Introduction The pathogenesis of postoperative delirium, its causes, and factors contributing to its development remain a subject of debate. We consider it promising to study the dynamics of lipoperoxidation, cortisol levels and amino acid metabolism in patients with postoperative delirium. Such studies will reveal diagnostic and prognostic markers.

The aim was to identify differences in the dynamics of lipoperoxidation, amino acid balance and cortisol levels in patients with and without delirium.

Materials and methods A total of 41 patients who underwent surgery for a femoral fracture under epidural anaesthesia were included in the study. All patients underwent a daily test, the Confused Consciousness Assessment Method. If it was positive, delirium was diagnosed; thus, two groups were identified: with postoperative delirium (n = 12) and without delirium (n = 29).

Results In the preoperative delirium group, there was a relative lack of glucocorticosteroids as measured by reduced cortisol levels (pU < 0.01) and inhibition of lipid peroxidation as reduced Schiff bases (pU = 0.01). There were no significant differences in amino acid metabolism of the major amino acid pools. The intraoperative period in both groups had similar characteristics and no significant differences. In the postoperative period inhibition of lipoperoxidation in the delirium group changed into its greater activation, which was revealed by increased levels of ketodienes and conjugated trienes in isopropanol phase (pU < 0.01). There was also an increase in the aromatic pool (pU < 0.01) due to an increase in large neutral amino acids (phenialanine, pU = 0.0, tryptophan, pU = 0.02, tyrosine, pU < 0.01) and a decrease in the aliphatic pool (pU < 0.01). Cortisol levels remained significantly lower in the delirium group (pU < 0.01).

Discussion The preoperative decrease in the studied indices in the delirium group may indicate initial reductive stress. In the postoperative period, patients with and without delirium differ in their metabolic activity with respect to lipoperoxidation and amino acid metabolism, and cortisol levels remain significantly lower in the delirium group.

Conclusion The development of delirium is facilitated by initial reductive stress and a tolerant adaptation strategy. 

Introduction Helicobacter pylori has the most pronounced oncogenic potential among known biological carcinogens of humans. Helicobacter positivity leads to the development of chronic gastritis and with prolonged persistence of infection in the gastric mucosa it is associated with the development of atrophic gastritis and adenocarcinoma of the stomach. According to international data, the prevalence of infection in Russia corresponds to the level of countries with low socio-economic status. The domestic literature contains data for a limited number of reggions, such as North-West Russia, Siberia and the Far East.

The aim of the study was to determine the prevalence of Helicobacter pylori infection and chronic atrophic gastritis among patients residing in the Ural Federal District and to identify risk factors for these diseases using modern diagnostic methods used in clinical practice.

Materials and methods Observational non-interventional anonymous cross-sectional study of 11,721 primary patients among those tested for H. pylori infection residing in the Ural Federal District. 13C-urease breath test was performed in 10,882 patients, FGDS with gastric mucosal biopsy according to OLGA and histological evaluation of biopsy specimens – in 839 patients.

Results The prevalence of H. pylori infection among primary care patients by 13C-UT was 46.9 % and that of chronic atrophic gastritis by histological evaluation of a biopsy specimen was 24.9 %. The risk of chronic atrophic gastritis was higher in those infected with H. pylori (OR 1.71; 95 % CI: 1.24–2.37, p = 0.002) and in patients over 60 years old.

Discussion The resulting prevalence of H. pylori infection in the Ural Federal District is below the levels reported in the current literary for Russia. The increasing prevalence of infection with age confirms the principle that the prevalence of infection depends on changing socio-economic conditions in a generation. The observed prevalence of chronic atrophic gastritis is comparable with the national data. The risk of gastric mucosal atrophy increases with age and in the presence of H. pylori infection, which prompts active screening of gastropathology in this category of individuals.

Conclusion The prevalence of H. pylori infection and atrophic gastritis among primary patients, as determined by reference diagnostics, was 46.9 % and 24.9 %, respectively.

