Objective: assessment of the microbiome of the vagina and uterine cavity using a uterine catheter with a collet guide in infertile patients before the in vitro fertilization procedure. Materials and methods: samples of vaginal and endometrial scrapings obtained from 73 infertile women who had planned an in vitro fertilization (IVF) procedure were taken and studied. The samples were analyzed by V3-V4-V6 regions using the 16S rRNA gene sequencing method. Results: significant differences were found in the taxonomy of the endometrium and vaginal microbiome - coincidences in microbiological composition were detected in 18.2% of patients. Endometrial lactobacillus-dominant microbiocenoses occurred in 24.8% of women, vaginal — in 56.7%. Comparisons between patients with negative and positive IVF (onset of biological pregnancy) results failed to identify any microorganism associated with the success of the procedure, with endometrial microbiota biodiversity being higher among women who successfully exercised their reproductive function. The Shannon Equality Index (J) for pregnant and non-pregnant women was 0.76 (0.57–0.87) and 0.55 (0.51–0.64), respectively (p=0.002). Conclusion: the use of a developed uterine catheter with a collet guide for an adequate assessment of the endometrial microbiome is promising and justified. The correct assessment of the endometrial microbiocenosis contributes to the adequate diagnosis of pathological processes occurring in the uterine cavity, which will allow for proper therapy aimed at increasing the receptivity of the endometrium and, in the future, contributing to the realization of the reproductive function of a woman. 

Diagnosis is one of the most important concepts in medicine, the correctness of which determines in many respects the success of treatment, prevention and, ultimately, the quality and life expectancy of the patient. Currently, in medical science and practice, there is a great diversity both in understanding the essence and form of a medical diagnosis, and in approaches to its establishment. However, in the practice of doctors, what is formulated as a diagnosis does not even meet the basic requirements for this concept. We have made an attempt to bring to a common denominator both the theoretical understanding of the diagnosis and the forms of its implementation in practice, to scientifically substantiate the definition of diagnosis and diagnosis, to strictly define its subject, content, boundaries and forms in order to increase the effectiveness of prevention and treatment of diseases on the way to achieving the main goal of medicine to improve the quality and increase the life expectancy of the patient.

Objective: to study the prevalence of vitamin D level disorders in therapeutic patients and the features of their correction. Materials and methods: 322 patients who applied for medical help in the field of therapy («rheumatology» and «cardiology») were examined. Materilas and methods: clinical, laboratory (study of the level of vitamin D in the blood), statistical. Results: it was found, that among patients with a therapeutic profile, vitamin D concentration disorders (deficiency and insufficiency) occur in 72.7% of the surveyed. There is a high prevalence of risk factors for osteoporosis in the examined patients: female sex prevails (81%), age (average age was 53.6 ±14.3 years), drug use (50% take proton pump inhibitors, 21.4% take glucocorticoids). When comparing the proportion of people with impaired vitamin D levels in comparison with the data of previous years, there was a decrease in the proportion of people with vitamin D deficiency and an increase in the proportion of people with vitamin D deficiency. Among people with a vitamin D level of 30-100 ng/ml, daily use of vitamin D preparations in dosages exceeding the recommended consumption levels was noted. Conclusion: based on the data obtained, the prevalence of vitamin D deficiency and insufficiency remains high. However, recently there has been a trend towards a decrease in the proportion of people with vitamin D deficiency and an increase in the proportion of people with vitamin D deficiency. In this connection, it is necessary to inform the population about the recommended adequate levels of vitamin D in blood serum and safe dosages of vitamin D preparations for daily intake.

Objective: to study the effect of a combination of azoximer bromide (AB) and human placenta hydrolysate (HPН) on metabolic processes in patients with chronic liver lesions on the background of secondary immunodeficiency. Materials and methods: 95 patients with chronic liver pathology on the background of secondary immunodeficiency (VIDS) aged 35 to 56 years were examined. The main group is 45 people, and the comparison group is 50 people. After a general clinical and bacteriological examination, all patients were subjected to the study of metabоlic processes. The assessment of metabolic disorders was carried out by the level of macroergic compounds in the hemolysate of the washed suspension of erythrocytes of patients by thin-layer chromatography. In addition to treatment with conventional methods, patients who were under observation were additionally prescribed a combination of drugs — bromine azoximer and human placenta hydrolysate. Patients of the comparison group received milk thistle preparations as a hepatoprotector and did not use any immunoactive drugs. Results: when studying the state of indicators of metabolic disorders after the completion of treatment, it was found that patients in the main group who received AB and HPН had almost complete normalization on the part of the studied indicators, which cannot be said about patients from the comparison group who received only conventional drugs in average therapeutic doses in the treatment complex. Conclusions: from the data obtained, it is possible to judge the positive effect of AB and HPН on the indicators of the state of energy homeostasis and consider it pathogenetically justified and clinically promising to include their combination in the complex of treatment of patients with CLP against the background of VIDS.

