Introduction. Placenta previa (PP), especially invasive forms (placenta accreta spectrum PAS), is one of the leading causes of maternal and perinatal morbidity and mortality.
The aim of the study is to study the features of the anamnesis, pregnancy and childbirth outcomes for the mother and fetus with placenta previa, and to identify the main risk factors for this pathology.
Materials and methods. Retrospective cohort study by continuous sampling method: Group 1 – 64 patients with PP, 2 – 30 women with normal childbirth. The anamnesis of women and pregnancy outcomes were studied. Statistical calculations: Mann-Whitney criteria, χ2 Pearson, odds ratio indicator (OSH).
Results. The probability of PP increases in a woman's history with cesarean section in anamnesis (OR 20.53 (7.2–58.53), p < 0.001), premature birth (OR 4.29 (1.45–12.68), p = 0.04), abortion (OR 3.77 (2.32– 6.12), p = 0.004), including induced (OR 14.16 (4.95–40.53), p = 0.001) and spontaneous (OR 3.65 (2.01–6.62), p = 0.02), as well as somatic diseases (OR 6.17 (3.8–10.02), p < 0.001), especially the presence of anemia (OR 19.84 (6.95–56.61), p < 0.001), gastrointestinal diseases (OR 13.18 (4.6–37.75), p = 0.002), overweight/obesity (OR 6.23 (2.14–18.14), p = 0.015), varicose veins (OR 5.37 (1.84–15.72), p = 0.005). The threat of miscarriage (p = 0.012), placental disorders (p = 0.012), anemia (p = 0.026), genital infection (p = 0.023) were recorded more often in women with placenta previa. All women with PP were delivered by operation caesarean section, often prematurely (45.3 %; p < 0.001), urgently (45.3 %, p < 0.001) because of bleeding (37.5 %, p < 0.001). The expansion of the volume of surgery was required in 37.5 % of cases, hemotransfusion – 50.0 %. Morphofunctional indicators of children from mothers with PP were significantly lower, and the frequency of asphyxia, respiratory distress syndrome, аrtificial lung ventilation was higher than in the control group.
Discussion. PP and PASS are potentially dangerous pathologies for the life and health of women and children, which is confirmed by the results of this study. However, problems of diagnosis of this pathology were revealed at the outpatient stage. In addition to the well-known risk factors for abnormal placentation, associations of PP with a low socio-economic status of a woman and a number of somatic nosologies, such as obesity, anemia, gastrointestinal tract diseases, varicose veins, the influence of which is probably indirect. The association of abnormal placentation with excessive use of gestogens during pregnancy cannot be ruled out.
Conclusions. The risk factors for PP were the presence of a history of cesarean section, abortions, premature birth, low socio-economic status, somatic pathology (overweight / obesity, anemia, gastrointestinal diseases, varicose veins). PP is associated with a high frequency of the threat of miscarriage, placental disorders, genital infection, premature birth, cesarean section operations, bleeding, decreased morphofunctional indicators of newborns, perinatal morbidity and mortality

