Objective: to identify clinical features of the course of the peri- and postmenopausal period in women depending on the morphofunctional asymmetries of women. Materials and methods: a total of 205 women in the late stage of the transition to menopause (clinical group I) and 185 women in the postmenopausal period (clinical group II) with clinical manifestations of climacteric syndrome were examined. The severity of climacteric syndrome was assessed using the Green scale, and the lateral behavioral profile of asymmetries was determined using the modified Annette test. Results: in women in the perimenopausal period, regardless of the nature of the lateral phenotype and the severity of climacteric syndrome, vasomotor and psychoemotional disorders were 1.6 times more common than in the postmenopausal period. The highest frequency of clinical manifestations of climacteric syndrome was found in patients with ambidextrous lateral phenotype in both the peri- and postmenopausal periods. Regardless of the severity of climacteric syndrome, vasomotor, somatic and psycho-emotional symptoms statistically significantly prevailed in women with ambidextrous lateral phenotype compared to representatives of the polar right and left phenotypes. Conclusion: the greatest adaptive resource and the lowest frequency and severity of vasomotor, psycho-emotional, somatic and metabolic disorders in climacteric syndrome were found in women with the polar right lateral phenotype, while the most vulnerable constitutional subgroup were women with the ambidextrous phenotype in the peri- and postmenopausal periods.

Objective: assessment of the morphological features of the placenta during antenatal fetal death in comparison with the clinical features of the course of pregnancy at various gestation periods. Materials and methods: a retrospective analysis of 270 fetal autopsy protocols was conducted. Exclusion criteria included multiple pregnancies and congenital anomalies. Morphological assessment involved macroscopic examination (placental mass and size) and histology (sections stained with hematoxylin and eosin, examined under 10x and 40x magnification). Statistical analysis was performed using MedCalc, GraphPad Prism 8, and Excel, with ROC analysis, Student’s t-test, and Pearson’s correlation (p < 0.05). Results: the incidence of AFD was 41.85% at 22–27/6 weeks, 27.41% at 28–33/6 weeks, 18.15% at 34–36/6 weeks, and 12.59% at ≥37 weeks. Placental hyperplasia was more frequent at early gestations (54%), while hypoplasia predominated at later terms (56%). PFC showed no prognostic value for CPI (AUC = 0.52, p = 0.648) or inflammation (AUC = 0.559, p = 0.169). An inverse correlation was observed between PFC and gestational age (rxy = -0.66, p < 0.001). CPI peaked at 34–36/6 weeks (66.7%), while inflammatory changes were most prevalent at 22–27/6 weeks (47.2%). Conclusion: the retrospective study identified key patterns in placental morphological changes depending on gestational age. The findings underscore the need for individualized prenatal monitoring, infection prevention, and correction of fetoplacental blood flow disturbances to reduce stillbirth rates, particularly in high-risk groups. Future research should focus on differentiating the causes of CPI to optimize clinical strategies.

In recent years, there has been an increase in the frequency of labor induction in obstetrics. In developed countries, their frequency ranges from 6.8 to 35.5 per cent. The reasons for the increase in the frequency of induction of labour are the growing number of women with high perinatal and obstetric risk. Induction of labour is not a safe procedure, and its effectiveness depends on the correct choice of indications, contraindications, timing and methods. Induction is considered justified if its use improves maternal and perinatal outcomes and does not increase complications. One of the complications of induction is uterine rupture. The article presents a scientific review of the literature devoted to an important problem – uterine rupture in obstetric practice associated with induction of labor. The data were analyzed based on foreign and domestic sources (e-Library, MedLine, PubMed) for 2005–2025 using the following keywords: “uterine rupture”, “labor induction”, “hemoperitoneum”, “perinatal mortality”. Of the 90 articles reporting uterine rupture associated with labor induction, 39 articles were selected that met the selection criteria (there were no other risk factors for uterine rupture). Summarising the information available in the literature reflecting aspects of this issue will help to adequately assess the risks of induction of labour and make it safe.

