Vol 106, No 2 (2025)

BACKGROUND: Alterations in phospholipid fraction balance represent one of the mechanisms underlying lipid metabolism disorders in HIV infection.

AIM: To investigate the dynamics of phospholipid fractions in patients with HIV/tuberculosis coinfection undergoing monotherapy with antitubercular agents versus combined antiretroviral and anti-tuberculosis therapy.

MATERIAL AND METHODS: A comparative study of phospholipid fractions (sphingomyelin, phosphatidylcholine, lysophospholipids, phosphatidylethanolamine) was conducted using chromatography in two groups of patients with HIV-associated tuberculosis: Group 1 (100 patients) received tuberculosis chemotherapy (isoniazid, rifampicin, pyrazinamide, ethambutol), while Group 2 (100 patients) received antiretroviral therapy (tenofovir, lamivudine, efavirenz) alongside treatment with antitubercular agents. The control group consisted of 50 healthy individuals. CD4 lymphocyte counts and HIV RNA viral load were measured in all patients. Assessments were performed before treatment initiation and after 1 and 2 months of therapy. Statistical analysis was conducted using parametric methods, with differences considered significant at p <0.05.

RESULTS: Before treatment initiation, both groups of patients with HIV/tuberculosis coinfection had higher levels of sphingomyelin, lysophospholipids, and phosphatidylcholine compared to healthy individuals (p=0.001). In Group 1, receiving only anti-tuberculosis therapy, levels of sphingomyelin, lysophospholipids, and phosphatidylcholine significantly increased (p=0.001), with no change in the number of patients exhibiting bacterial shedding. In Group 2, after one month of antiretroviral therapy combined with anti-tuberculosis treatment, levels of sphingomyelin, lysophospholipids, and phosphatidylcholine decreased below those of the control group (p=0.001). A significant reduction in patients with bacterial shedding was observed (from 100% to 18%, p=0.001).

CONCLUSION: In the group of patients receiving combined antiretroviral and anti-tuberculosis therapy, a reduction in sphingomyelin and lysophospholipid levels was observed, along with a decrease in the number of patients exhibiting bacterial shedding.

BACKGROUND: Quantitative data on structural remodeling of the lower limb veins are limited and primarily concern changes associated with varicose vein disease.

AIM: This study aimed to investigate and compare age-related changes in the quantitative parameters of structural components in the femoral and great saphenous veins.

MATERIAL AND METHODS: A total of 120 vein specimens were analyzed, including 60 from the great saphenous vein and 60 from the femoral vein, obtained from 60 deceased individuals aged 25–98 years. According to the World Health Organization classification, the individuals were divided into five age groups: young adults (n = 10), middle-aged adults (n = 15), older adults (n = 15), elderly (n = 15), and the oldest-old (n = 5). Morphological and quantitative assessments of the femoral and great saphenous vein walls were conducted on hematoxylin and eosin-stained sections, including the volume fraction of the intima and the volume fractions of smooth muscle and connective tissue components in the media and adventitia. Statistical analysis was performed using the Kruskal–Wallis and Mann–Whitney nonparametric tests.

RESULTS: In older adults, the volume fraction of the intima was significantly lower in the great saphenous vein compared with the femoral vein (p < 0.0001). In all age groups except the oldest-old, the volume fraction of subintimal longitudinal smooth muscle cells in the media of the great saphenous vein was significantly higher than in the femoral vein (p ≤ 0.00017). No age-related changes in the volume fraction of circularly arranged smooth muscle cells were observed in the great saphenous vein (p = 0.36). The volume fraction of longitudinal smooth muscle cells in the adventitia was significantly greater in the great saphenous vein compared with the femoral vein in the young (p = 0.046), middle-aged (p < 0.0001), and older (p = 0.017) groups. In the oldest-old, the volume fraction of connective tissue in the adventitia was significantly reduced in both veins (p < 0.005), with a lower proportion found in the great saphenous vein compared with the femoral vein (p < 0.05).