Introduction. Studies show a low efficiency of postoperative pain relief, especially in gynecological patients. The psychogenic component is of no small importance in the formation of postoperative pain syndrome.
Purpose of the study was to determine the factors influencing the development of uncontrolled pain syndrome in patients who underwent uterine surgery.
Materials and methods. We examined 30 patients who underwent elective surgery for hysterectomy, conservative myomectomy by laparoscopic or laparotomy access or in combination with perineal plastic surgery. Patients of the study subgroups did not differ in age, BMI, and somatic status. Epidural analgesia with 0.2 % ropivacaine solution was performed. We studied preoperative anxiety and depression scores (HADS scale), the dynamics of C-reactive protein level, glucose, lactate, acid-base status, hemostasis, and pain level initially and in the postoperative period, postoperative recovery rate of the patients and satisfaction with anesthesia.
Results. The greatest number of reliable differences in the subgroups was obtained when dividing by the level of preoperative anxiety. Patients with an elevated level of preoperative anxiety were less active in the postoperative period and had three times higher levels of C-reactive protein on the day of discharge. Patients with depression had significantly higher glucose levels compared to the subgroup without signs of preoperative depression on the third postoperative day, and C-reactive protein levels on the second day. The data of regression analysis show the relationship between the level of preoperative anxiety and uncontrolled pain in the postoperative period in gynecological patients.
Discussion. The dynamics of the laboratory indices testify in favor of adequate anesthesia and pain control in the study group. The protocol of pain control during uterine surgery that we use allows us to reduce the level of postoperative pain to acceptable values and increase patients' satisfaction with the recommended analgesia. The impact of anxiety and depression on the severity of pain and the course of the postoperative period among gynecological patients necessitates the use of the HADS scale in the preoperative period. Patients with symptoms of clinically pronounced preoperative anxiety should be prescribed counseling by a psychotherapist and anxiolytics at the preoperative examination stage.
Conclusions. Prehospital anxiety level is a significant factor influencing the development of uncontrolled pain syndrome. The HADS scale identifies a "high risk" group for the development of uncontrolled pain in the postoperative period in patients awaiting uterine surgery and is a screening test.

Introduction. Ablative fractional laser photothermolysis (A-FLPh), used for rejuvenation of aging skin, is based on its controlled damage. Factors of the immune system are involved in the reparative regeneration processes triggered, which, in turn, is also subject to age-related remodeling or immunostaining.
The aim of the work was to evaluate in dynamics the response of the immune system to the A-FLPh procedure performed for correction of age-associated facial skin changes.
Materials and methods. The study included 25 women aged 42 to 55 years who underwent A-FLPh treatment of facial skin with an Erbium laser. The number of leukocytes, monocytes, neutrophils, lymphocytes, T-lymphocytes, T-helpers, cytotoxic T-cells, regulatory T-cells, NKT-lymphocytes, NK-lymphocytes were counted in the peripheral blood before, on the 8th and 24th after the procedure. We studied phagocytic function of neutrophils and monocytes, NBT-reducing and lysosomal activity of neutrophils; determined the amount of IgA, IgM, IgG, IL-4, IL-6, IL-8, IL-10, circulating immune complexes (CIC).
Results. On the 8th day after A-FLPh, the number of neutrophils, neutrophils and monocytes phagocytosis, the number of lymphocytes, regulatory T-cells, IL-6 and IL-8 levels significantly increased; in parallel, the number of CD11b+ NK-lymphocytes, CD11b+ NKT-lymphocytes, IgA, IgG, IL-10 concentrations decreased. On the 24th day, quantitative functional indices of neutrophils, total number of lymphocytes, concentrations of IgA and IgG had no reliable difference from pre-procedure values, phagocytic parameters of monocytes, number of regulatory T-cells, IL-6 and IL-8 levels remained significantly higher, while the number of CD11b+ NK-lymphocytes, CD11b+ NKT-lymphocytes and IL-10, on the contrary, significantly lower than the initial level.
Discussion. The revealed changes of systemic immunity indices after A-FLPh testify to both direct and regulatory-modulatory influence of immune factors on skin repair and remodeling after laser damage.
Conclusion. The A-FLPh procedure induces a response from both cellular and humoral factors of the immune system, predominantly innate immunity.

