Introduction. Non–alcoholic fatty liver disease (NAFLD) is a chronic metabolic disease associated with insulin resistance, with a high potential for progression and increased prevalence among the population of all countries. The search for modifiable factors associated with the development of NAFLD, especially among young people, is an urgent healthcare task. The relationship between vitamin D availability and the high incidence of metabolic disorders in young adults and its contribution to the progression of NAFLD is currently under active discussion.

The aim of the work was to reveal the relationship between the components of metabolic syndrome and the level of vitamin D supply in young men with NAFLD.

Materials and methods. The study enrolled 123 male patients aged 18−44 years. Two groups were formed: the main group consisted of the patients with NAFLD, the control group − the patients without NAFLD. Anthropometric data were analyzed; blood plasma parameters of lipid metabolism, glucose, insulin, 25(OH)D levels were determined. Insulin resistance index (HOMA-IR) was calculated. Steatosis and hepatic fibrosis were verified by transient elastometry. The nature and strength of the relationship of the variables were assessed using the Spearman rank correlation coefficient.

Results. Significant associations were found between 25(OH)D levels, steatosis scores, liver fibrosis, waist circumference, and NOMA-IR.

Discussion. Insufficient vitamin D supply is etiopathogenetically associated with the development of metabolic syndrome (MS) and NAFLD.

Conclusion. Low serum vitamin D concentrations are associated with both the severity of hepatic steatosis and components of the metabolic syndrome. Timely detection of vitamin D deficiency and supplementation can reduce the severity of metabolic disorders and progression of NAFLD.

Introduction. The choice of tactics for patients with adrenal masses (AM) with functionally autonomous cortisol secretion (FASC) remains controversial.

The aim of the study was to determine the most significant clinical manifestations of FASC in unoperated AM patients.

Materials and methods Thirty unoperated AM patients aged 67.0 [59.25 to 71.0] years with a disease duration of 92.0 [46.75 to 112.0] months were included in the study.

Results. We defined thresholds for morning blood cortisol levels to predict clinical manifestations of FASC: for obesity ≥ 300.7 nmol/L, (p = 0.02), DM2 ≥ 508.0 nmol/L, (p < 0.001), dyslipidemia ≥ 450.0 nmol/L, (p = 0.02). Increases in AM size were determined: at 36 months − by 0.146 cm, at 60 months − by 0.169 cm, its positive marked direct correlation with the initial AM size.

Discussion. According to the literature, FASC is diagnosed in 30−50 % of patients with AM. Our data are comparable with scientific sources: AH was observed in 86.7% (n = 26) of patients, obesity − 73.3 % (n = 22), T2DM − 36.7 % (n = 11), dyslipidemia − 60 % (n = 17), osteoporosis − 43.3 % (n = 13).

Conclusion In unoperated outpatients with AM, obesity, DM2, and dyslipidemia are the most significant clinical manifestations of FASC. In patients over 60 years of age with a benign CT-phenotype of adrenal masses and controlled clinical manifestations of FASC, the treatment tactic is observation.

Introduction. Obstruction due to benign prostatic hyperplasia (BPH) is a common condition in men over 40 years of age. This study determined the association between body mass index (BMI) and preoperative prostate volume (PV).

The purpose of the study was to determine whether there is an association between obesity and prostate volume in men with BPH.

Materials and methods. The medical records of 96 patients who underwent holmium enucleation of the prostate as a treatment for BPH and who met the inclusion criteria were retrospectively reviewed. The mean age of the patients was (70.6±8.5) years. Correlation analysis was performed to assess the relationship between BMI and prostatic volume.

Results. A total of 96 patient charts were analyzed. When assessing the relationship between BMI and prostate volume, a statistically significant direct correlation of moderate strength was found (ρ = 0.456, p < 0.001). Patients with prostate volume > 75 mL were significantly more likely to have urinary retention (p < 0.001; OR = 4.7; 95% CI: 1.9−11.4).

Discussion Studies on larger patient samples are needed to verify the results against true population figures.

Conclusion A positive correlation between BMI and prostate volume has been established.