Introduction Conducting a comprehensive epidemiological etiological analysis of the development of the СОVID-19 pandemic in a metropolitan area is of interest to specialists of didderent profiles (epidemiologists, infectious disease specialists, pediatricians, therapists, immunologists, virologists). An important element of epidemiological surveillance is the assessment of collective immunity to infectious agents, including the SARS-CoV-2 virus. The natural ability of viruses to variability leads to the emergence of new types and strains. Currently, a number of mutations and polymorphisms have been identified that affect the structure and stability of proteins, factors of susceptibility to SARS-CoV-2 infection, pathogenicity and virulence of the virus, and the ability to “elude” the immune response of the host organism.

The aim of the work was to assess evaluate the character of the epidemic process development of a new coronavirus infection on the territory of the metropolitan area in the period 2020–2022.

Materials and methods A total of 331,013 people were examined by PCR for the presence of SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal swabs. Specific IgM and IgG antibodies to SARS-CoV-2 in serum were detected by ELISA in 42,955 people. Genetic variants of the virus were typed (by PCR and sequencing).

Results During the entire follow-up period, the highest percentage of “positive for Covid-19” was observed in February 2022 (58.9 %) and September 2022 (46.8 %). Among the total number of patients examined (n = 331,013), adult patients accounted for the largest proportion, – 83.9 %, children – 16.1 %. The proportion of individuals with specific IgG to SARSCoV-2 in 2020–2021 ranged from 53.3–82.6 %.

Discussion In 2020–2022, there was an increase in the proportion of individuals with detectable RNA virus. The greatest infection was observed in the age groups 19–27 years and 28–65 years. It was found that the linear dependence of the increase in the specific weight of seropositive persons with respect to IgG among the residents of Ekaterinburg has a progressive trend, the approximation reliability coefficient R2 corresponds to 0.8172. In samples of patients examined in April–August 2022, markers of the genetic variant Omicron were detected in 96.9 % of cases. The increase in the structure of infected pediatric population (almost twofold over 2020–2022 years) is probably caused by the adaptation of the pathogen to a new susceptible cohort of people.

Conclusion The dynamics of the number of people examined and the proprtion of detectability of SARS-CoV-2 RNA in Ekaterinburg during the entire period of the pandemic (March 2020–December 2022) had a wave-like character. By the end of 2022, the level of seropositive individuals in all age groups increased significantly, which confirms the presence of collective immunity in the territory.

Introduction When analyzing the risk of the impact of harmful factors on the health of employees, some researchers explain the low incidence of occupational diseases in Russia by errors in their detection during preventive examinations, lack of interest of employers and employees in the detection and registration of these diseases, and other reasons. At the same time, we did not find any works in the literature devoted to errors in coding of diagnoses of occupational diseases and their registration.

The purpose of the work is to identify the cause of poor accounting of occupational diseases in Russia.

Materials and methods The work was carried out on the basis of the Industrial Register of persons with occupational diseases. The registry was developed by the A.I. Burnazyan Federal Medical and Biological Center and has been in commercial operation since 2011. As of 31.12.2020, the register contains information about 2 300 patients with occupational diseases from among the employees of enterprises and organizations served by the health care institutions of FMBA of Russia. Directive documents on identification and registration of occupational diseases were analyzed.

Results and discussion Analysis of the health of the working contingent and the subsequent creation of plans for medical and rehabilitation measures to reduce the incidence of occupational diseases among persons working at enterprises and organizations that are on dispensary registration in health care institutions of FMBA of Russia, requires knowledge of correct morbidity indicators about them. For this purpose, it is necessary to improve the registration of occupational diseases in Russia by switching to the diagnosis coding system adopted in the country’s sanitary statistics, and to make appropriate changes in policy documents.

Conclusion One of the reasons for errors in recording occupational diseases is the violation of classification principles in the Order of the Ministry of Health and Social Development of Russia No 417n.

Introduction A clinical and statistical analysis of the medical records of the first obstetric hospital of the Ekaterinburg Clinical Perinatal Centre (ECPC) was performed to assess the medical effectiveness of the integration of telemedicine technology (TMT) into the system of medical care in the case of threatened and preterm birth (PB).

The aim of the work was to assess the medical effectiveness of integrating a range of telemedicine technologies into the system of medical care in the case of threatened and preterm birth as exemplified by the ECPC (First Obstetric Hospital).

