Osteoporosis is a progressive multifactorial systemic disease of the skeletal system characterized by the damage of the microarchitectonics of the bone tissue, which leads to the occurrence of low-energy fractures and impairment of the quality of life of individuals. The risk factors for the development of osteoporosis include smoking, which inhibits calcium absorption in the intestine and not only contributes to the reduction of bone density but also acts as a predictor of bronchopulmonary pathology. The systemic inflammation that develops in patients with chronic obstructive pulmonary disease, associated with the production of interleukins (IL)-6, IL-1, IL-8, and tumor necrosis factor – α, stimulates osteoclast-mediated bone resorption and a low level of osteoprotegerin closes the circle. In clinical practice, the determination of markers of bone resorption is required. This is a tartrate-resistant acid phosphatase, the 5β fraction of which signals the end of the resorption process; these are hydroxypyridine crosslinks – pyridoline (PYD) and deoxypyridoline, that stabilize the bone collagen molecule. Genetic factors also play an important role in the development of osteoporosis. The presence of the GG genotype or the G allele of the 283 A> G polymorphism (Bsml) of the VDR gene is a predictor of osteoporosis of the lumbar vertebrae L1-L4. The substitution of cytosine for thymine (C> T) in exon 17 of the calcitonin gene (CALCR) at position 1340 leads to the substitution of the amino acid proline (CCG) for leucine (CTG) at position 463 of the receptor protein molecule and affects bone density. But the most phylogenetically ancient mechanism for regulating the development and maintenance of tissue homeostasis by controlling cell proliferation, differentiation, migration, and apoptosis is the Wnt signaling pathway (SP-Wnt). Alterations in Wnt signaling observed in cases of genetic mutations cause various diseases of the human skeleton. A systematic literature search was carried out using the Scopus, PubMed, Web of Science databases.

The first coronavirus NСoV-B814 was isolated from humans in 1965 and did not survive to the present time. For a long time, it was believed that coronaviruses were not pathogenic to humans. They were not included in the list of particularly dangerous infections and represented a serious problem exclusively in veterinary medicine. But in 2002, after the SARS outbreak, scientists’ opinions changed. A new subtype of the coronavirus called SARS-CoV penetrated the human population. In 2012, it was possible to discover natural foci of Middle East Respiratory Syndrome. The epidemic of a new coronavirus infection that emerged in late 2019 and early 2020 attracted the attention of scientists around the world. The priority was a detailed and close study of all the varieties of this virus. This review describes seven types of coronaviruses that can cause emergencies in populations around the world.

The efficacy of depressive disorders treatment is insufficient. It is explained by an incomplete understanding of both pathogenesis of depression and antidepressants mechanism action. An improvement of the treatment efficacy of depression disorders is closely associated with complete knowledge of the pathogenesis of disorders and antidepressant mechanism of action. The effect produced by the first line of antidepressants prescribed currently in the clinical practice includes the accumulation of monoamines and prolonged activation of their membrane receptors. However, a decrease in the membrane receptors density evoked by prolonged activation of monoaminergic receptors is counteracted by the second line of antidepressant activity. It is associated with the expression of inducible regulatory protein S100A10 (p11) and its partners. In this review, the authors examined the structure and function of protein p11, its interaction with such proteins as annexin A2, Ahnak, chromatinremodeling factor SMARCA3. The authors analyzed the influence of p11 on the membrane density of serotonin 5-HT1B and 5-HT4 receptors, metabotropic glutamate receptors 5, voltage-dependent potassium Kv3, and calcium Cav1.2 and 1.3 channels, that play an important role in both the effect of antidepressants and the pathogenesis of depression disorders. A systematic literature search was conducted in Scopus, Web of Science, MedLine, elibrary, and other databases.

The present review describes pathogenetic mechanisms and clinical features of COVID-19 associated delirium. Potential factors leading to the named condition and pathophysiological chains were described elaborately, including older adults’ manifestation analysis based on the latest clinical studies. A systematic literature review was conducted in the following databases: PubMed, Scopus, e-library, Google Scholar and others.

Objective. The study aimed to evaluate the effect of therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in combination with melatonin on the dynamics of the quality of life (QOL), clinical and laboratory activity, and mixed anxiety– depressive disorder (MADD) in patients with ankylosing spondylitis (AS).

Materials and methods. The study involved 65 patients with AS and RTDS. Patients from Group I (n=32) were prescribed melatonin at a dose of 3 mg per day at night, 30–40 minutes before bedtime, in addition to standard AS therapy. Patients from Group II (n = 33) received standard therapy. 8 weeks after, the dynamics of QOL indicators, clinical and laboratory activity, and the severity of MADD in patients from both groups were evaluated.

