophils in patients with newly diagnosed infiltrative pulmonary tuberculosis in exudative and productive types of inflammatory tissue response.

M a t e r i a l s a n d m e t h o d s . The randomized prospective study included 180 patients aged 18–59 years with newly diagnosed infiltrative pulmonary tuberculosis divided into two groups: group 1 – 120 patients whose pathological process characteristics corresponded to the exudative type of inflammatory tissue response; group 2 – 60 patients with a process characterized predominantly by the productive type of inflammatory tissue response. The NET-forming ability of neutrophils was evaluated according to the author’s method of D.G. Novikov and colleagues, therefore, the content of citrullinated histone H3 was determined in peripheral blood serum samples.

R e s u l t s . Patients with the exudative type of inflammatory tissue response had more active bacterial shedding (34.8% higher), the growth of Mycobacterium tuberculosis culture was faster (less than 30 days) and more massive (+++) than in productive tissue reaction. The ability of peripheral blood leukocytes to form сloud-like NETs in the exudative type of inflammatory tissue response was 8.5 times higher than in the productive type; thread-like NETs formed 10% more often, which was accompanied by a high content of citrullinated histone H3 in the blood serum of patients.

C o n c l u s i o n . The revealed peculiarities of NET-formation in the exudative type of inflammatory tissue response are essential, and can serve as an additional diagnostic criterion of activity and severity of inflammation in pulmonary tuberculosis, which should be considered when developing prognosis models – variants (favorable, unfavorable) of the course of pulmonary tuberculosis and substantiation of indications for adjuvant therapy and choice of its regimen(s).

I n t r o d u c t i o n . Among perinatal infections, the significance of intrauterine encephalitis (IUE) is determined by the high mortality rate in fetuses and newborns and the development of disabilities in subsequent periods of life, including cerebral palsy, schizophrenic, and autistic disorders. The morphological picture of IUE is characterized by significant polymorphism, which is due to both the multietiological nature of encephalitis and different types of neuron response under pathological conditions.

A i m . Studying the etiology and morphological features of IUE and its outcomes.

M a t e r i a l s a n d m e t h o d s . The brains of 37 fetuses and newborns at a gestation period of 24–27 were examined, in which the signs of IUE were detected morphologically. Light microscopy and immunohistochemical examination were used. By immunohistochemical typing, the markers of the following pathogens were determined: herpes simplex virus types 1 and 2, cytomegalovirus, Toxoplasma gondii, Epstein-Barr virus.

R e s u l t s . IUE was at most a manifestation of systemic intrauterine infection – 86,48% of cases. The morphological picture in IUE was characterized by two main manifestations: productive encephalitis, including granulomatous one, and exudative and productive encephalitis, which probably reflects its etiological features. Etiology of IUE: viral (66,7%), bacterial and fungal (33,3%) pathogens predominated. IUE was complicated by hemorrhagic syndrome with the development of fatal forms: in 21,68% (8 cases) – by subependymal hemorrhages, in 16,2% (6 cases) – by intraventricular hemorrhages.

C o n c l u s i o n . The IUE development in fetuses and newborns is a severe form of systemic intrauterine infection associated primarily with the pathogens of the TORCH complex, the complications of which are fatal subependymal and intraventricular hemorrhages.

I n t r o d u c t i o n . Oxidative stress plays a key role in the pathogenesis of various human pathologies, including cardiovascular disease, cancer, neurological disorders, Parkinson’s disease, Alzheimer’s disease, inflammatory diseases, muscular dystrophy, liver diseases, and even human aging. The prevalence of the above diseases is a significant challenge for modern medicine. One of the possible solutions is the development of novel pharmaceutical agents for the prevention and comprehensive treatment of these conditions. Such agents include, in particular, antioxidants. A i m . Development of standardization methods for a sulfur-containing antioxidant sodium 3-(3’-tret-butyl-4’-hydroxyphenyl)propylthiosulfonate (TS-13).

M a t e r i a l s  a n d  m e t h o d s . The object of the study was a substance of the water-soluble antioxidant TS-13. The methods of spectrophotometry, voltammetry, titration and thin-layer chromatography were used.

R e s u l t s . The developed methods for the quantitative determination of TS-13 have been validated in accordance with the General Pharmacopeial Monograph 1.1.0012 “Validation of analytical methods”. The correlation coefficient of each method is not less than 0,997, the relative standard deviation is not more than 2%.

C o n c l u s i o n . The results of this study demonstrate the potential for utilizing the proposed techniques in the quality control of a novel water-soluble antioxidant TS-13.