Materials and methods Preterm births between 22 and 36 weeks and 6 days of gestation were selected for the study. The number of PBs was 2,468 before the introduction of telemedicine technology and 2,112 after the introduction of telemedicine technology. The incidence of extremely low birth weight was analyzed to assess the impact of TMT implementation on neonatal outcomes. Criterion of Kolmogorov – Smirnov was applied to assess the normality of the distribution; to analyse the difference between groups – criterion of Kruskal – Wallis for K-independent samples. The arithmetic mean, standard error and standard deviation were calculated. Significance of differences between the averages was assessed using Student’s t-test.

Results Before the introduction of TMT, no significant difference was found in the proportion of PB groups between different years and the structure of PP did not change according to gestational age. After the introduction of TMT there was also no significant difference in the pattern of PB. The proportion of extremely early PB before TMT implementation was significantly higher than after implementation. There was a significant decrease in the number of preterm infants with extremely low birth weight after implementation compared with the period before TMT.

Discussion The use of automated systems implemented in the Sverdlovsk region, which are applications for mobile phones or personal computers, does not require the financial investment associated with the purchase of additional expensive equipment by pregnant women. Like the authors of earlier studies, we note a prolongation of gestational age and a reduction in the frequency of extremely low birth weight babies.

Conclusion The incidence of extremely early PB decreased from 10.81 % to 7.13 % (p = 0.012) during 2016–2021, the incidence of late PB increased from 54.6 % to 60.1 % (p = 0.027) due to increasing gestational age. The number of babies born with extremely low birth weight decreased from 13.69 % to 8.36 % (p ≤ 0.001). 

Introduction The search for new compounds with putative antitumor effects and the development of domestic anticancer and antimetastatic drugs based on them is a priority task for specialists in the field of medical chemistry, experimental pathophysiology and pharmacology. Melanoma B16 and Lewis lung epidermoid carcinoma are universal models for evaluating the effect of compounds with putative antitumor action on the primary focus of tumor growth and the process of tumor cells dissemination.

The aim of the work is to determine the feasibility of using models of solid tumor growth and metastasis activity of Lewis lung epidermoid carcinoma and B16 melanoma for preclinical studies of antitumor and antimetastatic pharmacological activity of hybrid organotin compounds depending on experimental objectives.

Materials and methods The experimental part was performed on C57B1/6 mice (females). Hybrid organotin compounds were administered five times, intraperitoneal, the beginning of treatment – 48 hours after tumor cells transplantation in the same regimes for both models. In this work, the most effective (375 mg/kg and 250 mg/kg, respectively) and toxic (500 mg/kg and 375 mg/kg, respectively) doses of the leader hybrid organotin compounds Me3 (bis(3,5-di-tert-butyl-4-hydroxyphenylthiolate) dimethytin) and Me5 ((3,5-di-tert-butyl-4-hydroxyphenylthiolate)triphenyltin) were used.

Results At all stages of the experiment on both models of tumor growth we obtained similar results characterizing the pharmacological activity of the tested compounds: moderate antitumor and high antimetastatic effect. The rates of growth and tumor process development are comparable and convenient for planning preclinical studies in vivo and can be interchangeable.

Discussion The Lewis lung model of epidermoid carcinoma has a higher degree of convenience for data interpretation (number of metastatic foci in the lungs) when conducting exploratory analysis of pharmacological activity in a wide range of doses. When studying pathogenetic peculiarities of metastasis under the action of compounds with presumed antitumor action due to the possibilities of contrast immunohistochemical staining of tumor cells, the B16 melanoma model has an advantage. In our experiment with immunohistochemical staining for Melan A the hematogenic pathway of metastasis through the bloodstream is clearly traced.

Conclusion For exploratory screening studies to select promising candidates for in-depth study it is reasonable to use the Lewis lung epidermoid carcinoma model. The B16 melanoma model is more informative for in-depth study of compounds that have proven to be effective.

Introduction Malignant neoplasms of the liver are one of the most common pathologies in oncology. Chemoembolization of the hepatic artery is currently widely used in the treatment of unresectable liver tumors. Transradial vascular access is actively used in interventional cardiology due to fewer local vascular complications. At the same time, until recently, chemoembolization of the hepatic artery was more often performed via transfemoral vascular access.

The aim of the work is a comparative analysis of the results of transradial and transfemoral vascular accesses for the purpose of hepatic artery chemoembolization.