Introduction. Despite significant advances in the diagnosis and treatment of patients with cardiovascular pathology, it is diseases associated with atherosclerosis that are still the main cause of mortality and disability. Atherosclerosis is based on local inflammation of the vascular wall and disruption of the lipid profile. Neutrophillymphocyte ratio is an indicator that can serve as a new diagnostic criterion of atherosclerotic changes.
Materials and methods. The study enrolled 240 patients with coronary heart disease (150 men and 90 women). The subjects gave voluntary informed consent to participate in the study. All patients with CHD underwent coronary angiography, echocardiography and general blood analysis. Statistical processing of the results was performed using "Microsoft Office Excel" for Windows and "Statistica 10.0" software. Mann-Whitney test was used to assess the statistical significance of differences between the two groups for any parameters in the distribution of features other than normal. The Spearman rank correlation coefficient and its significance were used to assess the relationship between the two traits.
Results. An increase in NLS values with progression of atherosclerotic coronary lesion severity was found; an inverse correlation between NLS value and LV ejection fraction (EF) was detected.
Discussion. Our results, demonstrating an increase in this index with increasing severity of atherosclerotic lesions of the coronary arteries, are consistent with the literature data.
Conclusion. Taking into account the fundamental role of inflammation in atherogenesis, as well as the difficulties of routine determination of expensive markers in everyday practice, the inclusion of an uncomplicated and economically affordable index of LVEF to assess the severity of coronary atherosclerosis and stratify the risk of adverse outcomes in patients with CHD is of undoubted scientific and practical interest and dictates the need for further study of its use in various patient cohorts.

Introduction. Fractures of the maxilla are characterized by such features as the close location of vital anatomical structures, the visual organ, as well as the aesthetic importance of this area of the face and the presence of risk of serious complications.
The aim of the work was to estimate the level of angiogenic factors in the oral fluid: vascular endothelial growth factor A (VEGF-A), vascular endothelial growth factor D (VEGF-D), placental growth factor (PIGF), platelet-derived growth factor BB (PDGF-BB) (VEGF-A, VEGF-D, PIGF, PDGF-BB) and neurotrophins: nerve growth factor (NGFb) and basic brain-derived neurotrophic factor (BDNF) in orbital maxilla fractures.
Materials and methods. A single-center, open-label, prospective case-control study was conducted in which 10 patients an upper jaw fracture of the maxilla (study group) and 10 practically healthy volunteers (comparison group) were examined. Along with clinical-instrumental and laboratory examination, patients were also examined for the content of VEGF-A, VEGF-D, PIGF, PDGF-BB, NGFb and BDNF in oral fluid by multiparametric fluorescent analysis with magnetic microspheres (xMAP technology, Luminex 200, USA).
Results. The content of VEGF-A, VEGF-D, NGFb did not differ significantly between trauma patients and healthy practically volunteers. The content of PIGF-1 and PDGF-BB was markedly elevated in maxillary fracture, with the latter concentration being 12-fold higher than in the comparison group.
Discussion. The results suggest that such injuries are accompanies by an imbalance of angiogenic and neurogenic polypeptides, manifested by increased levels of placental growth factor, platelet-derived growth factor and basic brain-derived neurotrophic factor.
Conclusions. The study of the vascular remodeling and neuroprotection is important not only for extensive skeletal and craniocerebral trauma, but also for relatively local trauma – skull bone fracture in the orbit. 

Introduction. Glaucoma is a socially significant disease. With the advent of new technologies it has become possible to diagnose this disease at an earlier stage.
The aim of the investigation was to reveal the relationships between biomechanical parameters of the optic nerve disc (OND) in patients with primary open-angle glaucoma (POAG) against the background of achieving the "target" intraocular pressure (IOP).
Material and methods. A retrospective cohort study was conducted in which 51 patients with POAG were included. All patients underwent a standard ophthalmologic examination. Central corneal thickness and biomechanical parameters of the cornea were also evaluated. Optical coherence tomography (OCT) was performed to assess the state of the OND.
Results and discussion. Goldman IOP levels had no differences depending on glaucoma stage, but corneal compensated IOP levels differed: the lowest IOP was detected in patients with advanced glaucoma, and the highest – in patients with far advanced glaucoma. Corneal hysteresis factor (CH) and corneal resistance factor (CRF) values also depended on the glaucoma stage: the highest – in initial, the lowest – in far advanced glaucoma. The coefficient of biomechanical tension of the fibrous membrane of the eye was the highest in the group of patients with advanced glaucoma. When assessing the correlation between corneal biomechanical properties and OND parameters, there was a positive correlation of CTR with the mean thickness of RNFL, RNFL thickness in the upper segment and neuroretinal band area (NRB), and a negative – with horizontal, vertical size and excavation area.
Conclusion. This investigation demonstrated the correlation between corneal parameters (CCT, CH, CRF) and their derivatives: CH/CRF ratio, corneal biomechanical tension coefficient and corneal biomechanical coefficient characterizing IOP compensation degree and morphological parameters of the optic disk in POAG against the background of "target" IOP. Protective properties of a thicker cornea, higher indices of corneal hysteresis and corneal resistance factor to glaucoma progression were shown. Keywords: glaucoma, corneal hysteresis, opti