Introduction. In the modern literature, the problem of the influence of multifocal brain damage in vascular dementia on the development of aggressive behavior in patients is only partially covered.

The purpose of this work is to study the influence of neurobiological factors (number, localization of lesions) on the development of aggressive behavior in multi-infarct dementia.

Materials and methods. The study involved 98 subjects diagnosed in multi-infarct dementia (F 01.1), established according to the ICD-10 criteria (1992), in which 52 were men (53.1 %) and 46 women (46.9 %), aged 60 to 90 years, the average age was 74.5 [67; 81] years. Patients are divided into a main group – with aggressive behavior (n = 49), and a control group − without aggressive behavior (n = 49). The study used clinical-anamnestic, clinical-psychopathological, psychometric and neuroimaging methods.

Results. The study showed that patients with aggressive behavior compared to patients without aggressive behavior have a greater number of lesions (p < 0.0001). The localization of which is statistically significantly more often determined in the left frontal lobe, subcortical nuclei on the left and in the left ventricular region (p = 0.0002, 0.0212, 0.0036), and patients without aggressive behavior often do not have frontal lobe lesions.

Discussion. Patients who show aggression in general, or in isolation physical, verbal aggression, or irritability, have a statistically significantly greater number of lesions than patients without these symptoms (p < 0,0001). Each additional lesion increases the likelihood of developing aggression and its severity. In patients with irritability, lesions localized in the left frontal lobe and left ventricle.

Conclusion The study suggests that the number of lesions from four or more, as well as their predominant localization in the left hemisphere of the brain, leads to the development of various types of aggressive behavior.

Introduction. Rhinosinusogenic orbital complications (RSOC) rank first among all serious complications of inflammatory diseases of the paranasal sinuses and require timely diagnosis and an interdisciplinary approach in the administration of this category of patients.

The aim of the study. was to study the features of the nature of the course, diagnosis and tactics of managing children with RSOC according to the children’s ENT department of the OKB No. 2, Tyumen.

Materials and methods. A retrospective analysis of the medical records of children with RSOC was carried out. The leukocyte shift indices (LSI) were calculated. The microbiological landscape in purulent RSOC and the tactics of introducing patients with these complications were studied.

Results and Discussion. Among the entire pathology of the paranasal sinuses, RSOS were observed in 12.9% of cases. In 53.6% of cases, RSOC occurred in boys. Reactive edema of the tissue of the eyelids and orbits was in 86.1% of cases, other forms were less common. Of the microflora, the leading positions were occupied by Staphylococcus spp. In 54.2 % of cases, only conservative therapy was used, in every third case − minimally invasive manipulations, in 11 % − surgery. In 84.6 % of cases, empiric therapy was started with protected aminopenicillins, 3rd generation cephalosporins (12.8 %). In the presence of a subperiosteal abscess or phlegmon of the orbit (23.1 %), a transfer was made to reserve preparations. LSI values greater than 3.58 were more typical for purulent-septic complications of the eyelids and orbit, which required early surgical intervention and prevention of intraorbital and intracranial complications.

Conclusion Among RSOC in children, reactive edema of eyelids and eye sockets predominates. The microbial landscape in purulent orbital complications was characterized by pronounced polymorphism, which makes it difficult to choose empirical antibiotic therapy. Calculation of the LSI allows for early diagnosis and timely therapy with the choice of the optimal scope of medical intervention and an interdisciplinary approach, which reduces the risk of developing purulent-septic complications of the orbit and eyelids.

Introduction. Among the mechanisms of pathogenesis of tuberculosis is damage to the pulmonary surfactant. In patients with tuberculosis who previously worked in an industrial dusty environment, the pulmonary surfactant system is affected by two damaging factors simultaneously.

The aim of the work was to determine the role of biochemical criteria of pulmonary surfactant damage as early molecular markers of the sub-radiological stage of pneumoconiosis in pulmonary tuberculosis patients.