I n t r o d u c t i o n . Action Bitters (AB) is an alcoholic polyherbal preparation widely consumed in Nigeria because of the belief that it purportedly boosts energy and overall well-being. Despite its usage, there is little information on its effect on the prefrontal cortex (PFC) and cognitive functions.

A i m . To examine the effects of AB and neutral-flavoured alcohol (NFA) on the PFC young adult male rats in a four-day binge alcohol exposure model.

M a t e r i a l s a n d m e t h o d s . In this study, 15 rats were randomly divided into three groups of five rats each. The 1st group, control rats, were administered 5 g/kg of a diluted nutritionally complete meal (NCM, 50% v/v); the 2ndgroup of rats received 5 g/kg of AB in NCM, and the last, 3d group – 5 g/kg of NFA in NCM. The novel object recognition and T-maze tests were employed to investigate the effect of both substances on cognitive functions. To assess potential neurodegenerative alterations, histological examinations were performed on PFC samples.

R e s u l t s . A lower exploration time for novel objects, percentage alternation, novel object discrimination indexes were revealed. The histological findings showed neurodegeneration in the PFC of AB and NFA feed rats.

C o n c l u s i o n . Our study indicated that both substances induced substantial cognitive impairment and neurodegeneration, with alcohol exhibiting a more pronounced effect. However, the findings suggested that the dangers of binge drinking may be also present in this herbal alcoholic product consumption.

I n t r o d u c t i o n . Currently, in Russia there is an annual increase in the number of criminal and especially civil cases brought in connection with the professional activities of healthcare workers, which is associated with the growth in the number of lawyers, the emergence of the institution of independent examination and insurance companies trying to lay the compensation payments on physicians or healthcare facilities. A i m . An analysis of forensic examinations in civil medical “malpractice” cases in order to identify defects in medical care providing.

M a t e r i a l s  a n d  m e t h o d s . An analysis of the materials of 23 forensic examinations in civil medical “malpractice” cases was performed. All forensic examinations were carried out by expert panels; for their performing, along with forensic medicine experts, qualified physicians were involved in accordance with the specialization of the clinical situation being examined (obstetricians-gynecologists, surgeons, traumatologists, etc.). The forensic examinations were carried out by an expert organization established by the Novosibirsk Regional Association of Physicians and having the appropriate authorization for the implementation of activities to evaluate the quality of medical care (license, etc.).

R e s u l t s . In most of the cases analyzed, the examinations were performed due to the plaintiffs’ claims regarding untimely or inadequate diagnostics and treatment, as well as the lack of reliable information provided to relatives about the patient’s condition. In all 23 cases, the court was satisfied with the interpretation and scientific validity of the expert opinions, which served as the basis for making judicial decisions. When considering the performed examinations, the courts did not have any misunderstandings or disagreements with the content of the conclusions; not a single point was called into question. In 96% of the cases considered, the plaintiffs’ claims were partially satisfied by the court; in 4% (one case), the parties came to a voluntary settlement. In 18% of cases, appeals were filed against the court decisions by both the plaintiffs and the defendants; however, only in one case out of four was the decision of the first-instance court changed in terms of recovery in favor of the plaintiff. In one case, the decision of the first-instance court was overturned in terms of imposing fines on a healthcare facility. One claim was considered by the cassation court, the decision of the first-instance court was left unchanged.

C o n c l u s i o n . Based on the analysis of materials of civil forensic examinations and the literature, it can be concluded that there is no unified approach to working out a number of problems at the intersection of medicine and jurisprudence. To settle these problems, it is necessary to develop new methodological approaches. The issue of personal injury due to defects in the provision of medical care can only be resolved if there is a direct cause-and-effect relationship between the physician’s actions and adverse outcome for a patient.

I n t r o d u c t i o n . To assess the effectiveness of the executive bodies of the constituent entities of the Russian Federation (RF) in implementing the delegated powers to provide citizens, included in the Federal Register of Individuals Entitled to receive state social assistance with medicines for medical use, medical devices, as well as special medical foods for children with disabilities, monitoring the amount of funding, completed contracts, made supplies of medicines, and also the analysis of beneficiary categories of citizens using pharmaceutical marketing tools and segmentation, in particular, are needed. A i m . Development of a methodological approach to micro-segmentation of beneficiary categories of citizens (on the example of the Novosibirsk region (NR)).

