The prevalence of obesity is growing all over the world. Obesity is an important risk factor for cardiovascular diseases, type 2 diabetes. However, not all obese patients have an unfavorable cardio-metabolic profile. Recently, much attention has been paid to the concept of «metabolically healthy obesity» (MHO). To date, there are no single criteria for identifying individuals with MHO, which makes it difficult to study this subgroup of patients and to conduct a comparative analysis of various studies. The article presents data of modern literature, including the definition, prevalence and mechanisms of MHO development, also discusses potentially protective factors involved in MHO development and the consequences of the therapeutic impact on MHO.

In this review we presented data about infection cases of people and animals with anthrax in the world, CIS and Russia based on the materials of WHO, Promed-mail andRospotrebnadzorwebsites and monographs of Russian scientists. The epidemiological situation of this serious infection remains quite serious and is evaluated as stressful and having no tendency to stabilization due to existence of soil bornefocus which are active for many years, causing periodic outbreaks among farm animals and people.

Objective: analysis of the connection rs4860 Val158Met polymorphism of catechol-ortho-methyl transferase gene (COMT) with thinking, memory, attention of patients with schizophrenia taking into account comorbidity alcohol abuse and gender identity.

Materials and methods: 200 patients with paranoid schizophrenia, 100 men and 100 women. Patients are distributed into subgroups by the factor of comorbidity alcohol abuse. Short-term memory, attention, thinking has been evaluated by psychometric scales. The variant of polymorphism rs4680 of gene COMT is determined by a genetic method. The subgroups were compared among themselves. The association of alcohol abuse, gender identity, genotype with features of these cognitive functions was investigated.

Results: the study demonstrated a high prevalence of alcohol dependence in patients with schizophrenia. There is no clear direct effect of alcohol abuse on cognitive status. Gender peculiarities of the cognitive status of schizophrenic patients have been revealed. In men, the conjugation of the genotype Met158Met is noted with greater safety of short-term memory and attention against the background of more severe disorders of thinking in the schizophrenic type. Conclusions: the study did not confirm the significant effect of the comorbidity alcohol abuse on the cognitive processes of patients with schizophrenia. In men more severe short-term memory, attention disturbance predominate, unlike women who have a greater depth of schizophrenic thinking disturbances. The variant of Met158Met polymorphism is associated with relative safety of short-term memory and attention among men, without comorbidity alcohol abuse.

Objective: study and analyse features of metabolic disorders of connective tissue in postoperative abdominal hernia and its possible resolution.

Materials and methods: 68 patients with postoperative ventral hernias of different age groups were studied and screening of undifferentiated connective-tissue syndromes (UCTS) was carried out, to study its metabolic markers.

Results: it has been proved that with aging, there is an increase binded hydroxyproline, indicating increased fibrillogenesis. In patients in age group of 51-60 years, there was an increase in the free hydroxyproline, confirming the predominance of collagen breakdown over its synthesis. With increase in severity of UCTS, there was an increase in the level of free hydroxyproline, indicating a more pronounced decay of collagen. At the same time, faster recovery was noticed in collagen metabolism in the postoperative period in groups of patients with mild and moderate UCTS severity.

Conclusions: collagen breakdown is more pronounced in patients with severe UCTS and its recovery in the postoperative period is directly related to the severity of UCTS that requires pharmacological resolution.

Objective: to assess the impact of air pollutants on respiratory tract diseases in children and adolescents of industrial region.

Materials and methods: the study of respiratory tract diseases and their prevalence for children 0-14 and adolescents 15-17 for long-term period was made on the base of analysis of official statistical data of the yearbooks prepared by Luhansk Regional Focal Point for Health and the Focal Point of the Luhansk Regional Children’s Clinical Hospital.

Results: the number of respiratory tract diseases (on 1000 child’s population) in children 0-14 for long-term period (2000-2013) in the Luhansk area, and also prevalence of the indicated diseases for certain higher in industrial cities with the high technogenic loading, as compared to rural settlements. In Alchevsk with the large of ferrous metallurgy and coke-chemical productions morbidity of children and adolescents of respiratory organs and prevalence of the indicated pathology is determined by average annual concentrations in atmospheric air of the self-weighted substances, oxide of carbon, oxide of nitrogen, phenol and also CIAP7 by a complex 7 basic components of extrass metallurgical and coke-chemical productions (self-weighted substances, oxide of carbon, oxide of nitrogen, dioxide of nitrogen, dioxide of sulphur, phenol and ammonia). It was established the meaningful statistical conformity of increasing of morbidity and prevalence of diseases of class X among children in age 0-14 and adolescents 15-17 for longterm period in industrial cities and rural districts.

Summary: recommendation of the prophylaxis of negative influence of air pollutants on respiratory tract diseases in children and adolescents were offered.

Objective: to estimate the clinical safety of open and endovascular interventions in the carotid arteries in the treatment and prevention of ischemic stroke.