Materials and methods. The object of the study was 91 patients with pulmonary tuberculosis, of whom 59 patients had contact with industrial quartz-containing dust in the course of their work (the main group) and 32 patients − with an unburdened professional route (the control group). The content of total protein (TP), total phospholipids (TPL), phospholipid spectrum by thin-layer chromatography as criteria of pulmonary surfactant damage were studied biochemically in bronchoalveolar flushes (BAF).

Results. It was found that in bronchoalveolar flushes of patients with tuberculosis of dust-hazardous professions, in group 1, the content of total protein increases, while the level of total phospholipids does not statistically significantly change in comparison with patients with an unburdened professional route. Among the phospholipids of BAF, phosphatidylcholine (PC), phosphatidiylethanolamine (PEA) and cardiolipin (CL) are the most common. In the BAF of the 1st group of patients, a frequent combination of fractions of PC and CL was found, in the 2nd group − PC, PEA and CL. Combinations containing sphingomyelin (SPM), PC and CL were found only in groups 1 and 2. It was also found that the level of total protein in BAF varies depending on the activity of the process, so in patients of group 1 with the presence of areas of destruction of lung tissue, the content of total protein significantly exceeded that in patients with specific inflammation subsiding.

Discussion. Patients with pulmonary tuberculosis with dust exposure develop sub-radiological manifestations of pneumoconiosis in the form of impaired metabolism and biochemical composition of pulmonary surfactant, which is caused both by the dust factor and the influence of specific inflammation.

Conclusion The role of biochemical criteria of pulmonary surfactant damage as early molecular markers of the sub-radiological stage of pneumoconiosis in pulmonary tuberculosis patients was determined.

Introduction. Norovirus infection (NI) is the most prevalent cause of acute gastroenteritis and outbreaks in semi-closed settings. Forecasting of NI may improve situational awareness and control measures.

The aim of the study is to evaluate accuracy of time-series models for forecasting of norovirus incidence (on Sverdlovsk region dataset).

Materials and methods. Simple ARIMA time-series models was chosen to forecast NI incidence via regression on its own lagged values. Dataset including passive surveillance monthly reports for Sverdlovsk region was used. All models were trained on data for 2015−2018 and tested on data for 2019. Models were benchmarked using Akaike information criterion (AIC) and mean absolute percentage error (MAPE).

Results and discussion. NI incidence in Sverdlovsk raised in 2015-2018 with strong winter-spring seasonality. The time-series incidence data was stationary. Nine significant models were found and the most accurate model was SARIMA (1,0,0)(0,0,1). Despite its accuracy on 2019 test sample, forecast on COVID-19 pandemic period was failed. It was supposed that including additional regressors (climate and herd immunity data) and choosing of more robust time-series models may improve forecasting accuracy.

Conclusion. ARIMA time-series models (especially SARIMA) suitable to forecast future incidence of NI in Sverdlovsk region. Additional investigations in terms of possible regressors and improved model robustness are needed.

Introduction. In recent decades, there has been a decrease in occupational morbidity at enterprises producing rough and refined copper, in the structure of which, nevertheless, bronchopulmonary pathology retains a leading position.

The aim is to study the occupational risk of developing respiratory pathology in workers engaged in obtaining cathode copper by electrolysis and electorowinning methods, based on the study of working conditions of workplaces and clinical observation.

Materials and methods. The object of the study were: Uralelectromed, V. Pyshma (UEM); Uralhydromed, Polevskoy (RMK). The subject of the study were 100 employees of the electrolysis shop of UEM – the 1st observation group; 102 people of the auxiliary workshops of UEM – the 2nd observation group; 92 workers of the extraction and electorowinning department of UGM – the 3rd observation group.

Results.  During electrolytic refining of copper, the leading harmful factors with respiratory toxicity are sulfuric acid aerosol, selenium dioxide, nickel, arsenic, and during electrovinig – sulfuric acid aerosol. Violations of ventilation function and pulmonary gas exchange were observed in 21.0 % of cases in persons of the 1st and in 15.7% of cases in patients of the 3rd observation group).