The presented clinical case describes orphan disease known as MAS with manifested symptoms of precocious puberty, recurrent ovarian cysts, fibrous dysplasia, café-au-lait skin pigmentation and abnormal cardiac conduction. The pathogenesis is based on the GNAS gene mutation that cause hyperactivation of glycoprotein hormone receptors and hypersecretion. There are genetic tests that confirm the diagnosis, however, given the high percentage of false negative results, in most cases the disease is diagnosed based on a combination of clinical and laboratory-instrumental data. Given the high clinical variability and absence of management algorithms for patient with this syndrome, the article pinpoints the necessity of thorough examination of patients to select further management tactics. Multidisciplinary approach and collegiate case management will improve diagnosis of the disease and prevent the development of severe complications.

Inflammatory myofibroblastic tumor (VMO) is a rare neoplasm, which is currently referred to as a mesenchymal neoplasm with intermediate biological potential. The tumor consists of differentiated myofibroblastic fusiform cells. The frequency of occurrence of VMO among primary lung neoplasms is up to 1%. This type of tumor is the most common type of primary lung tumors in children. VMO can occur both in childhood and in adulthood. VMO is found in the soft tissues of the abdominal cavity, in the pelvic organs, larynx, mammary gland, head and neck tissues. Extra-organ localization (retroperitoneal space, mediastinum) is also diagnosed. Lung VMO often has no clinical manifestations, and if present has nonspecific symptoms, such as cough, hemoptysis, shortness of breath, hyperthermia, chest pain. VMO was previously considered as a neoplasm with a benign course, but these tumors tend to local relapses and distant metastasis. The article presents data on the prevalence, clinical manifestations and treatment of VMO, as well as own clinical observation of the course of this disease in an 8-year-old child.

Idiopathic intracranial hypertension (IVH) is a condition or a heterogeneous group of vessels characterized by an increase in intracranial pressure (ICP) without signs of mass formation, hydrocephalus, infection, venous thrombosis, and hypertensive encephalopathy. The term "pseudotumoral cerebral hypertension" is used to describe the secondary origin of ICP due to various causes and is a diagnosis of exclusion. One of the risk factors for the development of IVH are hypocalcemic conditions of the development of etiology, leading to the development of ICP. Long-term use of zoledronic acid, which is a risk factor for the development of hypocalcemia, can contribute to the occurrence and fluctuating course of IVH, requires monitoring clinical monitoring of the patient's condition in order to prevent the occurrence of secondary atrophy of the optic discs, with further progressive decline and loss of vision. The choice of vaccine for a 12-year-old child with a clinically-instrumentally-histologically confirmed diagnosis of Gorham-Stout syndrome, with progressive bone resorption, receiving zoledronic acid therapy. Attracting the attention and informing a wide range of specialists in various fields about the likelihood of IVH on the background of long-term use of bone and cartilage metabolism correctors can serve as an important factor in the timely diagnosis, prevention and correction of this pathological condition in childhood.

Objective: to study the deep and skin temperatures of the knee joint by microwave radiothermometry (RTM) in healthy girls of comparable age in the pre- and pubertal periods. Materials and methods: the study was carried out in the "Problem Scientific Laboratory of Physical Methods of Diagnosis and Treatment" of Rostov State Medical University and the children's health camp "Mir" (Krasny Desant village, Rostov region). It was 45 girls aged 12 years, taking into account gender development, divided into two groups: 1st gr. (n=28)  — prepubertal period; 2nd gr. (n =17) — puberty. RTM of the knee joints was performed according to a certain scheme using the MWR2020 system (ex RTM-01-RES) (Moscow, Great Britain). Results: in the groups, the color fields of deep and skin temperature, when compared, are characterized by a slight geometric and color transformation are similar to each other; the lowest temperature is noted in the projection of the patella. Temperature fields of thermoasymmetry make it possible to reveal temperature differences in groups of subjects. In the 2-nd group, there are also higher growth and weight indicators, lower deep and skin temperature in almost all areas of the knee joint, fluctuations reach 0.4 –1.4 ° C. Conclusion: a decrease in temperature in the knee joints in pubertal girls with a relatively mature menstrual cycle reflects general changes in hormonal regulation in this period of development. When forming the temperature indicators of healthy girls, it is necessary to take into account the hormonal processes of puberty with division into groups of pre- and pubertal periods of development.