CONCLUSION: In the great saphenous vein, a reduction in the volume fraction of the intima begins in older adulthood. In the femoral vein, a decline in the subintimal longitudinal smooth muscle layer is observed in the elderly. In both the femoral and great saphenous veins, a decrease in longitudinal smooth muscle bundles and connective tissue stroma in the adventitia occurs during longevity.

BACKGROUND: The study of age-related changes in the hair bulb and shaft is relevant due to the lack of data distinguishing normal from pathological hair characteristics across different age groups.

AIM: This study aimed to assess changes in hair bulb and shaft parameters in the parietal region across different male age groups.

MATERIAL AND METHODS: The study was based on microscopic examination of hair samples from 77 men who underwent evaluation at a medical center in Perm,in 2022–2023, specializing in the treatment of hair and scalp conditions. Participants were divided into three groups based on age. group 1 included 25 men aged 21 to 35 years (young adults). group 2 consisted of 27 men aged 36 to 59 years (middle-aged adults). group 3 included 25 men aged 61 to 74 years (elderly). Hair samples were obtained from the parietal region by gently extracting hairs in the late telogen phase, which were easily detached from the scalp and had fully developed bulbs and shafts. The width of the hair bulb and shaft was measured under a microscope. The width of the hair bulb was measured under a microscope as a line perpendicular to the shaft connecting the most distant points of the bulb. To determine shaft width, the height of the bulb was first measured as the distance from the most prominent point of the hair root to a perpendicular line connecting the narrowest part of the bulb. The shaft width was then measured at a distance from the narrowest point of the bulb equal to its height. It was defined as a line parallel to the bulb width, connecting the opposite sides of the hair shaft. Statistical analysis was performed using Student’s t test. Differences were considered statistically significant at p < 0.05.

RESULTS: A 1.3% decrease in hair bulb width was observed from young to middle adulthood (p = 0.7597). A similar trend was observed from middle to older adulthood, with a 3.3% reduction in hair bulb width (p = 0.4853). No significant age-related changes in shaft width were observed. A 3.8% decrease was noted from young to middle adulthood (p = 0.4995), and a 2.2% decrease from middle to older adulthood (p = 0.6488).

CONCLUSION: Despite age-related vascular changes, the thickness of the hair bulb and shaft in the parietal region remains largely stable.

BACKGROUND: The search for novel compounds that exert a positive impact on liver morphology and function having a beneficial effect on carbohydrate and lipid metabolism remains an urgent research priority.

AIM: This work aimed to evaluate the effect of a novel thienopyridine derivative on liver structure in rats with diet-induced obesity.

MATERIAL AND METHODS: A novel thienopyridine derivative AZ-020 was selected through in silico screening using online platforms based on its potential effects on the liver, as well as carbohydrate and lipid metabolism. An in vivo study was conducted in Wistar rats, which were randomized into five groups (8 per group): an intact group (maintained under standard conditions), control group (received excess palm oil 30 g/kg for 8 weeks), two reference groups (rats on high-fat diet received either metformin 300 mg/kg or vildagliptin 8 mg/kg during 2 weeks), and a test group (received AZ-020 1 mg/kg for 2 weeks under the same diet). Liver structure was assessed using histological and morphometric analyses, including hepatocyte count, binucleated hepatocyte count per field of view, hepatocyte size, hepatocyte cytoplasmic and nuclear area, and hepatocyte nuclear-to-cytoplasmic ratio. Statistical evaluation was performed using the fourfold table method with Pearson’s χ² test, normalized Pearson’s test, Yates’ correction, and Fisher’s exact test. Parametric statistical methods and Student’s t-test were applied to morphometric data with normal distribution.

RESULTS: Administration of AZ-020 normalized liver histoarchitecture disrupted by prolonged dietary overload and confirmed a positive trend in key morphometric parameters of hepatocytes compared with the control group. A statistically significant 1.7-fold increase (66%) in binucleated hepatocyte count (an essential marker of liver regeneration) was observed following AZ- 020 administration. Treatment with AZ-020 led to normalization of the nuclear-to-cytoplasmic ratio, which showed a statistically significant 16% decrease compared with the control group. In the test group (treated with AZ-020), hepatocyte cytoplasmic area was 76.04 ± 0.35 μm² (vs. 75.54 ± 0.31 μm² in the control group, p = 0.0186); nuclear area was 11.13 ± 0.24 μm² (vs. 13.9 ± 0.3 μm², p < 0.001); and average hepatocyte area was 87.17 ± 0.59 μm² (vs. 89.44 ± 0.61 μm², p < 0.001).