Material and methods The data of 69 patients who underwent 212 hepatic artery chemoembolization procedures for malignant neoplasms in the liver were analyzed. The group of transradial access included 107 (50.5 %) interventions, the group of transfemoral access – 105 (49.5 %). The groups were comparable in terms of the main initial clinical and anamnestic data.

Results Chemoembolization of the hepatic artery was successfully performed in 98.1 % in the transradial access group and 99 % in the transfemoral access group (p = 1.0). The total duration of intervention, time spent on catheterization of the target artery and radiation exposure were significantly shorter in the transradial access group than in the opposite group. The incidence of local vascular complications was not significantly different between the groups: 11 (10.3 %) and 12 (11.4 %) cases, respectively (p = 0.79). According to the results of patient interviews, the use of transradial access was accompanied by significantly less discomfort associated with the procedure.

Discussion Traditionally, embolization of peripheral arteries is performed via transfemoral access, and the total incidence of local vascular complications (large subcutaneous hematomas, false aneurysms, arterovenous fistulas, etc.) is relatively high. According to the results of studies, it is possible to reduce the incidence of local vascular complications without increasing the cost of the procedure by performing the same interventions using transradial access.

Conclusion Transradial vascular access has a number of significant advantages over transfemoral access, and therefore can be recommended as a priority for performing hepatic artery chemoembolization.

Introduction Venous thromboembolic complications after abdominoplasty are associated with increased intraabdominal pressure and altered venous return without taking into account possible changes in the activity of the blood coagulation system.

Purpose of work was to evaluate the state of the plasma hemostasis system in the early postoperative period in patients after abdominoplasty.

Materials and methods The study included 100 patients who underwent aesthetic abdominoplasty. Prothrombin (PT), fibrinogen (FG), activated partial thromboplastin time (APTT), soluble fibrin-monomer complexes (SFMC), euglobulin clot lysis (ECL), antithrombin-III (AT-III), and protein C (PrC) levels were evaluated before surgery, immediately after surgery, on the first, third and fifth days after surgery. Statistical data analysis was performed using SPSS 16, Excel 2010 for Windows, using the Kruskal – Wallis criterion.

Results Coagulation hemostasis was characterized by a decrease in PT immediately after the surgery and on the first day by 13.9 and 5.3, and an increase in PT on the third and fifth days by 12.3 and 15.5 (p < 0.001), decrease in FG on the first, third and fifth days by 0.49 g/L, 2.34 g/L, and 2.04 g/L, respectively (p < 0.001). SFMC increased at all postoperative stages by 4.7, 8.2, 10.8, and 10.0 times (p < 0.001). Inhibition of XII-dependent fibrinolysis was characterized by an increase in ECL time on the first, third and fifth days by 2.8, 9.7, and 6.3 minutes, respectively (p < 0.001). AT-III and PrC levels decreased immediately after the surgery by 18.8 and 8.9, on the first day by 14.2 and 11.2, and on the third day by 8.8 and 6.3 respectively (p < 0.001).

Discussion Activation of blood coagulation processes with imbalance of coagulation, anticoagulation, and fibrinolytic systems create conditions for venous thrombosis formation after abdominoplasty, which substantiates the necessity of VTE pharmacoloprophylaxis for at least five days.

Conclusion In the early postoperative period abdominoplasty is accompanied by activation of plasma coagulation, inhibition of fibrinolytic system activity and reduction of natural anticoagulant activity. 

Introduction Osteoporosis (OP) is a major social and medical problem for society.

The aim of research was to identify risk factors for OP and the incidence of low-energy fractures in women with OP of Russian and Buryat ethnicity in Trans-Baikal region.

Materials and methods We examined 98 women with OP (50 of Russian and 48 of Buryat nationality) and 100 women without objective signs of OP, comparable by age and nationality with the main group. All women underwent a questionnaire to identify risk factors for osteoporosis and osteoporotic fractures, determination of bone mineral density (BMD) using dual-energy X-ray absorptiometry, and determination of the absolute 10-year risk of major osteoporotic fractures using the online FRAX® calculator.