Results. The application of melatonin in addition to standard therapy in patients with AS and MADD provided a statistically significant improvement in the functional and clinical-laboratory data (frequency and severity of anxiety and depression, pain syndrome indicators, ESR, CRP, integrative indicators of physical and psychological components of health).

Conclusion. The application of melatonin in complex therapy for patients with AS and MADD contributes to the improvement of clinical and laboratory parameters, psychoemotional state, and QOL of this category of patients.

Objective: the study aimed to reveal the daily periodicity of labor, the nature of melatonin metabolism, and the outcome of childbirth in women with a physiological and complicated pregnancy, depending on the sex of the fetus.

Materials and methods: to study the chronophysiological characteristics of birth outcomes depending on fetal sex, 1 980 birth histories and stories of newborns were analyzed. The neonates were born between January 1 and December 31, 2016, in a maternity ward of the Federal State Budgetary Educational Institution of Higher Education “RostGMU” of the Ministry of Health of Russia. Melatonin production was identified by the level of urinary excretion of 6-sulfatoxymelatonin (6-SM) (its main metabolite) examining the morning portion of the urine of women by the ELISA method (at 8 am 3 ml of urine were collected in Eppendorf tube).

Results: it was revealed that fetal sex modulated the activity of the central regulatory mechanisms responsible for the daily period functional processes in the female body and the initiation of labor. The largest number of spontaneous births by male fetuses occurred in the early evening before midnight when daily illumination was decreased, while the birth of girls was observed more often in the period from midnight to early morning. At the same time, mothers of boys had lower production of melatonin compared to that of girls’ mothers.

Conclusions. The peculiarities of labor and birth complications associated with the sex of the fetus were identified.

Objective. The study aimed to compare the diagnostic value of different methods of assessing the condition of the scar on the uterus after a cesarean section.

Materials and methods. A comparative analysis of the diagnostic value of assessing the validity of the scar on the uterus in the pre-graviridar period and during pregnancy ultrasound (ultrasound) investigation with dopplerometry (DM), magnetic resonance imaging (MRI), and microwave radiothermometry (RTM). The study included fertile patients after delivery by cesarean section (n = 56), at the planning stage, during pregnancy and after delivery, both through natural birth pathways and by re-cesarean section.

Results. A comparative analysis of the assessment of the scar in the uterus by the mentioned methods revealed the comparable diagnostic value of these methods during the planning phase of pregnancy and in gestation time 11–12 and 20 –21 weeks, while at the period of 37–38 weeks, the sensitivity of RTM was significantly (1.6 times) higher than ultrasound investigation.

Conclusions. Despite the high diagnostic effectiveness of all three methods of assessing the condition of the uterine scar after cesarean section, the method of microwave radiothermometry has advantages in the simplicity of the method, lack of need for expensive equipment, and specialized qualifications of the doctor.

Objective. The study aimed to compare the level of INF a2 immunoexpression in tissues obtained during medical abortion with the corresponding level of IFNa2 expression in a retained fetal egg tissues after the first missed abortion. The authors compared the anamnestic data on previous inflammatory diseases of the genital tract with the results of an extended morphological study of the material obtained during the evacuation of the contents of the uterine cavity during the first non-developing pregnancy in the first trimester.

Materials and methods. The study included 15 patients with first-time missed abortions caused by a viral infection (6-8 weeks of pregnancy). All patients demonstrated either recurrent herpes simplex labialis/genitalis or PCR confirmed HSV, HPV, CMV. Exclusion criteria were recurrent miscarriage, blighted ovum, endocrinopathies, male factor infertility, and other causes of miscarriage. The comparison group included 20 women of the same age that chose to undergo a medical abortion.

Results. In patients from the comparison group, the main producer of IFN a2 was syncytiotrophoblast as well as maternal decidual cells in the parietal endometrium and uteroplacental area. In the main group, manifested hematogenous infection (microabscesses, vasculitis, lymphocytic and macrophage infiltration) with dystrophy and necrosis of decidual maternal cells and secondary pathological changes in the placental villi were diagnosed, which led to a significant decrease in the IFN a2 immunoexpression in all the studied cells.

Conclusion. The lack of anamnestic data on previous urogenital infections does not exclude the etiological role of the inflammatory component in the genesis of non-developing pregnancy. First-time occurred pregnancy loss requires adequate postoperative interferon therapy and a thorough examination of a couple.

Objective. The study aimed to assess the dynamics of the systemic immune response in patients during mesotherapy with hyaluronic acid (HA).

Materials and methods. The observation group included 26 women who received the first-time mesocorrection with drugs based on hyaluronic acid (HA). Injections of low molecular weight HA were carried out according to standard methods in a course of 5 procedures with an interval of 14 days. The parameters of the innate and adaptive immune response were studied before and two weeks after the end of the course. The skin condition was assessed by dermatoscopy (Aramo Smart Lite 300, Southern Korea).