M a t e r i a l s  a n d  m e t h o d s . The sources of information were the Federal Register of Individuals Entitled to receive state social assistance as a set of social services (for the NR); departmental materials of the Ministry of Health of the NR, Novosiboblfarm, the database of Novosiboblfarm on the cost and number of provided prescriptions over the period of 2019–2023 by municipal districts (MD) and urban districts (UD) of the region. Research methods were: content analysis, logical, statistical, retrospective, and marketing methods of analysis. The developed methodological approach included segmentation of beneficiaries according to a geographical criterion, the level of provision (financing) of beneficiaries. Federal and regional beneficiaries exercising the right to social support measures were segmented by gender and age, as well as criteria such as categories of citizens, categories of diseases, and population groups under the legislation of the RF. A comparative analysis of the identified segments over the period of 2019–2023 was carried out.

R e s u l t s . According to the geographical criterion, two segments of beneficiaries are distinguished: those living in UD and those living in MD. The segment of beneficiaries who lived in the UD was 3,92 times higher than the segment of beneficiaries who lived in the MD of the NR. Segmentation according to the criterion “level of provision (source of financing)” allowed to identify two segments of beneficiaries: federal (proportion in 2023, 26,17%) and regional (proportion in 2023, 73,83%). During the period analyzed, the proportion of the federal segment increased by 19,12%, while the proportion of the regional segment decreased by 8,29%. During segmentation by disease category, 9 segments of beneficiaries were identified, with an increase in the following segments: rheumatism and rheumatoid arthritis (by 22,93%); diabetes mellitus (by 36,75%); bronchial asthma (by 29,73%); Parkinson’s disease (by 0,96%); tuberculosis (by 3,29%); schizophrenia and epilepsy (by 31,60%); others (syphilis, AIDS, HIV) (by 3,72%); in two segments (cancers and glaucoma, cataract) the increase had a negative value: –0,65 and –11,8%, respectively.

C o n c l u s i o n . Micro-segmentation-based monitoring of beneficiaries will optimize the activities of executive authorities responsible for implementing beneficiary provision of medicines, improve the system of regional drug management, which, in turn, will allow the implementation of state guarantees for the social support to the population on a full scale, create conditions and mechanisms for the effective use of financial, material and information resources, ensure the stability of providing the accessible qualified medical care.

I n t r o d u c t i o n . Viral hepatitis A (VHA) remains an urgent problem due to its widespread prevalence in the world, including Russia, high incidence among adults, characteristic epidemic outbreaks, and polymorphism of clinical forms. The world is conventionally divided into countries with high, medium, low, and very low endemicity. Russia is classified as a medium-endemicity country, and there is uneven distribution of cases of the disease across individual territories of the country. In the Novosibirsk region, the incidence of hepatitis A virus (HAV) infection in 2015–2023 was uneven, often explosive, and its rates varied from 28 to 239 cases, which occurred under approximately equal sanitary and epidemiological conditions in the region. The maximum rise in the incidence of HAV infection was recorded in 2017, 2019, and 2023. The incidence rate in 2023 (3,04 per 100 000) exceeded the hepatitis A incidence rate in the Russian Federation by 20,4%. A i m . To evaluate clinical, epidemiological and laboratory parameters in VHA patients hospitalized in the City Infectious Clinical Hospital No. 1 in Novosibirsk from February to April 2024.

M a t e r i a l s  a n d  m e t h o d s . Clinical, epidemiological and laboratory parameters were analyzed in 56 patients with VHA hospitalized from February to April 2024. The distribution of patients by gender was as follows: 22 men (41,4%), 34 women (58,6%). The median age was 30.3 (15; 62) years. The diagnosis of HAV infection was verified by enzyme immunoassay. To exclude viral hepatitis B and C, hepatitis C total antibodies, hepatitis B antigens and antibodies were determined in the blood serum. Hemogram and blood biochemistry indices were analyzed. Ultrasound examination was used to diagnose pathology of the abdominal cavity organs. When assessing the severity of HAV infection, we followed the criteria of the Clinical Recommendations of the Ministry of Health of the Russian Federation.

R e s u l t s . The dominant age group was represented by individuals aged 15 to 20 years (25%), patients aged 30 to 62 years accounted for 46%, and women predominated. In 19,2% of patients, the contact route of transmission was identified, in 80,8% – the food-borne transmission route. Four outbreaks of VHA were registered. The icteric form of hepatitis A prevailed (87.5%); the severe form was diagnosed in 37% of cases. A relationship between the route of transmission and severity of the disease was found – the severe form was more often observed in food-borne transmission. The clinical picture of VHA was characterized by a typical cyclical course with the presence of influenza-like syndrome, asthenia and dyspeptic syndrome during the pre-icteric phase. In 9% of patients during the pre-icteric phase, abdominal pain was noted, which was a reason for differential diagnosis with surgical pathology. Variability of cytolysis and cholestasis parameters was revealed. In severe cases of VHA, there were manifestations of hepatocellular insufficiency syndrome (hypoalbuminemia down to 24 g/l, a decrease in the prothrombin index down to 33%).