Results The mean age of women with OP of Russian ethnicity was 65.5 [57.0;71.0] years, of Buryat nationality – 65.3 [56.0;69.0] years. Among risk factors in female members of Russian nationality, age older than 65 years, tendency to fall and decreased creatinine clearance were found more frequently. There was an inverse association between proximal femoral BMD and risk of falls (R = -0.31, p = 0.04) and a direct correlation between family history of ОP and spinal BMD (R = 0.65, p = 0.02).

Discussion Age over 65 is a significant risk factor for osteoporosis and is included in the FRAX (Fracture Risk Assessment Tool) model. Reduces creatinine clearance and a tendency to fall have been associated with the development of OP and fractures in some studies. Our findings are consistent with previous studies.

Conclusion Russian women were more likely than Buryat women to have risk factors for OP, such as falls and decreased creatinine clearance. Associations were found between proximal femoral BMD and falls, spinal BMD with a family history of OP and smoking among Russian women.

Introduction Sverdlovsk region still has a high prevalence of HIV infection and tuberculosis, which affects the effectiveness of anti-tuberculosis measures. The new coronavirus infection for a number of years makes it necessary to redistribute the limited health care resources of the subject of the Russian Federation. This determines the need to develop science-based methods for analyzing and forecasting the development of the epidemic process in tuberculosis infection in the region.

The aim of the work is to scientifically substantiate the method of forecasting the epidemic situation of tuberculosis on the territory of the subject with a set of municipalities with the construction of mathematical models and application of artificial intelligence.

Materials and methods The source material for the study was statistical data obtained in 2007–2012 from state statistical reporting forms: Form No. 8 “Information about diseases with active tuberculosis”, Form No. 33 “Information about tuberculosis patients”, Forms 089u/tub, data from the Federal Register of Tuberculosis Patients, police registers of tuberculosis patients in health care institutions of Sverdlovsk region. Information processing was carried out using MS Excel, complex analytical tables of absolute values and epidemiological coefficients were compiled. Using artificial intelligence technology, a mathematical simulation dynamic model of the tuberculosis epidemic situation at the regional level and in the context of 63 municipalities of the Sverdlovsk region was developed.

Results Comparison of the forecast values made in 2017 with the actual values of 2018–2021 revealed a reliable coincidence of the trend of movement of tuberculosis epidemiological indicators in the region, the maximum deviation was no more than 14.8 %.

Discussion The proposed dynamic model made it possible to identify, reliably calculate and graphically display trends in the movement of the values of the studied characteristics of the tuberculosis epidemic process, despite the insignificant discrepancy between actual and forecast values.

Conclusion The forecast results obtained using the simulation dynamic model can be used in practice for operational resource planning of resources for the implementation of measures to counter the spread of tuberculosis at the regional level.

Introduction Among the diseases of urgent pathology the leading place belongs to acute pancreatitis, which is second only to acute appendicitis and acute cholecystitis. Moreover, a significant share is occupied by mild forms, which account for 85%. In the Clinical Recommendations for Acute pancreatitis in the section “Prevention and dispensary monitoring”, the authors recommend regular dispensary monitoring by a gastroenterologist and a surgeon. However, this nosology according to the Order of the Ministry of Health of the Russian Federation from 03.15.2022 No 168N is not included in the dispensary observation. In this regard, patients remain without proper attention of doctors when they are discharged from hospitals, or when they refuse hospitalization after examination in the emergency room.

The aim of the work – is to present the result of applying the diagnostic algorithm of differential diagnosis of diseases and detection of gastrointestinal tract pathology on the clinical example of a patient with recurrent abdominal pain syndrome.

Materials and methods The analysis of medical records of a 59-year-old patient who repeatedly applied to the network of polyclinics and hospitals providing emergency specialized medical care for recurrent abdominal syndrome was carried out.