Discussion. Changes in the function of external respiration (FVD) were established mainly by the obstructive type, namely, an increase in RV, FRC and RV/TLC and a decrease in FEV1, VC, FEV1/VC, FEV25-75 of mild and moderate severity were noted. The bronchodilation test revealed the reversibility of bronchial obstruction in both groups 1 and 3. Obstructive disorders and dynamic hyperventilation of the lungs in copper refining workers are probably a consequence of hyperreactivity of the bronchi in response to the irritating properties of sulfur-containing gases, arsenic and nickel compounds.

Conclusion. The results of the study indicate respiratory toxicity of harmful factors in workers of electrolysis and electrovining, which corresponds to a high and average occupational risk of class 3.3 and class 3.2 assessment of working conditions and the results of mandatory periodic medical examinations.

Introduction. Treatment for multidrug-resistant tuberculosis lasts 18 to 24 months, so there is a high rate of therapy interruptions, including patient-initiated interruptions. In recent years, the use of shorter regimens for the treatment of multidrug-resistant tuberculosis has been actively discussed around the world. The first use of shorter chemotherapy regimens was conducted in three regions of the Russian Federation in 2019. However, the prevalence of the use of shorter chemotherapy regimens in our country remains low.

The purpose of the study was to demonstrate the high efficacy of a shortened chemotherapy regimen with surgical intervention.

Materials and methods. In the conditions of the Central Research Institute of Tuberculosis, the patient underwent a comprehensive examination, including mandatory, additional and optional methods of investigation. Based on the findings of the comprehensive examination and established broad drug resistance of Mycobacterium tuberculosis, a shorter course of chemotherapy was prescribed and surgical treatment was performed after 2 months of therapy.

Results and Discussion It was decided to carry out anti-tuberculosis therapy according to a shortened scheme in the amounts: Linezolid, Bedaquiline, Cycloserine, Levofloxacin, Pyrazinamide. Taking into account positive radiological dynamics after two months of treatment and absence of contraindications, early surgery intervention was performed. At the end of a nine-month course of chemotherapy the patient had a stable radiological picture, “fresh” focal and infiltrative changes in the lungs were not detected. Early surgical treatment with a shorter chemotherapy regimen may become a highly effective method in the cure of drug-resistant tuberculosis in the Russian Federation.

Conclusion. A shorter chemotherapy regimen with optimal timing of surgical intervention is highly effective and safe to use.

Introduction. Reverse twin arterial perfusions, also known as cardiac malformation, is a uniquely rare complication of monochorionic multiple pregnancy due to the presence of a large arterio-arterial anastomosis, the formation of a rudimentary heart or its absence in one of the fetuses. The heart of a morphologically normal twin (fetus-pump, fetus-donor) provides blood circulation for both fetuses.

The aim of the work was to determine a possible way to reduce perinatal mortality using the clinical example of monochorionic multiple pregnancy with the presence of cardiac twins.

Materials and methods. Materials for clinical case analysis were the exchangenotification card of the pregnant and parenting woman, labor history, the results of functional and laboratory tests. Methods: analysis of anamnesis, results of functional and laboratory tests, peculiarities of pregnancy and delivery.

Results. The analysis successfully demonstrates the possibility of improving perinatal outcomes in monochorionic twins complicated by the presence of acardia syndrome in the case of timely diagnosis of the complication, close dynamic monitoring of pregnancy and timely delivery in the case of functionally confirmed deterioration of the living fetus.

Discussion. Monochorial type of placentation is recognized as a high risk factor for adverse perinatal outcomes (fetal-fetal hemotransfusion syndrome, the formation of discordant growth andfetal growth retardation, cardiac twins, increase frequency of preterm birth, perinatal morbidity and death). The presence of cardiac twins is the highest risk factor for antenatal death of a second fetus in the absence of timely surgical treatment and delivery. The presented clinical case demonstrates the possibility of improving perinatal outcomes by prolonging a multiple pregnancy complicated by cardiac malformation up to 33 weeks of gestation and delivery at decompensation of the placental complex.

Conclusion. In the vector of reducing the incidence of perinatal mortality, individual management of pregnant women with monochorionic multiple pregnancy is necessary to enable timely diagnosis of its complicated course by cardiac malformation of one of the fetuses, dynamic functional examination of the placental complex, determination of indications for surgical correction and choice of term of delivery.