C o n c l u s i o n . Activation of the epidemic process was observed in a season that was not typical for hepatitis A (February – April). The food-borne transmission route was predominant; 46% of patients were over 30 years old. The icteric form prevailed in hospitalized patients (87,5%), and the severe form was observed in 37%. Significant variability in cytolysis and cholestasis syndromes parameters was noted. Hepatocellular insufficiency syndrome was observed in patients with the severe form of hepatitis A.

I n t r o d u c t i o n . Pulmonaria mollis is a perennial rhizomatous hemicryptophytic plant, a mesophytic ephemeroid with a dicyclic development. In this regard, three types of raw materials are distinguished: rhizomes and roots – Pulmonariae rhizomata et radices, grass (reproductive shoot) – Pulmonariae herba, and leaves (vegetative) – Pulmonariae folia. Phytopreparations from different organs of Pulmonaria mollis have different effects, allowing to consider them as promising raw materials for use in phytotherapy. However, the plant may contain not only toxic elements, but also hepatotoxic pyrrolizidine alkaloids. A i m . Determination of acute toxicity of extracts from different organs of Pulmonaria mollis in laboratory animals in vivo.

M a t e r i a l s  a n d  m e t h o d s . The organs of Pulmonaria mollis, which grows in a pine forest in the Kolyvansky district of the Novosibirsk region, were used as objects of research. The content of toxic trace elements (As, Cd, Pb, Hg, Be, Sr, Sb, Tl, and U) in the raw materials was determined by inductively coupled plasma mass spectroscopy. Acute toxicity was studied on 60 mature outbred albino mice (CD-1) and 20 Wistar rats.

R e s u l t s . The content of trace toxic elements in the raw materials turned out to be below acceptable standards. The maximal dosages of dry extracts of reproductive shoots, vegetative leaves and roots administered intragastrically to mice and rats did not have toxic effect on the animals during a 14-day follow-up.

C o n c l u s i o n . In different morphological types of medicinal raw materials of Pulmonaria mollis, alkaloids are present in trace amounts, and the content of trace toxic elements does not exceed the reference range. The absence of toxicity in the total extract from reproductive shoots, combined with the previously revealed anti-anemic activity, makes it possible to consider Pulmonariae herba raw materials as a promising source for development of preparations for the phytotherapy of anemic conditions.

Stroke occupies leading positions among the causes of disability and mortality. Prediction of functional outcomes of stroke has the potential to improve the efficiency of patient management, optimize strategies for providing medical care and rehabilitation measures, taking into account the rationalization of resource use. To date, there are no tools for rapid and comprehensive assessment of the prognosis for a physician to make a timely decision on choosing the most appropriate and promising management tactics for each patient, which requires systematization of known data on predicting stroke outcomes for the possibility of further optimization of this process. We have studied the existing possibilities for predicting the functional outcomes of ischemic stroke via PubMed, Scopus, eLIBRARY, Cyberleninka platforms, analyzed their advantages and disadvantages.

Pulmonary arterial hypertension (PAH) is a progressive disease accompanied by proliferative remodeling of the pulmonary arteries. Despite the obvious advances in its treatment that have occurred recently, the mortality associated with PAH remains high. We present a review of modern Russian and foreign literature devoted to the problem of PAH and the search for methods to solve it. The following resources were used in our review: Russian Science Citation Index, Best Evidence, Scopus, Elsevier, PubMed, Clinical Evidence, Cochrane Library. Therapeutic strategies that have a potency for modification of the disease are presented. Among the novel drugs, two seem to be particularly promising since they have potent disease-modifying properties: sotatercept, which targets the TGF-β superfamily pathway, and seralutinib, an inhaled PDGFR inhibitor. Although sotatercept has demonstrated great efficacy, seralutinib has a potential for the combined therapy use.

Uterine congenital anomalies are the most difficult and comprehensive problems of modern gynecology. For example, the incidence of septate uterus ranges from 1–2 per 1000 to 15 per 1000 women, depending on the region. Currently, this topic is widely covered by the interest of the scientific community. For this review, 14 studies conducted between 1992 and 2020 were selected from 336 identified publications. With regard to anomalies of the uterus and intrauterine septum, the diagnostic accuracy of magnetic resonance imaging was 90,2%, three-dimensional sonography – 95,6%, saline infusion sonography – 96,2%, two-dimensional sonography – 61,3%, hysterosalpingography – 56,1%.