Despite the fact that rabies in the modern world is a rare sporadic disease, the relevance of its methods of treatment is beyond doubt, since in the absence of timely prevention, it is characterized by 100% mortality. As of 2020, there are about 70 cases of experimental rabies treatment protocols according to the Milwaukee Protocol Rabies Registry. The very idea that the human body can cope with the virus itself has been around for a long time. Even before the advent of the Milwaukee protocol, there were attempts at treatment at the stage of clinical manifestations. The first was Michael Huttwick of the Center for Infectious Disease Control in Atlanta, although the scientific community is still arguing whether it was really rabies. The essence of this protocol is the introduction of a patient into an artificial coma, the introduction of antiviral drugs, symptomatic therapy (anticolvusants, mechanical ventilation, etc.). At the moment, there is the sixth version of the Milwaukee Protocol (from 2018), which provides general recommendations for its maintenance, since the material base is too small to draw any general conclusions.

Purpose: To evaluate the effectiveness and expediency of using vesicles of the outer membranes of atoxygenic strains of Vibrio cholerae O1 serogroup for the prevention of experimental cholera. Materials and methods: atoxigenic strains of V. cholerae O1 El Tor 18950 (ctxAB-tcpA-) and 18780 (ctxAB-tcpA+) isolated from the water of surface reservoirs were used to obtain vesicles. The protective properties of the obtained drugs were evaluated using a model of generalized cholera in white mice and a model of an isolated loop of the small intestine of an adult rabbit. Results: it has been shown that vesicles of the outer membranes isolated from atoxygenic strains of V. cholerae have a protective effect and prevent the development of infection in experimental animals when infected with a virulent strain of cholera. The obtained drugs are most effective when administered parenterally twice, with an interval of seven days, preventing the death of all white mice taken in the experiment and the development of pathogenetic processes in the small intestine of adult rabbits. Summary: the data obtained indicates the formation of pronounced immune protection against the disease in animals, as well as the possibility of using these structures to create preventive anti-cholera drugs.

Objective: evaluation of the epizootic and epidemiological situation for HFRS in the Rostov region. Materials and methods: from 2020 to 2022, an enzyme-linked immunosorbent assay was used to study the presence of hantavirus antigens in samples of small mammals and class G immunoglobulins in the blood sera of healthy donors. Results: epizootological monitoring conducted in 35 administrative districts of the region and in the vicinity of Rostov-on-Don (2157 animals, 15 species) revealed the circulation of hantaviruses in populations of small mammals. Infection with hantaviruses of six species of mammals was registered: house mouse, common vole, yellow-bellied mouse, European forest mouse, East European vole, small forest mouse. 1062 blood samples from residents of various regions of the region were tested. Class G antibodies to hantaviruses were detected in 7.0%, 4.5%, 7.1% in different years. Conclusions: the coincidence in the territories of Azovsky, Kamensky, Neklinovsky, Salsky, Morozovsky districts of positive findings of the hantavirus antigen in samples of small mammals and seropositive samples of donors suggests the presence of a natural focus of HFRS, the establishment of boundaries and activity of which needs further research.

Objective: to form a brief overview of data on the main historical stages in the development of medical societies in Russia and the contribution of the Rostov branch of the All-Russian Scientific and Practical Society of Epidemiologists, Microbiologists and Parasitologists to ensuring the sanitary and epidemiological well-being of the population. Materials and methods: analysis of archival materials and literary sources from the databases of electronic libraries e-library, CyberLeninka and others. Results: the contribution of medical societies to the development of domestic medicine and the sanitary and epidemiological service of our country is indicated. Particular attention is paid to the activities of the Rostov regional branch of the All-Russian Scientific and Practical Society of Epidemiologists, Microbiologists and Parasitologists, which brought together specialists from both research and educational institutions, and practical health care of the Don region. Conclusion: The results of practical undertakings and scientific research of medical societies throughout their existence contributed to the development of preventive medicine and were focused on protecting the health of the country's population. The activities of the Rostov Regional Branch of the All-Russian Scientific and Practical Society of Epidemiologists, Microbiologists and Parasitologists are aimed not only at developing domestic medical science and promoting achievements among the medical community and the population, but also at improving the professional level of specialized specialists, developing and implementing effective scientific, practical, educational technologies .