Results and discussion In this clinical observation of recurrent abdominal syndrome in a patient, the biliary mask of acute pancreatitis was revealed. In outpatient conditions using the developed diagnostic algorithm, choledocholithiasis, juxtapapillary diverticulum of the duodenum and hernia of the esophageal aperture of the diaphragm were detected. The diagnosis made it possible to perform the treatment competently and lead to the patient's recovery. Thanks to the dispensary observation and additional methods of investigation according to the developed algorithm, the following were detected: juxtapapillary diverticulum of the duodenum, which may not be visualized at video esophagogastroduodenoscopy with direct optics, as well as ductal stones, which are not always visualized at transabdominal ultrasound and are detected at endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography. Difficulties may arise in the diagnosis of gastrointestinal diseases due to the variability of the clinical course and polymorphism of symptoms in this category of patients. Such a course of diseases causes difficulties at the stage of patients' admission to the emergency room of clinics, can lead to diagnostic errors that lead to incorrect treatment tactics.

Conclusion The application of an algorithm based on the assessment of clinical criteria in conjunction with instrumental imaging methods and laboratory tests allowed to optimize the diagnostic process and facilitated the choice of optimal therapy and surgical tactics for the treatment of the patient with recurrent abdominal pain syndrome.

Introduction Osteoarthritis (OA) is a degenerative disease that leads to gradual loss of cartilage and the formation of osteophytes, and consequently to joint instability, pain, and limited mobility. Treatment options include drug therapy, physiotherapy, lifestyle changes and surgery to correct or replace the joint. Intra-articular treatments, such as the injection of hydrogels modified for specific clinical tasks, are becoming increasingly popular due to their ability to provide targeted and effective relief with minimal side effects.

Purpose of this study was to evaluate the use of hydrogels for the intra-articular treatment of osteoarthritis (OA) based on a review of scientific literature.

Materials and methods Literature sources for the evaluation of the use of hydrogels for the intraarticular treatment of OA were selected using the subject search queries “hydrogel” AND “intra? articular” AND “osteoarthritis” in the PubMed, ScienceDirect and SciSpace databases. The search period was limited to 2018–2023 years of publication. An initial selection of articles by search glories resulted in 1,576 articles; after analysis and application of exclusion criteria, 53 of the most relevant sources were included in the review.

Results Two types of hydrogels for intra-articular use have been dentified: injectable and implantable. Injectable hydrogels are used to replace synovial fluid, deliver drugs or fill focal cartilage defects. Implantable hydrogels are used to replace or repair damaged cartilage in joints affected by OA, thereby restoring surface integrity, reducing pain and improving function.

Discussion Hydrogels demonstrate promise as a potential material for the treatment of OA as they offer several advantages, such as biomimicry, biocompatibility, minimally invasive administration and the ability to deliver therapeutic agents directly to the affected joint. However, there are limitations: uncontrolled degradation, low durability and a high likelihood of negative local and systemic immune reactions.

Conclusion Further research is needed to optimize the design and composition of hydrogels for clinical use, including the development of new compositions with programmable properties, studying long-term effects and comparing effectiveness with other OA treatment.

Introduction Research into the use of platelet-enriched plasma has been conducted in various fields of medicine over the last decade. In ophthalmology, autologous blood plasma products are widely used for retinal pathologies such as macular rupture, retinal detachment, and inflammatory and degenerative corneal diseases.

The aim of the work was to prove on the basis of current data on the pathogenetic mechanisms of platelet-enriched plasma its effectiveness and safety in retinal surgery and to substantiate the possibility of its use in eye injuries.

Materials and methods A search of scientific literature and publications in PubMed, CyberLeninka, eLibrary databases and electronic libraries was performed using the search words and phrases: platelet-rich plasma, platelet growth factors, macular rupture, retinal detachment, vitrectomy.

Results and discussion The mechanisms of action of PRP plasma in retinal surgery are due to the high concentration of platelets. By participating in hemostasis, these blood cells trigger a cascade of reactions leading to the formation of a fibrin mesh, which, by contracting, pulls the edges of retinal tears together. In addition, the rich composition of platelet alpha granules after degranulation provides the tissue with a pool of growth factors that stimulate and accelerate tissue regeneration. The most studied of these are: PDGF, VEGF, TGF, IGF1, PF4, EGF, bFGF.

Conclusion Platelet-enriched plasma preparations and their individual components are promising in the treatment of retinal diseases and are safe because they are autologous. Studies prove their efficacy in the treatment of retinal tears, which can be used to close defects of traumatic etiology.

Introduction The COVID-19 pandemic is a serious problem for the health care system in Russia and worldwide, as the pathogenic influence of the pathogen can cause a systematic range of complications in the body, especially in the reproductive system.