Material and methods: 317 patients (61 women and 256 men) aged 41 to 82 were examined. Carotid endarterectomy (CEA) (Group 1) was performed in 246 patients. Carotid transluminal balloon angioplasty with stenting (CAS) (Group 2) was performed in 71 patients. Symptomatic stenosis of the internal carotid artery (ICA) was detected in 85 patients (in Group1 in 53 patients, in Group2 in 32 patients). Asymptomatic stenosis of the ICA was detected in 232 patients (in Group1 in 193 patients, in Group2 in 39 patients).

Results: in the immediate postoperative period in Group 1 of patients 15 complications (6,1%) developed. Ischemic stroke was stated in 8 cases (3,3%), 3 of which were lethal (1,2%). Transient ischemic attack was observed in 2 patients (0,8%). Myocardial infarction developed in 5 cases (2,0%). In the immediate postoperative period in the Group 2 of patients 4 complications (5,6%) was observed. Complications were demonstrated as an ischemic stroke in 2 cases (2,8%), myocardial infarction - in 1 observation (1,4%), a transient ischemic attack - in 1 patient (1,4%). In 1 observation (1,4%) there was a fatal outcome due to myocardial infarction in the background of hemorrhagic shock because of bleeding from an unidentified source. In the late postoperative period 12 complications developed in Group 1 of patients (6,0%). Th e restenosis of the operatedICA was observed in 8 cases (4,0%). An ipsilateral ischemic stroke was registered in 2 cases (1%). A myocardial infarction was stated in 2 cases (1%). A fatal outcome occurred in 3 cases (1,5%). In the late postoperative period 4 complications (6,8%) developed in Group 2 of patients. The restenosis of the operated ICA was stated in 1 observation (1,7%). A contralateral ischemic stroke was observed in 2 patients (3,4%). A myocardial infarction was registered in 1 observation (1,7%). A fatal outcome resulted from a myocardial infarction occurred in 1 case (1,7%).

Conclusions: CEA and CAS of carotid arteries have the same effi cacy and safety in the immediate and late postoperative periods.

Objective: determination of the infl uence of hemerin on the features of the course of chronic glomerulonephritis.

Materials and method: the study included 80 patients with chronic glomerulonephritis. Th e criterion for including patients in the study was the presence of indications for nephrobiopsy and the patient’s consent to perform it. All patients underwent general clinical examination with establishment of anamnesis of the disease, creatinine level, urea, calculation of GFR, determination of the general blood test, general urine analysis, daily proteinuria. Venous blood sampling was used to determine the level of hemerin. Twelve months aft er the patients were admitted to the study and treated according to standard therapy, several indicators were re-recorded.

Results: positive correlation associations of hemerin and sedimentation rate of erythrocytes, total cholesterol and negative - with the level of protein in the blood have been established. It was shown that significantly more significant improvement in the clinical manifestations of renal remodeling was observed in patients with a high level of hemerin (≥ 297 pg / ml) 12 months aft er treatment in comparison with the group of patients with lower values of Hemerin (<297 pg / ml) - the hyperhydration Syndrome, the proteinuria of a single and daily portion, total cholesterol, fibrinogen decreased to a greater extent.

Conclusion: based on the presented results of statistical analysis, it is possible to judge the severity of clinical manifestations associated in patients with elevated values of hemerin. However, aft er the standard therapy of chronic glomerulonephritis, these patients have better dynamics in stabilizing clinical parameters. It is possible to assume some protective function of hemerin in patients with glomerulonephritis.

Purpose: оbjectivize the diagnostic criteria of acute cholangitis in acute obturational biliary pancreatitis.

Materials and methods: a retrospective analysis of the treatment of 90 patients with a wounded OBD stone after ECST was performed. To diagnose and assess the severity of acute cholangitis in the preoperative period, the diagnostic criteria of theTokyo classification of 2013 (TG13) were used. Endoscopic diagnosis of acute cholangitis was established during ESTT in visual assessment of bile, the presence of edema, hyperemia, fibrin deposits in the distal bile duct. A comparative analysis of laboratory-instrumental parameters before and aft er EPST in patients with acute cholangitis depending on the degree of severity according to TG13, and in patients with or without endoscopic signs of cholangitis was performed

Results: according to TG13, acute cholangitis was diagnosed in all patients. An easy degree was established in 31 patients (34.4%), moderate in 53 (58.9%), severe in 6 (6.7%). Th e markers of systemic infl ammation had an upward character depending on the degree of severity of the cholangitis, the tendency of decrease and the normalization time aft er EPST directly correlated with the initial parameters in the groups (r = 0.728, p = 0.000). Laboratory indices of cholestasis were of an upward character in patients with mild to moderate cholangitis, which was refl ected both in the ultrasoundographic imaging of the bile ducts upon admission and in the data of cholangiography with EPST (p <0.05). Th e levels of transaminase and amylase did not have statistically significant diff erences (p> 0.05).Endoscopic signs of cholangitis were revealed in 44 (48.9%) patients. When comparing the ratio between patients who had endoscopic cholangitis signs and severity, according to TG13, in 11 (35.5%) acute cholangitis was classified as easy, in 30 (56.6%) as average, in 3 (6.8%) as (P = 0.174) and the correlation between endoscopic signs and severity of cholangitis was not noted (r = 0.162 p = 0.126). In the comparative analysis of laboratory-instrumental parameters of patients, no statistically significant diff erences were found (p> 0.05), depending on the presence or absence of endoscopic signs of cholangitis.