Objective: to study the correlations of serum levels of cytokines, regulating the synthesis of structural macromolecules of connective tissue, in undifferentiated connective tissue dysplasia in adolescent girls with menstrual cycle disorders. Materials and methods: 176 adolescent girls aged 11 to 17 years with menstrual cycle disorders (MCD) and undifferentiated connective tissue dysplasia (UCTD) and 69 healthy girls of the same age were examined. Levels of cytokines IL-1β, IL-4, IL-6, IL-10, IL-17A, TNF-α, OPG, RANKL were studied in serum samples. Results: a significant increase in serum IL-6 and RANKL (p<0,01), as well as a tendency (p<0,1) to increase OPG production was found in adolescent girls with UCTD with MCD. In UCTD with NMC, correlations between the studied cytokines are much more common than in the control group (p=0,01). The most pronounced in adolescent girls with UCTD are positive correlations (moderate strength) between the concentrations of three cytokines IL-6, RANKL and OPG. Conclusions: The data obtained reflect the mechanisms of cytokine dysregulation of metabolism and remodeling of connective tissue and indicate the development of a weakly expressed systemic inflammatory process in UCTD with MCD in adolescent girls. The results of the study can be used to develop effective individualized schemes of therapeutic and preventive measures.

Objective: to assess the dynamics of the immune system functioning when using mesotherapy with peptide complexes. Materials and methods: the observation group consisted of 26 women (from 35 to 55 years old) who received a course of mesotherapy with preparations containing peptides for the first time. Injections were carried out in a course of 5 procedures with an interval of 14 days. The exclusion criteria were the absence of same manipulations in the past, hormone replacement therapy, combined oral contraceptives, pregnancy, lactation, acute infections, somatic pathologies. The parameters of innate and adaptive immunity were studied before the course of procedures, right after it, 3 and 6 months after the course. Skin quality changes were assessed using the Aramo Smart Lite 300 dermatoscope. Results: improved skin quality, decreased skin creases, increased skin moisture. The obtained clinical improvements last for three months after the end of the course and there is a tendency for the effects to decrease after six months. In the functioning of the immune system, there is a redistribution of lymphocytes population in the peripheral bloodstream immediately after the course of mesotherapy. In addition, an increase in peripheral T-regulatory lymphocytes responsible for intraimmune suppression was documented. The activation of spontaneous oxygen-producing activity was noted. 3 months after the procedure, no significant changes in immunological parameters were found. 6 months after the course of procedures, a decrease in the level of T-lymphocytes with an increase in the expression of markers of early T-cell activation was recorded. In the humoral link, an increase in circulating B-lymphocytes was documented. In the parameters of innate immunity, there is a decrease in the spontaneous oxygen-producing activity of neutrophils. Conclusion: as a result of the study, a positive persistent clinical effect is documented, simultaneously with the mobilization of factors of innate and adaptive immunity. It is important to note the fact that the immune response restores completely within 6 months after a course of mesotherapy with peptide complexes, with still noticeable clinical results.

Detection of a combination of aplasia of the inferior vena cava and retroaortic left renal vein is extremely rare. A description of a clinical case with similar anomalies in the development of the inferior vena cava and the left renal vein is given. In our case, the combination of an anomaly of the inferior vena cava and the left renal vein in a 59-year-old male patient was an incidental finding during examination and treatment for acute cerebrovascular accident. Asymptomatic aplasia of the prerenal and hepatic sections of the inferior vena cava with drainage into the azygous vein was revealed. The hepatic veins empty into the right atrium. The identified variant of aplasia of the prerenal and hepatic sections of the inferior vena cava with drainage into the unpaired vein is the result of atrophy of the right subcardinal vein. A rare unclassified type of retroaortic left renal vein was found, the lower branch of which flows into the inferior vena cava, and the upper branch into the unpaired vein. The retroaortic left renal vein is formed while maintaining the anastomosis between the right and left supracardinal veins. The possibility of accidental radiographic findings of anomalies in the development of the inferior vena cava and its tributaries in humans before clinical manifestations has been established. Given the possible manifestation of an anomaly of the inferior vena cava in people over 40 years of age with a clinic of peripheral venous thrombosis, and the manifestation of the retroaortic left renal vein - the development of congestive venous hypertension in the kidney, the patient was given the necessary recommendations.