Introduction. An orbital foreign body, especially of an organic nature, is often difficult to diagnose during the initial examination. A thorough history taking, clinical examination, and the use of additional imaging techniques are of great importance. Due to the risk of purulent-inflammatory complications, foreign bodies must be surgically removed.

The aim of the work was to demonstrate the importance of timely diagnosis and complex approach to treatment of patients with X-ray non-contrast foreign bodies of the orbit using the example of clinical observation.

Materials and methods. Patient R. came in with complaints of redness, pain, lacrimation and lack of vision in the left eye after falling and hitting the left side of his face on a metal corner. Left eye visual acuity = 1/∞PrLinc, IOP = T−3 (palpatory).

Results. Control X-ray computed tomography (CT) of the orbits and paranasal sinuses (PNS) suspected the presence of a radiopaque foreign body. A rhinoendoscopic examination was performed by an otorhinolaryngologist and a fragment of a large wooden foreign body was found in the nasopharyngeal arch. Surgeons of the ophthalmologic and otorhinolaryngologic departments performed surgery: removal of the foreign body, endonasal endoscopic opening of the labyrinth on the left, endoscopic endonasal maxillary sinus maxillary sinus maxillotomy on the left, left microcoidectomy, resection of trauma-exposed tissue. During his stay in the 2nd Ophthalmologic Department of the Regional Clinical Hospital named after N.A. Semashko. N.A. Semashko Regional Clinical Hospital, the patient’s condition improved, infection was eliminated, prevention of possible complications was carried out. The patient was referred to the Pirogov National Medical-Surgical Center, where the following surgery was performed: microinvasive vitrectomy + FEC + PFOS + retinotomy + endotamponade with silicone oil 1300 of the left eye, and a consultation with a laser surgeon was recommended for laser iridectomy.

Discussion The clinical case considers a comprehensive approach to the treatment of intraorbital foreign bodies, the participation of a multidisciplinary team of specialists, while the patient still has a long road to rehabilitation.

Conclusion In orbital trauma with penetration of a foreign body, an accurate history, timely diagnosis, and rational surgical and conservative treatment are important. This will help to avoid serious complications and prevent visual and oculomotor disorders of the visual organ.

Introduction. The staff of the Bureau of Forensic Medicine (BFM) experience a high microbial load in the performance of their professional duties, which poses a serious health hazard. Cases of infectious diseases continue to be recorded among the medical personnel of the BFM, which requires the prevention of infection during professional activities. The process of legal regulation of BFM activities in terms of compliance with sanitary and hygienic measures ensuring the safety of BFM employees from infectious contamination and improving the quality of expertise is becoming highly relevant.

The purpose of the study is to propose measures to improve the regulation of relevant procedures based on the analysis of the legal regulation of BFM activities in matters of infectious safety.

Materials and methods. We studied laws and bylaws at the federal and departmental levels. The regulatory framework was evaluated at the following conditional stages of forensic medical examination: processing of the sectional table; processing of instruments used for autopsy; personnel hand hygiene; current and general cleaning in the sectional rooms of the BFM.

Results It was noted that there are no recommendations for disinfection after each dissection when processing the sectional table, the disagreements in the documents regulating the processing and disinfection of sectional instruments were revealed, the necessity of processing the instruments by mechanized method with the help of ultrasonic washers was shown. The points requiring attention with respect to the use of personal protective equipment, treatment of experts’ hands and other antiepidemic measures in the light of the new regulatory documents that have come into force are listed: Sanitary Rules and Regulations 3.3686-21 and Sanitary Rules 2.1.3678-20.

Discussion The identified contradictions in the issues determining the actions of the expert at each of the stages indicate that the sanitary and hygienic measures are covered insufficiently and require more detailed elaboration.

Conclusion Changes are required at the legislative, subordinate, and regulatory levels. Standard operating procedures must be implemented for BSMSE staff, which must be carried out in compliance with the requirements of the legislation regulating the activities of BFM, as well as precautions to ensure the infectious safety of employees.