Introduction. The use of fluoroquinolones is associated with prolongation of the QT interval on the cardiogram and increased risk of ventricular tachycardia. To study the mechanism of the cardiotoxic effect of fluoroquinolones and to develop methods of its prevention it is necessary to create models on laboratory animals.
The aim of the work was to analyze the effect of fluoroquinolones on the electrocardiographic parameters of laboratory rabbits.
Materials and methods. 20 rabbits were divided into 3 groups: 6 animals were control, 7 animals received ciprofloxacin 150 mg/kg for 14 days orally, 7 animals received levofloxacin 150 mg/kg for 14 days orally. Electrocardiography was performed before and after 14 days of drug exposure. P wave width, PQ interval, QRS complex, QT interval, corrected QT (QTc), RR interval were analyzed. Data are presented as median and interquartile range.
Results. Rabbits treated with ciprofloxacin showed a prolongation of the QTc interval compared with controls (QTc according to Bazett 306.2 (285.8; 319.8) versus 271.1 (255.2; 285.8) ms, p = 0.022; QTc according to Frederick 241.4 (225.3; 245.5) ms versus 219.1 (201.1; 225.3) ms, p = 0.022), as well as P wave shortening during the experiment (from 55.0 (50 .0; 70.0) ms to 40.0 (35.0; 50.0) ms, p = 0.027).
Discussion. Observed electrocardiographic changes indicate the ability of ciprofloxacin to accelerate atrial conduction, slow down ventricular myocardium repolarization and increase the risk of arrhythmias.
Conclusions. Oral ciprofloxacin administration at a dose of 150 mg/kg/day for 14 days simulates cardiotoxic effect in laboratory rabbits.

Introduction Novel coronavirus infection (NCI) COVID-19 in women during pregnancy has a different course – from asymptomatic to severe and extremely severe. Associations between the severity of NCI COVID-19 and the serum level of 25-hydroxycalciferol (25(OH)D), which is an active metabolite of vitamin D, are currently being studied. There are few data on the association of vitamin D deficiency with severe NCI in the general population, even less data reflecting the level of 25(OH)D in the blood serum of pregnant women suffering from NCI of varying degrees of severity.
Purpose of research was to conduct clinical laboratory comparisons, including the level of the active metabolite of vitamin D 25-hydroxycalciferol in the blood serum of pregnant women with COVID-19 NCI of varying degrees of severity.
Materials and methods. Under observation there were 29 pregnant women living in Chelyabinsk and Chelyabinsk region, who were admitted to the maternity obstetric service of the infectious hospital for patients with NCI COVID-19 during the 3rd–4th wave of the pandemic. Group 1 consisted of 16 pregnant women with severe NCI COVID-19. Group 2 included 13 pregnant women with mild NCI COVID-19. Serum 25(OH)D levels in these patients were determined by chemiluminescent immunoassay.
Results. The patients with severe NCI COVID-19 are statistically more likely to be deficient in vitamin D, while adequate levels of the latter are not recorded.
Discussion. Vitamin D deficiency may contribute to a more prominent systemic response with the development of a cytokine storm and cause a severe course of NCI COVID-19.
Conclusions. The conducted research demonstrated the relationship of vitamin D deficiency with the severity of NCI COVID-19 in pregnant women. We suggest that vitamin D deficiency can be considered as a predictor of the severe course of NCI COVID-19.

