Purpose. The aim of the study was to investigate the subpopulation composition and prooxidant activity of adipose tissue cells in the big omentum of patients with metabolic syndrome.Material and Methods. A fragment of white adipose tissue obtained from the greater omentum during planned endoscopic cholecystectomy in 37 female patients aged 48 (34; 65) years was used as a material for the study. The main group was represented by patients with metabolic syndrome (n = 31) diagnosed according to current recommendations for management of patients with metabolic syndrome. Six patients without signs of metabolic syndrome, comparable with the main group in terms of age and gender, made up the comparison group. The subpopulation composition of the adipose tissue cells in the greater omentum was determined by immunohistochemical analysis. The content of reactive oxygen species in the isolated cell pools of adipocytes and mesenchymal stromal cells was identified using flow cytometry.Results. Comparison of the mean values in the groups showed a statistically significant prevalence in patients with metabolic syndrome only in the level of cells expressing CD68 (macrophage marker) on their surface (p < 0.05). Correlation analysis allowed to detect a positive relationship between morphometric indicators determining the severity of infiltrative changes of adipose tissue (the number of infiltrates) and the relative number of cells presenting CD3 (r = 0.357, p < 0.05), CD36 (r = 0.575, p < 0.05), and CD68 (r = 0.374, p < 0.05) on their surface, respectively. A comparative analysis of the level of reactive oxygen species in adipose tissue cells showed statistically significantly (p < 0.05) higher values of reactive oxygen species in patients with metabolic syndrome compared with the control group both in adipocytes and in mesenchymal stromal cells.Conclusion. The presence of a positive correlation between the relative numbers of cells presenting CD3, CD36, and CD68 markers and the morphometric parameters reflecting the severity of infiltrative manifestations suggested that the mentioned cell lymphocyte and macrophage populations were involved in the development of infiltration in the adipose tissue in metabolic syndrome. The pro-inflammatory phenotype of adipose tissue in metabolic syndrome was characterized not only by a number of morphological features, but also by enhanced prooxidant activity of the adipocytes and mesenchymal stromal cells.

The review summarizes and analyzes the results of domestic and major foreign studies of recent years concerning gender characteristics of the epidemiology and development mechanisms of metabolic syndrome and urolithiasis as an associated disease. A deep understanding of gender aspects in the pathogenesis of these pathologies can form the basis for development of high-quality diagnostic algorithms and pathogenetically grounded approaches to treatment.

Aim. To perform a scintigraphic assessment of the bronchopulmonary system and pulmonary microcirculation in patients with connective tissue dysplasia.Materials and methods. The study included 31 male patients of conscription age with connective tissue dysplasia (CTD), diagnosed according to the 2019 clinical guidelines (average age (19.6 ± 2.6 years)), and 25 practically healthy individuals comparable in gender and age, who formed a control group. All patients underwent planar pulmonary ventilation – perfusion scintigraphy with determination of pulmonary alveolar – capillary permeability.Results. In patients with CTD, the apical to basal perfusion gradient (U/LQ) was on average 24% lower than in the control group (p = 0.046), and alveolar – capillary permeability was higher in both lungs, both at minute 10 and at minute 30.Conclusion. Static pulmonary ventilation – perfusion scintigraphy allows to identify functional disorders in patients with CTD at the preclinical stage: a decrease in the perfusion gradient on average by 24% compared with the control group and an increase in alveolar – capillary membrane permeability.

Unprecedented advances of recent decades in clinical pharmacology, cardiac surgery, arrhythmology, and cardiac pacing have significantly improved the prognosis in patients with chronic heart failure (CHF). However, unfortunately, heart failure continues to be associated with high mortality. The solution to this problem consists in simultaneous comprehensive use in clinical practice of all relevant capabilities of continuously improving methods of heart failure treatment proven to be effective in randomized controlled trials (especially when confirmed by the results of studies in real clinical practice), on the one hand, and in development and implementation of innovative approaches to CHF treatment, on the other hand. This is especially relevant for CHF patients with mildly reduced and preserved left ventricular ejection fraction, as poor evidence base for the possibility of improving the prognosis in such patients cannot justify inaction and leaving them without hope of a clinical improvement in their condition. The lecture consistently covers the general principles of CHF treatment and a set of measures aimed at inotropic stimulation and unloading (neurohormonal, volumetric, hemodynamic, and immune) of the heart and outlines some promising areas of disease-modifying therapy.

The lecture synthesizes and analyzes the findings of research concerning the impact of sleep disordered breathing (SDB) on the progression of the most prevalent chronic non-infectious lung diseases (CNLDs). SDB, including conditions, such as snoring, sleep hypoventilation syndrome, and obstructive and central sleep apnea syndrome, constitutes a significant medical concern due to its high prevalence and adverse health consequences. SDB is regarded as an independent risk factor for the development and progression of a range of CNLDs. Timely diagnosis and management of SDB may serve as an effective preventive measure against severe manifestations and complications associated with this group of diseases.

Idiopathic pulmonary fibrosis (IPF) is one of the most common diseases in the group of interstitial lung diseases, which is characterized by persistent progression and poor prognosis. Over the past decade, experts have made significant progress in developing a diagnostic algorithm for IPF patients. This algorithm includes analysis of clinical, laboratory, and instrumental data, primarily the results of high-resolution computed tomography (HRCT). Precise adherence to the diagnostic algorithm and correct interpretation of HRCT data are prerequisites for IPF diagnosis.Specialists of the Tomsk region have developed routing of patients with suspected IPF. The presented clinical case is a successful example of adhering to this algorithm. Wide implementation of modern diagnostic algorithms into diagnosis and treatment of IPF and quality improvement of imaging methods, primarily HRCT, carried out as a part of the differential diagnosis, open up prospects for early diagnosis of this pathology. A timely prescribed antifibrotic therapy (nintedanib, pirfenidone) in IPF allows to slow down pathological progression and improves the prognosis.