The aim of the work was to determine the state of the reproductive system in men after coronavirus infection and vaccination based on the analysis of literature data.

Materials and methods The search for papers on the state of the reproductive system in men after coronavirus infection and vaccination was conducted in PubMed, Medline, EMBASE and eLibrary.ru databases.

Results The reproductive capacity of male patients who have undergone COVID-19 is affected by numerous factors: general health status, activity of the renin-angiotensin-aldosterone system, development of systemic inflammatory response, activation of lipoperoxidation processes, etc. This changes cause inflammatory response in the tissues of the reproductive system, secretion of pro-inflammatory cytokines, imbalance of the antioxidant system, formation of oxidative stress, damage to Leydig and Sertoli cells, formation of reproductive insufficiency and infertility.

Discussion The pathogenetic role of SARS-CoV-2 in the development of reproductive depression in men with coronavirus infection, which has a prolonged, negative and persistent effect on the state of testicular hemodynamics, the level of total testosterone in blood and ejaculate parameters, was confirmed.

Conclusion The results of the study suggest a deterioration of the reproductive system in men following coronavirus infection.

Introduction Metabolic syndrome is a complex of disorders including abdominal obesity, impaired glucose tolerance, dyslipidemia, and arterial hypertension. Antioxidant and anti-inflammatory properties of the pineal hormone melatonin are of great importance for preserving body homeostasis, and potentially melatonin can be a a safe and effective agent in the complex treatment of menopausal women with metabolic syndrome.

The aim of the study is to determine the prospects of using the epiphysis hormone melatonin in the complex treatment of menopausal metabolic syndrome based on the analysis of scientific publications.

Material and methods The review includes data from studies on the effect of melatonin (MT) on the components of metabolic syndrome in periand postmenopausal women. Sources were searched for the period 2016–2023 in the international databases Medline, Scopus, Web of Science and the Russian scientific electronic library eLibrary by search words and phrases: melatonin, menopause, perimenopause, metabolic syndrome, obesity, insulin resistance, dyslipidemia, arterial hypertension.

Results and Discussion The analysis of the literature data showed a number of advantages of the effect of exogenous MT preparations on individual components of metabolic syndrome, but some results were contradictory. Scientific evidence of MT influence on anthropometric indices, markers of glucose homeostasis, hemodynamic parameters and signs of body's inflammatory response, as well as multidirectional effects on lipid profile was found.

Conclusion Given the multifunctionality and safety of exogenous MT preparations, its use in the complex therapy of menopausal metabolic syndrome should be considered.

Introduction The problem of iron deficiency anemia (IDA), especially in pregnant women, continues to be relevant. Despite the achieved methods of diagnosis and treatment, the number of pregnant women with IDA continues to grow. Thus, according to WHO 2020 data, the prevalence of anemia among women of reproductive age ranged from 9.1 % in Australia to 69.6 % in Yemen.

The aim of the work was to determination of the current state of the problem of IDA in pregnant women.

Materials and methods Original articles, randomized clinical trials, and meta-analyses were reviewed in the Scopus database, PubMed and the eLibrary platform, using the key words “iron”, “oral”, “intravenous iron”, “intravenous iron therapy”, “pregnancy”, “anemia”, “treatment”, “randomized control trial”, “anemia in pregnancy”, “treatment of anemia in pregnancy”, “intravenous iron in pregnancy”, “IDA complications for mother and fetus”. The depth of the search was 5 years.

Results and discussion There are different views on the classification and diagnosis of IDA in the guidelines of professional organizations. According to most guidelines hemoglobin and ferritin levels are the most reliable tests for the verification and prediction of IDA. Despite the fact that the peculiarities of the pathogenesis and approaches to the treatment of IDA have been studied, its prevalence among women remains very high. The reasons for this lie in inadequate diagnosis and incomplete therapy in terms of its duration and drugs selection. The methods of diagnosis and treatment of IDA are currently being actively studied and improved in anticipation of obtaining the greatest benefits.

Conclusion Complications of IDA in the third trimester for newborns are the development of anemia, impaired development of the nervous system and cognitive disorders, which requires active prevention in the second trimester using, among other things, parenteral iron preparations.