Introduction. Pre-transport preparation reduces the risks of deterioration when transporting a newborn. Correction of intensive care in the original medical organization may be an indicator of the need for the transport team to travel to the patient.
Purpose of the study is to identify predictors of the need for correction of neonatal therapy during pre-transplant preparation.
Materials and Methods. Data from all transport team departures of the neonatal intensive care and consultation center between July 1, 2014, and December 31, 2018 (n = 2029) were included in an observational, cohort, retrospective study. Two groups were identified: the first group (n = 502) – patients who underwent correction of intensive care, the second group (n = 1527) – newborns who did not require correction of the ongoing therapy before evacuation.
Results. Statistically significant differences in the volume of intensive care administered at baseline medical organization, parameters of respiratory support were observed between patient groups. The oxygenation saturation index demonstrated good predictive properties regarding the need for correction of intensive care with an AUC ROC of 0.696 [0.662–0.730]. Logistic regression revealed the following reliable predictors of the need for therapy correction: Apgar score at 1 and 5 minutes, giving the patient respiratory support, SpO₂/FiO₂ ratio value, catecholamine infusion, and giving therapy in a Level 1 organization.
Discussion. The identified predictors indirectly indicate the need for correction of intensive care, which is an argument in favor of an evacuation trip and can be a tool for determining the order of such trips.
Conclusion. Predictors of the need to adjust the neonate's therapy include the need for respiratory support (EVI or pCPR), SpO₂/FiO₂ ratio, need for adrenaline or dopamine infusion, Apgar scores at 1 and 5 minutes, and therapy in a Level 1 medical organization.

Introduction. Despite the global achievements of obstetric science and practice, massive bleeding with premature progressive detachment of the normally located placenta, as well as in placenta previa and ingrowth, hypotonic bleeding, occupy one of the leading positions in the structure of obstetric bleeding and are associated with high rates of nearly dead women (near miss), with maternal and perinatal morbidity and mortality.
The purpose of the study was to demonstrate the effectiveness of organizational methodology of emergency care in a 24-hour hospital using the clinical example of PPCR with atypical clinical picture, massive obstetric hemorrhage, and favorable outcome for the patient.
Materials and methods. Material for the analysis of the clinical case was an exchange and notification card of a pregnant woman and a parturient and a labor history. Methods: anamnestic data analysis based on the study of official documentation of pregnancy and its outcome, peculiarities of delivery and labor outcome. Results. The analysis demonstrates the possibility of a rapid diagnosis of PPDNLP, which proceeded without the classical triad of symptoms, with a severe course, massive obstetric hemorrhage and timely specialized care, which led to a favorable outcome for the patient.
Discussion. The speed of care on admission to the hospital, the timeliness of the correct diagnosis even in the absence of the classical clinical picture of PPDNLP, the equipment of the maternity hospital, the timely and adequate obstetric tactics allowed to avoid maternal mortality in massive blood loss and the presence of the disseminated internal coagulation (DIC) syndrome, complicating PPDNLP. Further study of mechanisms of formation, determination of the most significant predictors and triggers of PPDNLP, improvement of organization of care and planned trainings should make a certain contribution to the improvement of maternal and perinatal morbidity and mortality.
Conclusion. In the maternal mortality rate reduction vector, an effective organizational technology of care is demonstrated in a case of PPONR with an atypical clinical picture, the presence of massive obstetric hemorrhage, which ended favorably for the patient.