Introduction. At least 3% of all cancer cases are associated with hereditary changes in genes predisposing to malignant neoplasms. In addition to the widely known BRCA1,2 genes, other genes involved equally with BRCA1,2 in the DNA repair system and maintenance of genome integrity, such as PALB2, CHEK2, are being introduced into routine diagnosis. In this review we present current information from recent studies on the structure and function of PALB2 and CHEK2 genes, and the diagnosis of mutations in these genes, as well as their clinical significance.

The purpose of this work was to update and systematize the data on PALB2 and CHEK2 genes in order to better understand their significance in carcinogenesis, associated risks of malignant neoplasms, prevention and treatment tactics for mutation carriers.

Materials and methods. PubMed, Google Scholar, Cyberleninka databases were searched. The criteria for inclusion of articles were the novelty and relevance of the data, compliance to the topic of the review. Based on this, 79 literary sources were selected.

Results and discussion. Mutations in the PALB2 gene are common in 0.5 to 2.1 % of cancer cases and are associated with an increased risk of breast cancer (52.8 % by age 80), as well as ovarian cancer (5 %), pancreatic cancer (2.8 %). The frequency of changes in the CHEK2 gene reaches 5 % and is associated with a risk of breast cancer (up to 40 % by age 80) and colorectal cancer. Numerous studies have shown that mutations in these genes are associated with prostate, lung, kidney, and melanoma cancers.

Conclusion. A better understanding of the spectrum of genetic predisposition and identification of genespecific cancer risks could lead to improved screening, prevention, and therapeutic strategies for patients with hereditary cancer and their families.

Introduction. Cardialgia is a common reason for seeking medical care in the practice of the pediatrician and pediatric cardiologist. The combination of cardialgia and syncope in children can pose a health risk, leading to possible injuries, and is a factor of fear and anxiety in these families. Insufficient information on the pathophysiological basis of the development of cardialgia and syncope in children and the absebce of clear criteria for their prognosis and prevention were the reasons for a detailed study of the literature related to this issue.

The aim of the work was to systematize the current literary data on the causes of cardialgia and syncope in children and to determine directions for further study of the problem to improve monitoring by pediatricians and pediatric cardiologists.

Materials and methods. We searched for scientific articles using the keywords pediatric chest pain and syncope in the Pubmed, UpToDate 2022, Customer Service, and RSCI databases. Sixty publications were selected for analysis.

Results and discussion. Cardialgia is pain in the heart region, which in combination with fainting can be a symptom of a large number of diseases, which determines the different approach of medical specialists involved in the treatment of diseases of the cardiovascular system, and requires a special diagnosis. Cardialgia is characterized by polymorphism of both complaints and subjective sensations, and objective data. All this is caused by a variety of etiopathogenesis of this symptom.

Conclusion. Cardialgia is a current problem in pediatric practice. This literature review summarizes the information accumulated over several years on the diagnosis of cardialgia and syncope in children and determines the trajectory of further study of the problem.

Introduction. The problem of the quality of forensic examinations has existed throughout the history of forensic medicine, which determines the relevance of quality control of examinations.

The purpose of the work was to evaluate and analyze, from a historical perspective, the literature and the provisions of regulatory documents on quality control of forensic examinations, the definition of defects and their prevention at all stages of forensic examination.

Materials and methods. A literature search on the subject was performed in the PubMed, ResearchGate, and Elibrary databases. The depth of the search is 151 years. Fifty-six sources were included in the review.

Results and discussion. For the first time the right of a forensic physician to err was recognized in the 19th century, doctors were prosecuted for mistakes. Expert errors are relevant nowadays, the conclusions of experts are not satisfied by courts, investigation and prosecutor’s office. The significance of quality control of expert examinations at the state level was determined in 1951. The first measures to improve expert examinations were adopted in 1962. In 1978, provisions were formulated for the execution of the expert report, the possibility of a dubious conclusion was pointed out. In 1991, the requirements for the execution of documents were outlined. In 2003 a procedure for organizing repeated commission expert examonations after poor-quality primary ones was presented. Currently, however, the regulatory documents lack criteria for defective examinations and measures to prevent defects. In the Russian Federation in 2019 a plan of measures to improve the production of expert examinations is approved, which determines the relevance of studying the issues of organization of quality control of expert examinations and prevention of expert errors.