Results. The clinical effect of the course of procedures was reflected in the subjective improvement in the appearance. The improvement was confirmed by hardware analysis, which recorded an increase in hydration, a smoothing of the skin relief, and a decrease in the depth of wrinkles. At the end of the course, redistribution of lymphocyte populations towards natural killer cells and B-lymphocytes was revealed with a decrease in the total number of T cells. The antibody production of immunoglobulins of classes M and G was increased, the serum content of Ig A and IgE was reduced, the number of both T-effectors and T-lymphocytes with immunosuppressive activity increased. Changes in the neutrophil system were characterized by the inhibition of the production of reactive oxygen intermediates; the dynamics of the expression of Toll-like receptors by monocytes was ambiguous.

Conclusion. The results of the study confirmed the active involvement of the factors of innate and adaptive systemic response in the cosmetic effect, which manifested itself immediately after mesotherapy as systemic dysregulatory immune changes.

Objective. The study aimed to perform a comprehensive morphofunctional assessment of the effectiveness of recreational activities in children aged 9–12 years in the summer of 2019.

Materials and methods. The study was conducted by the “Problem scientific laboratory of physical methods of diagnosis and treatment” of RostGMU in the children’s health and recreation camp “Mir” (Krasnyi Desant village, Gulf of Taganrog). Procedures and time of the study: somatometry, bioimpedance analysis, сardiointervalography, stabilometrics on the 2nd day of stay and 2.5 weeks after. Two groups were formed: Group I included overweight children (OW), n = 15 (boys, n = 9; girls, n = 6); Group II included children with normal physical development (NPD), n = 37 (boys, n = 17; girls, n = 20). The children received a non-drug complex of camp resource provision for 3 weeks.

Results. Health measures did not lead to significant changes in the somatometric parameters. According to the results of the сardiointerval recording, an authentic increase in the variational range and vegetative rhythm index was found in children with NPD, which indicates an increase in the parasympathetic activity of regulation. The stress index decreased by 30% in the case of NPD, and by 6% in the case of OW. Data from the stabilometric “Balls” simulator showed that after the recovery, the regulation of postural control was optimized, and decision-making processes were accelerated, especially in children with NPD.

Conclusion. The study showed that in order to assess the effectiveness of recreational activities, along with “mandatory” methods, it is advisable to use functional methods such as cardiointervalography and stabilometrics, which can be recommended for use in health and rehabilitation institutions to assess the adaptive capabilities of the organism.

The article describes a clinical observation of a newborn patient with a rare congenital cardiovascular disorder of the left pulmonary artery sling. There are few publications in the world’s literature on the clinical observations of the above pathology, which causes the key difficulty in diagnostics. Moreover, this case features a favorable outcome thanks to a timely diagnosis and a successful surgical correction that followed.

The article presents the experience of using mentoring as the most effective method of adapting new employees to fully include them in the work of the Rostov-on-don anti-plague Institute. The purpose of the study was to analyze the work on mentoring in the Rostov-on-Don anti-plague Institute and to compare the experience of the Institute with the work in this direction in other institutions in Russia and abroad. It was shown how important the mentoring process was when working with pathogens of groups I–II of pathogenicity, including during the fight against the novel coronavirus infection COVID-19. The importance of mentoring when immersed in the scientific environment, when motivating to acquire new knowledge, and striving for innovative results in their research was also noted. Mentoring is a modern method of personnel work that provides quick adaptation, professional development, and career growth, and has a positive effect on the stability of the institution as a whole.

In November 1915, the Russian University of Warsaw appeared in Rostov-on-Don, which later became the Donskoy University, and in the present – the Rostov State Medical University. The Department and clinic of obstetrics and women’s diseases in Rostov-on-Don were set up as part of the medical department of the University of Warsaw, which was evacuated to Rostovon-Don also in 1915. The founder of the Department was a doctor of medicine, Professor Anastasiy Alexandrovich Sitcinski. The Rostov school of obstetricians and gynecologists, which is distinguished by continuity, the presence of family dynasties, observance of traditions in the transfer of knowledge, skills, and moral qualities, began with the activities of this doctor. The stages of development of the Rostov school of obstetrics and gynecology presented in the article are of current importance in the aspect of studying problems related to the history of medicine. In order to analyze the scientific directions of the Rostov school of obstetrics and gynecology, the peculiarities of the work of the departments of obstetrics and gynecology of the Rostov state medical University were studied. The assessment of continuity in scientific work and practical activities were carried out. The article presents the features of the development of the Rostov school of obstetrics and gynecology over the past 90 years. The work of individual departments of obstetrics and gynecology, their scientific directions were analyzed.