Introduction. Criss-cross syndrome is a rare congenital heart disease with an incidence of 8 cases per 1 million newborns. The purpose of the work is to demonstrate a rare CHD, a criss-cross heart diagnosed postnatally.
The purpose of the work was to demonstrate a rare CHD, a criss-cross heart diagnosed postnatally.
Materials and methods. A clinical observation of a newborn child with a rare congenital heart defect is presented. Medical documents with the results of clinical examination (physical examination) and instrumental examinations (X-ray examination, echocardiography, computed tomography) were used for analysis.
Results. A child with a rare congenital heart defect (CHD) – criss-cross heart with discordant atrioventricular connections, transposition of the great vessels and preductal aortic coarctation was monitored from the time of delivery until surgical treatment. This malformation was diagnosed postnatally, based on the characteristic clinical symptoms of the detailed segmental analysis of the ultrasound picture of the heart, which is presented as illustrations. Timely diagnosis allowed the choice of adequate medication and surgical tactics of treatment, and the diagnosis was confirmed by computed tomography.
Discussion. It is important for the clinician to remember that rare congenital heart diseases cannot always be diagnosed antenatally, and with the results of screening indicating the presence of more common malformations, the real postnatal heart picture may differ significantly. An additional difficulty is the differential diagnosis of the described malformation due to the rare anomalous mutual arrangement of the anatomical structures.
Conclusion. Detailed segmental analysis during echocardiography immediately after birth reveals the main diagnostic marker of criss-cross syndrome – inability to simultaneously visualize all four heart chambers and both atrioventricular valves from a four-chamber position.

Introduction. The problem of pregnancy management in women with extragenital pathology is multidisciplinary and requires the participation of various specialists. It is known that pregnancy does not adversely affect the course of multiple sclerosis, and the incidence of pregnancy and delivery complications in multiple sclerosis does not exceed the general population. Nevertheless, multiple sclerosis exacerbations with different clinical presentation are possible during pregnancy, which may require correction of tactical and therapeutic measures.
The purpose of the work was to demonstrate the role of a multidisciplinary team for favorable maternal and perinatal outcomes in visual pathology associated with worsening multiple sclerosis in pregnancy through a clinical example.
Materials and methods. We retrospectively reviewed the patient's medical records: individual pregnancy and maternity records, labor and delivery history, and medical records of patients receiving care in outpatient settings.
Results. A patient with multiple sclerosis had an exacerbation of the disease in the form of optic neuritis on the right side with temporary loss of vision in the first trimester of pregnancy. This required multiple consultations with an ophthalmologist and surgical treatment in the ophthalmology department of the hospital, followed by delivery by cesarean section.
Discussion. Multiple sclerosis and its exacerbation in the form of optic neuritis did not affect the development of pregnancy, its favorable outcome was registered, which corresponds to the data of other researchers.
Conclusions. A favorable outcome of pregnancy and delivery in a patient with multiple sclerosis and ophthalmopathology associated with its exacerbation during pregnancy was possible due to coordinated teamwork of specialists in various fields and timely correction of complications using a comprehensive approach and modern surgical techniques.

Introduction. In the structure of gynecological morbidity intrauterine pathology occupies a leading position because of its high frequency and negative impact on the reproductive health of a woman. Endometrial pathology is numerous and includes endometrial hyperplasia and polyps, endometrial cancer, abnormal uterine bleeding and dysmenorrhea, endometriosis and Asherman's syndrome. Pathological changes of the endometrium in women with reproductive problems, such as infertility, habitual miscarriage, are particularly relevant.

The aim of the work is to estimate the contribution of endometrial microbiota in the development of endometrial pathological processes and identify possible pathogens for the development of this process on the basis of scientific literature data.

Materials and methods. Data analysis and systematization were performed on the basis of scientific publications in the PubMed, Google scholar, and Scopus databases for the period 2010–2021. For the final scientific review 65 sources were selected.

Results and discussion. This article presents findings on the role of the uterine cavity microbiota and its contribution to endometrial pathology such as endometrial polyps and hyperplasia, adenomyosis and uterine bleeding, infertility and intrauterine synechiae. The correction of an altered microbiota opens up new insights into the development of uterine diseases and new therapeutic options.