Objective: to establish clinical and genetic associations in patients with paranoid schizophrenia with and without depressive manifestations. Materials and methods: patients with paranoid schizophrenia after 10–14 days of inpatient treatment were included. Psychometric methods were used: Calgary Depression Scale for Patients with Schizophrenia (CDSS), PANSS scale, Columbia Suicide Risk Rating Scale (C-SSRS). Genotyping of the HTR2A gene (rs6313) was performed by PCR. Statistical methods: Microsoft Excel, IBM SPSS Statistics 26. Results: depressive manifestations were detected in 31.8% (124/390). The least frequent item was “suicide”, but it was expressed most strongly in a severe degree. Conclusions: 31.8% of respondents with paranoid schizophrenia experienced depressive symptoms. An inverse relationship was found between the severity of the condition and the frequency of depressive symptoms: the most common was the absence of symptoms, while severe symptoms were the least common. Hopelessness demonstrated an association with the HTR2A rs6313 gene (p=0.044). No significant correlations were found when comparing the remaining values on the Calgary Depression Scale.

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease with unknown etiology that affects connective tissue and blood vessels. It develops due to imperfect immunoregulatory processes. A clinical case of SLE in a male patient aged over 50 will be presented. This condition is rare, with 2-20% of cases occurring in this age group. The prognosis for SLE in elderly patients is often unfavorable, as it can lead to damage to the nervous system and the development of neuropsychiatric disorders. This can be complicated by acute cerebral circulatory disorders, dyslipidemia, and diabetes.In men with SLE, serositis, thrombosis, cytopenia, and high titer of antibodies to phospholipids occur with high frequency. The atypical onset of the disease, incomplete compliance with diagnostic criteria, and insufficient awareness among doctors about the possibility of developing SLE in older people and, especially, males, were the reasons for the late diagnosis in the clinical case presented by us. In such cases, an interdisciplinary approach and collaboration of doctors of various specialties using all available laboratory and instrumental examination methods are reasonable for earlier diagnosis.

Infectious endocarditis (IE) of injecting drug users (IDU) remains an unresolved and very significant medical and social problem due to the rapid increase in the number of drug-addicted patients, high frequency of complications and hospital mortality, which determines the relevance of the search for their predictors, requires optimization of treatment in order to improve the prognosis in this category of patients. The article demonstrates our own clinical observation of a young IDU patient with primary IE and the formation of a combined aortic defect, Valsalva sinus abscess and its rupture into the right ventricular cavity with the development of acute cardiac activity decompensation, multiple organ failure, ventricular fibrillation, which led to the death of the patient. In view of the extremely serious condition of the patient, it was not possible to timely transport him to a cardiac surgery center for surgical treatment. The most probable causes of complications and death, as well as the possibilities of their prevention, are discussed.

The article describes a rare clinical case of hydroperitoneum in a patient with mantle cell lymphoma. This observation illustrates the diagnostic difficulties in identifying the cause of ascites of unclear etiology and emphasizes the important role of cytological analysis of ascitic fluid.

Mantle cell lymphoma is an aggressive mature B-cell lymphoma characterized by the proliferation of abnormal lymphoid cells with typical indolent nuclear circuits. Although extranodal involvement is not uncommon for a given vila lymphoma, the isolated occurrence of ascites as the first manifestation of the disease presents a unique and complex diagnostic situation.

The purpose of this clinical example was to demonstrate the importance of including oncological and hematological diseases in the differential diagnostic search for ascites, especially when standard methods (for example, imaging diagnostic methods, biochemical tests) do not reveal an obvious cause.

The work analyzes in detail the clinical case of a patient with hydroperitoneum, where a comprehensive diagnostic approach was applied, including ultrasound examination, laboratory tests and, most importantly, cytological and immunophenotypic examination of peritoneal fluid.

Cytological analysis of ascitic fluid revealed the presence of atypical lymphoid cells, which made it possible to establish the diagnosis of mantle cell lymphoma with peritoneal damage. This diagnostic method has become key for determining the tactics of patient management and the timely start of specific polychemotherapy.

 Early detection of specific cells in ascitic fluid allows for an accurate diagnosis, determination of the stage of the disease and immediate initiation of appropriate treatment, ultimately improving the prognosis for the patient.