CONCLUSION: The novel thienopyridine derivative with the laboratory code AZ-020, which belongs to the cyanothioacetamide class, demonstrated hepatoprotective effects in an experimental model of liver damage and metabolic disturbances.

BACKGROUND: Identifying new treatment strategies aimed at restoring intestinal wall integrity and preventing the development of abdominal sepsis remains a pressing issue in modern medicine.

AIM: This study aimed to examine the course of experimental peritonitis and the resulting intestinal dysfunction during etiotropic antibacterial therapy combined with pathogenetic treatment using a p38 MAPK inhibitor.

MATERIAL AND METHODS: Male Wistar rats were divided into control groups 1 and 2 and experimental groups 1, 2, and 3. All animals underwent induction of postoperative diffuse peritonitis via intraperitoneal injection of a suspension containing 10⁹ microbial bodies/mL of Escherichia coli and Bacteroides fragilis. One day after peritonitis modeling, rats in the control groups received 3 mL of saline intraperitoneally, while rats in the experimental groups received 3 mL of an aqueous solution of the p38 MAPK inhibitor (a conjugate of 4-[4-(4-fluorophenyl)-2-(4-methylsulfinylphenyl)-1H-imidazole-5-pyridine] with poly-1-vinylimidazole). All animals received antibacterial therapy (cefoperazone + sulbactam, 47 mg/day intramuscularly) starting on day 1 post-modeling. In control group 1 and experimental group 1, the duration of antibiotic therapy was 5 days; in control group 2 and experimental groups 2 and 3, it was 10 days. Animals were euthanized on days 3, 7, 14, and 28. Peritoneal fluid underwent microbiological analysis, and intestinal wall samples were examined histologically. Statistical analysis was performed using Statistica 10 for Windows. The significance of differences between the compared samples (p values) was assessed using the Wilcoxon (W) test and the Mann–Whitney U test. Differences were considered statistically significant at p < 0.05.

RESULTS: Administration of the p38 MAPK inhibitor alongside 5-day antibiotic therapy significantly reduced the severity of intestinal dysfunction on days 3 (p_u = 0.005), 7 (p_u = 0.005), and 14 (p_u = 0.003), compared with control group 1. With 10-day antibiotic therapy, both early (group 2) and delayed (group 3) administration of the inhibitor resulted in reduced intestinal wall damage on days 14 (p_u = 0.001) and 28 (p_u = 0.003), compared with control group 2.

CONCLUSION: The p38 MAPK inhibitor attenuated the severity of destructive changes in the intestinal wall when administered alongside antibacterial therapy.

The use of 3D technologies offers more precise planning of surgical procedures in complex cases of localized bone tissue deficiency, allowing adaptation to individual anatomical features, improved outcomes, reduced risk of complications, and faster postoperative recovery. To analyze the current capabilities of three-dimensional printing in the surgical management of pelvic and hip bone defects, we reviewed scientific literature available in open-access databases including PubMed, eLibrary.Ru, Scopus, and Dimensions, with a search depth of up to 10 years. This review highlights major trends and advances in the medical application of 3D technologies aimed at reducing perioperative risks and improving patients’ quality of life in the context of bone tissue defects. Particular focus is placed on revision hip arthroplasty and pelvic oncologic conditions, where modern additive manufacturing technologies can enhance treatment quality and surgical outcomes. The methodology of 3D scanning for designing patient-specific implants is described. The review also demonstrates current and promising applications of 3D printing in clinical practice. Modern 3D technologies, particularly additive manufacturing, play an important role in improving surgical outcomes for skeletal deficiencies by enabling personalized treatment, expediting recovery, and improving patient prognosis. Emerging directions significantly expand the range of available reconstructive procedures, reduce the risk of complications, and ultimately improve patient quality of life and surgical efficiency.