Conclusion. Numerous studies of the uterine cavity microbiota show its undoubted role in the development of uterine cavity pathology. However, the data obtained are quite contradictory. Further study of the uterine microbiota is necessary for a deeper understanding of the pathogenesis of endometrial pathological processes.

Introduction. Since the COVID-19 pandemic, there has been a great deal of evidence for a variety of post-COVID symptoms, including the presence of a musculo-articular syndrome.
The aim of the study was to analyze the current literature data on the prevalence of musculo-articular syndrome and to study the association of coronavirus infection with the development of rheumatoid arthritis.
Materials and methods. We searched PubMed, Medline, and Google Scholar (2020-2022) for articles using the following keywords: post-covid syndrome, muscular articular syndrome or muscle and joint pain, COVID-19, SARS-CoV-2, rheumatoid arthritis. We found 622 articles in which these words appeared in the text of the article. Further, 497 articles were excluded as irrelevant to the topic of the study. During the study of the remaining articles, special attention was paid to the occurrence of musculo-articular syndrome after COVID-19 infection and the association with rheumatoid arthritis.
Results and discussion. There are studies describing musculo-articular pain syndrome and cases of antibodies to cyclic citrullinated peptide (ACCP) after COVID-19, which may indirectly indicate the development of rheumatoid arthritis in these patients. Studies reflect the increased autoreactivity of the immune system in COVID-19, consisting in increased titers of antinuclear antibodies, anti-cardiolipin antibodies, ACCP, and rheumatoid factor. A number of articles have presented results on the association between COVID-19 infection and the appearance, or exacerbation, of rheumatoid arthritis. Several mechanisms are discussed, presumably leading to the occurrence of post-COVID rheumatoid arthritis: induction by coronavirus of excess synthesis of angiotensin II, which increases the expression of inflammatory cytokines, chemokines and production of reactive oxygen species; activation of proinflammatory T-cell subpopulations; activation of Toll-like receptor-7 synovial membrane triggering the inflammatory response; "cytokine storm".
Conclusion. A high percentage (from 15 to 47.7 %) of cases of musculo-articular lesions after COVID-19 infection has been identified. A number of articles have reported an association between COVID-19 infection and the onset, or exacerbation, of rheumatoid arthritis, but the issue is still under discussion, which necessitates large-scale studies specifically devoted to examining this association.

Introduction. The development of new methods and technologies for the treatment of atopic dermatitis (AtD) is an urgent medical task due to the growing incidence of the disease, increasing frequency of severe, continuously relapsing forms of dermatosis resistant to both external and systemic therapy. Appropriate experimental models of laboratory animals are needed to test new methods of AtD treatment.
The purpose of the study is to describe the technologies of creating experimental models for AtD in laboratory animals to conduct preclinical studies to evaluate the effectiveness of AtD therapy, based on foreign and domestic literature data.
Materials and methods. A search in the bibliographic databases PubMed, Scopus, Web of Science, scientific electronic library Elibrary was conducted, 58 sources were selected for the literary review. Search keywords: atopic dermatitis, animal models, mouse models, preclinical studies.
Results and discussion. Mouse models are mainly used to reproduce AtD. Experimental mouse models of AtD can be divided into three groups: mice that spontaneously develop skin lesions similar to AtD; models using transgenic mice that either overexpress selective molecules or lack them; models induced cutaneous application of sensitizers. Typically, these models mimic various aspects of human AtD pathophysiology, such as defects in the skin barrier, Th2 predominance, with additional activation of Th1 and Th22 and, in some populations, Th17 immune response.
Conclusion. Of the technologies for creating experimental models of AtD in laboratory animals, those with genetic predisposition and allergen-induced models are the closest to human AtD.