Conclusion. Since the establishment of the State Bureau of Forensic Medicine in the Russian Federation, criteria for the quality of forensic examination based on the identification of defects in the work of a forensic doctor have been developed and used. The formation of successive stages of control based on unified criteria for evaluating the expert work will allow to draw an objective conclusion about the quality of forensic examination.

Introduction The prevalence of depression averages approximately 6 % of the total population. The heritability of depression ranges from 28 % to 44 %. Genetic predisposition may be due to polymorphisms of genes involved in the processes of functioning and morphogenesis of the brain: the balance of monoamines, the action of navigational molecules and their receptors.

Purpose of the study To determine the role of genes that regulate the processes of nerve cell migration and directed growth of nerve fibers of navigation receptors (PLAUR and CDH13) or their ligands (PLAU, PLAT, ADIPOQ) in the development of endogenous depression and schizophrenia in the Russian population.

Materials and methods At the first stage of the study, the scientific literature was searched in the MEDLINE database. The primary prevalence of genomic variants will be established using whole genome sequencing of 20 patients with severe forms of schizophrenia and endogenous depression. Further, at least 100 patients in each group and 100 healthy donors will take part in the study.

Results and discussion The urokinase receptor (uPAR) is involved in neurogenesis by regulating the trajectory of axonal growth. The level of suPAR in blood plasma can act as a biomarker of mild inflammation underlying the etiology of depression. The level of suPAR in plasma can be considered a predictor of the effectiveness of combination therapy with antidepressants and anti-inflammatory drugs. Molecules of the cadherin superfamily are involved in the development of the nervous system, the transmission of intercellular signals, and the regulation of neuronal plasticity. Polymorphisms of the CDH7, CDH9, CDH13, CDH17 genes demonstrate a correlation with the presence of depression. Adiponectin is a hormone secreted by adipose tissue. One of the adiponectin receptors, AdipoR2, stimulates neuronal plasticity and inhibits inflammation and oxidative stress. Plasma concentrations of adiponectin are reduced in depressed patients.

Conclusion The results accumulated by researchers testify in favor of the important role of uPAR and T-cadherin in the processes of brain development, and most importantly, in the pathogenesis of the development of endogenous depressions.

Introduction. Hyperkinetic disorder (HR) and attention-deficit/hyperactivity disorder (ADHD) are traditionally regarded as a pathology of childhood, but the frequency of its detection among the adult population is high. GR and ADHD has a significant impact on professional, educational activities and social and domestic relationships.

The purpose of the work was to systematize the current data in the field of research on hyperkinetic disorder and attention deficit hyperactivity disorder in adults.

Materials and methods Full-text publications of metaanalyses from 2017 to 2022 were searched in the PubMed electronic search engine for full-text keyword matches. The criterion for not including a publication in this review was a study conducted on a sample of individuals under 18 years of age. A total of 154 unique references were checked, of which 70 articles were included in the review.

Results and discussion. ADHD is a polyethiological disorder. ADHD symptoms can be associated with other pathological conditions, which can influence the pathogenetic and clinical picture. A number of authors consider ADHD symptoms in terms of adaptation to the modern information environment. Positive aspects of ADHD are pointed out: the ability to be creative, the ability to find non-standard, original solutions, an increased capacity for empathy. In a number of modern works, persons with ADHD have an increased ability to “hyperfocus” on activities relevant to the individual, although not all researchers adhere to this opinion.

Conclusion. The clinical essence of ADHD is its dysontogenetic nature. The range of etiological factors, both external and internal, that can lead to the development of ADHD symptoms is quite wide, and the likelihood of comorbid conditions is extremely high. Not all of the classifications and diagnostic criteria aimed at identifying ADHD symptoms in individuals under 18 years of age can be applied to adult patients, which shifts the epidemiological indicators toward a reduction of the disorder in the adult population.