Conclusions: diagnostic criteria of acute cholangitis TG13 are applicable for the preliminary diagnosis of acute cholangitis in conditions of acute biliary pancreatitis and can serve as an indication for a timely EPST.

Objective: to study the association of genetic polymorphisms of chemokines (+1931А/Т ССL4, A/G CXCL11 (rs4512021), -403A/G CCL5, C/G CCL2 (rs2857657), -801G/A CXCL12) with arterial pressure in patients with chronic glomerulonephritis.

Materials and methods: the study group comprised 700 people, including 238 patients with chronic glomerulonephritis and 462 controls. When assessing the level of blood pressure, the patients were divided into three groups: with arterial pressure less than 140/90 mm Hg - 84 patients, with arterial pressure from 140/90 to 159/100 mm Hg - 96 patients with arterial pressure more than 160/110 mm Hg - 52 patients. Th e material for the study was DNA samples isolated from whole venous blood by the phenolchloroform extraction method. Th e analysis of the studied polymorphisms was carried out by the method of detection of TaqMan probes by means of real-time PCR.

Results: it was found that a high level of diastolic blood pressure in patients with chronic glomerulonephritis is associated with the molecular-genetic markers GG and CG CCL2 (rs2857657) (p=0,014), the risk factor for the development of severe arterial hypertension during the disease is the allele A CXCL11 (rs4512021) (p=0,04, OR=1,65).

Conclusion: new data on the involvement of A/G CXCL11 (rs4512021) and C/G CCL2 (rs2857657) polymorphisms of chemokine genes in the development of arterial hypertension in patients with chronic glomerulonephritis of the Central Chernozem Region of Russia have been revealed.

Objective: to evaluate the role of mental and emotional status in predicting of arterial hypertension in young adults.

Materials and methods: a total of 981 volunteers (535 men, 446 women) aged 20 to 29 were examined. By the level of blood pressure (BP) 2 groups were separated: group 1 (n = 842) - with normal BP level (<140/90 mm Hg), group 2 (n = 139) - with arterial hypertension (≥140/90 mm Hg). Th e psychoemotional status of the subjects was assessed using a neuropsychic adaptation test of S.B. Semichov, Situational State-Trait Anxiety Inventory of Charles Spielberger and Y.L. Khanin and the questionnaire “From uncertainty to confidence” N.N. Th e volunteers from the 1 groups were observed second time in 5 years. Th e endpoint of the study was AH.

Results: the incidence of neuropsychic adaptation violations of mental and emotional states among young people was 39.8% (95% CI 36.7-42.8%). High level of situational anxiety presented in 34.3% (95% CI 31.3-37.2%). Self doubt was found in 30.9% of cases (95% CI 28.0-33.8%). Th ere were no significant diff erences in the prevalence of psychoemotional violations depending on BP level. 78 surveyed were withdrawn from the study during the period of observation by the various reasons. Data of 764 patients were included in a second phase. Arterial hypertension was detected in 144 patients (18.8%, 95% CI 16.2-21.7%). Th e relative risk of arterial hypertension in 5 years in people with high level of situational anxiety was 1.64 (95% CI 1.22-2.19), with self-doubt – 1.73 (95% CI 1.29-2.31).

Conclusions: In patients with high level of situational anxiety arterial hypertension developing in 1.44 times and with self doubt — in 1.73 times more likely during next 5 years.

Objective: the study revealed a number of peculiarities in the location of blood vessels performing diff erent functions, their intensive branching and anastomosis were noted as well as ongoing neoformation.

Materials and Methods: we used classic histological, immunohistochemical, and morphometric methods to examine the vascular component of the umbilical region in 1-month-old infants. We identified the volume occupied by the blood circulation system in the upper and lower segments of the umbilical region.

Results: the results of histological examination demonstrate prevalence of great vessel branches in the lower segment of the umbilical region. Relative volumes of all the blood vessels are also statistically significantly higher in the lower segments of the paraumbilical region. Th e presence of vascular components in the umbilical region is slightly higher (though not reliably statistically) in the lower left segment compared to the right segment.

Conclusions: collected data can be taken into account in pediatric surgery to search for optimal section methods for the umbilical region in order to access the abdominal cavity.

Analysingthe example of unusual case of a successful direct constant His bundle pacing, we would like to draw specialist’s attention to details of procedure and some important electrophysiological particularities we have come across during operation. Long-term (7 years) results ( pacing options, ECG data, changes of left ventricle ejection fraction and patient’s quality of life) were considered too.