Cardiovascular diseases, as malignant neoplasms, occupy a leading position in the structure of total mortality. One of the common side effects of the treatment of malignant neoplasms is cardiotoxicity, which subsequently complicates the pathogenetic therapy of the formation. The purpose of this review was to summarize and clarify existing ideas about the influence of various risk factors for cardiovascular diseases on the occurrence of cancer. The presented review allows us to study in detail the results of meta–analyses and large-scale studies that complement the understanding of classical behavioral factors such as smoking, alcohol consumption, poor nutrition and biological risk factors such as hypertension, obesity, diabetes mellitus, reflecting the contribution of these factors not only to the development of cardiovascular diseases, but also malignant neoplasms. The influence of these factors was analyzed from the perspective of pathogenetic mechanisms – oxidative stress and chronic inflammation, cardiotoxicity of the treatment. The review also focuses on contradictory data regarding the influence of any factor on the occurrence of these nosologies and summarizes the analyzed material.

Ledd's syndrome is a rare form of congenital intestinal obstruction characterized by compression of the duodenum by fetal adhesions and midgut volvulus due to impaired antenatal rotation. The incidence of this condition is 0.8 per 1,000 live births, with boys being twice as likely to be diagnosed. Traditional diagnosis of Ledd's syndrome in newborns is based on clinical assessment and radiographic data. This article presents a clinical case of late detection of Ledd's syndrome in a child aged 1 month and 8 days with a favorable surgical outcome. Ledd's syndrome requires a multidisciplinary approach and a high level of vigilance from neonatologists, pediatricians, and pediatric surgeons to ensure timely diagnosis and prevent life-threatening complications.

The article presents clinical cases of chromosome 17q12 deletion syndrome in newborns. The analysis of clinical and phenotypic features suggesting the presence of pathology associated with the chromosome 17q12 region with an emphasis on the presence of cystic dysplasia of the kidneys is carried out. It is shown that cystic dysplasia was an isolated symptom that could not be detected without instrumental examination, which actualizes the need for early ultrasound examination. The established deletion of chromosome 17q12 in a patient born small for gestational age allows us to expand our understanding of the spectrum of genetic causes that cause low rates of physical development at birth. An algorithm for early diagnosis of this pathology in the neonatal period using whole exome sequencing and chromosomal microarray analysis is proposed. Monitoring of patients with cystic renal dysplasia associated with deletion of chromosome 17q12 should be carried out with the participation of a multidisciplinary team of specialists: nephrologist, pediatric endocrinologist, geneticist. A promising direction of research is the development and implementation of further monitoring of these patients, taking into account the diversity of the clinic.

Objective: to analyze epizootic and epidemic manifestations of naturally occurring focal infections (tularemia, ixodes tick-borne borelliosis, West Nile fever, Crimean hemorrhagic fever, Q-fever, leptospirosis, yersiniosis, hemorrhagic fever with renal syndrome) in the Rostov region in 2024. Materials and methods: the studies were conducted in accordance with current regulatory documents. The objects of the study were small mammals, birds, blood-sucking arthropods, environmental objects, and donor blood serum. Studies to find antigens of infectious disease pathogens were conducted using solid-phase ELISA and PCR. Results: The nosological profile of natural focal infections has been determined, which includes six main nosological units: West Nile fever; Ixodes tick-borne borreliosis, Q-fever, Crimean hemorrhagic fever, leptospirosis and tularemia. In a crosssectional seromonitoring study, 754 residual blood serum samples from a conditionally healthy population were tested for the pathogens of the studied infections. As a result of comprehensive epizootological studies, a modern range of small mammals has been established, consisting of 12 species of rodents and insectivores. Conclusion: The analysis of the epidemiological situation in 2024 confirmed the presence of natural foci of dangerous infectious diseases in the Rostov region.

Cholera remains a serious public health problem, especially in low-income countries with a lack of water supply and sanitation education among the population. Vaccination is currently the main measure to prevent this infection in endemic areas and during outbreaks, but for a number of reasons its effectiveness may decrease: there is always a group of people who have contraindications to vaccination and do not respond to the vaccine. In addition, there are problems with the delivery, storage and transportation of vaccine preparations. All these factors necessitate the search, development and implementation of various new means to prevent the spread of the disease. The purpose of this review was to analyze the literature data on the study of the possibility of using antibiotics, bacteriophages, probiotic microorganisms, plant components and other substances for the prevention of cholera. The list of references includes 56 sources for the last ten years, taken from databases: RSCI, eLibrary, MedLine, PubMed.