Introduction. A variety of patient complaints about sleep disorders and associated quality of life restrictions force patients to turn primarily to internists. Meanwhile, internist doctors often pay insufficient attention to detailing the symptoms associated with the patient's sleep state.
Main purpose of the work was to systematize modern data on the relationship between sleep disorders and pathology of internal organs and to increase the awareness of internists about sleep disorders and associated diseases.
Materials and methods. Literature sources were selected for the review by the keywords: sleep, sleep disorders, OSAS for the period 2003–2021 in PubMed, GoogleScholar, Web of Science databases.
Results and discussion. Disorders of sleep duration and quality in patients influence the development of other internal organ pathologies. Of particular importance is the relationship of sleep disorders with nocturnal cardiac rhythm and conduction disorders, changes in daily BP profile, OSAS, nocturnal heartburn and GERD, accelerated aging. Analysis of a patient's sleep status is of great importance in the practice of an internist and can improve the prognosis for a number of diseases.
Conclusion. When working with patients, internists should assess the state of sleep as a potentially modifiable risk factor for diseases of the internal organs.

Introduction. Presently, percutaneous endoscopic gastrostomy is considered to be the operation of choice when long-term enteral feeding in dysphagia syndrome is required. The technique is characterized by low incidence of early and long-term complications due to low traumatic access and operation time.
Aim of the work was to assess the risk predictors of percutaneous endoscopic gastrostomy complications and their significance for the postoperative period.
Materials and methods. We searched publications and analyzed literature sources using PubMed and MedLine databases and Cochrane Library and elibrary.ru scientific libraries mainly for the last ten years. The search was performed using a set of key words: percutaneous endoscopic gastrostomy, dysphagia syndrome, postoperative complications, risk factors.
Results and discussion. The leading and most studied predictors of early and long-term postoperative period complications after gastrostomy are hypoalbuminemia, uncompensated diabetes mellitus, thrombocytopenia, elevated levels of C-reactive protein, Charlson's comorbidity index (4 points or higher), antiaggregant and anticoagulant therapy, morphoconstitutional features of patients.
Conclusion. Data analysis has shown that percutaneous endoscopic gastrostomy at high patient flow and gastropectomy supplementation with gastropexy is practically safe and effective if the selection criteria for the operation are observed taking into account the general condition, risk factors and exclusion of absolute contraindications.

Introduction. The necessity to develop new substitutional medical technologies is associated with a high demand for rehabilitative measures of traumatological, surgical, and dental patients and persons with burn disease. The existing clinical practice of using allogeneic and autogenous cells, previously used for these purposes, has not yet been standardized.
The aim of the study was to summarize scientific literature data on the clinical effectiveness of cell-based medical biotechnologies for regenerative medicine.
Materials and methods. The authors reviewed 29 published scientific sources on the results of clinical trials of the preparation "Cell culture for substitution therapy" in 12 medical institutions of the Ural and Siberian regions of the Russian Federation during the period from 1998 to 2012.
Results and discussion. Developed and effectively tested on the basis of medical institutions of Sverdlovsk, Chelyabinsk, Tyumen, Kemerovo regions, the Republic of Sakha (Yakutia) and Khanty-Mansi Autonomous Okrug immunobiological preparation "Cell culture for replacement therapy" had high clinical effectiveness in pathological conditions associated with tissue damage in patients with burns, surgery, trauma and dental profile. The studies demonstrated the key activity of allogeneic fibroblasts in the lesion nidus while reducing the time of extracellular matrix formation during active tissue regeneration. The use of the drug prevented the development of generalized infectious-inflammatory complications, reduced the risk of secondary infections, reduced the period of hospitalization and rehabilitation of patients.
Conclusion. Analysis of the literature data on the high efficiency of immunobiological agents for substitution therapy on the example of using the preparation on the basis of allogeneic human fibroblasts, based on modern medical standardization and ethical norms, sets the actual task of their replacement by xenogenic and autologous preparations, which will increase the efficiency and safety of the presented method of treatment, improve the quality, life expectancy and demographic indicators in Russia.