This review analyzes international studies from the past five years that focus on glomerulopathies associated with malignant neoplasms of different sites. This study aimed to conduct a comparative analysis of histological and immunohistochemical features of morphological characteristics in glomerulopathies in cancer of different localizations, as well as identification of the specificity of the revealed features. Relevant publications were identified through Scopus, PubMed, and the Cochrane Library, with a search limited to studies published from 2019 to 2024. The review provides a detailed analysis of histological and immunohistochemical alterations in the glomerular apparatus in glomerulopathies associated with carcinomas of different sites. The identified morphological changes were assessed for their specificity. Particular attention is given to pathogenetic mechanisms that may underlie the development of glomerulopathies associated with carcinomas of different sites. A detailed analysis of the available literature demonstrates that understanding the histological and immunohistochemical features of glomerulopathies associated with malignant tumors contributes to improving diagnostic approaches for these conditions. Research in this area is of considerable importance, as it may offer new insights for the development of innovative strategies aimed at advancing prognosis and quality of life in patients with malignancies. Malignant cells are capable of expressing various substances, including proteins, that may contribute to the pathogenesis of glomerulopathies. Morphological evaluation of the glomerular apparatus enables the identification or exclusion of a pathogenetic association between the tumor and glomerulopathy, thereby allowing adjustment of the patient’s treatment plan. The review also discusses potential pathophysiological mechanisms of tumor-associated glomerulopathies, contributing to more accurate interpretation of glomerular changes and enabling differentiation between specific and paraspecific morphological features. In summary, this review presents an analysis of the histological and immunohistochemical features of glomerulopathies associated with malignant tumors of different sites, highlighting the importance of an interdisciplinary approach to diagnosing this condition as one of the clinical manifestations of malignancy.

Numerous publications have addressed gingival and bone augmentation involving both the alveolar processes of the jaws and the floor of the maxillary sinuses. In some cases, patients require not only dental restoration but also complex reconstruction of facial skeletal regions damaged by trauma, radiation exposure, cancer surgery, and other factors. Dental implantation is an essential component in the correction of extensive defects not only of the jaws but also of the paranasal sinuses. Additionally, various techniques have been described for covering the outer part of dental implants immediately after insertion to enhance integration. At the same time, certain disagreements remain regarding gingival manipulation during dental implantation and preparatory procedures. Some sources recommend covering implants with a flap of autologous soft tissue, whereas others support flapless approaches. Reports also differ on the source of soft tissue used for coverage: ranging from autologous grafts to allogeneic transplants, such as porcine-derived monolayer collagen matrices. There is no consensus on the optimal bone augmentation method for implant placement. Morphological data on the processes of lysis, replacement, or consolidation of autologous bone fragments that are placed into or left within tissues damaged during preparation and implantation are clearly insufficient, and existing publications lack detailed descriptions of these processes. All of this indicates that none of the challenges in dental implantation have been definitively resolved, including the need for a step-by-step understanding of the pathomorphological processes involved in bone graft consolidation or resorption.

BACKGROUND: Predicting and detecting paroxysmal atrial fibrillation at an early stage is a key priority for preventing cardioembolic complications.

AIM: This study aimed to develop a predictive tool for paroxysmal atrial fibrillation in patients with sinus rhythm.

MATERIAL AND METHODS: A single-center case-control study was conducted involving 6630 patients. The main group comprised 97 individuals with newly diagnosed paroxysmal atrial fibrillation. The control group included 99 patients without atrial fibrillation, matched for anthropometric and comorbidity parameters. Standard laboratory and instrumental methods were used. During 24-hour Holter ECG monitoring, the following parameters were analyzed: sex, age, monitoring duration, and rhythm driver. Special attention was given to early ectopic beats of the “P on T” and “R on T” types. Differences were considered statistically significant at p ≤ 0.05.

RESULTS: Holter ECG parameters (extrasystole, ectopy, and paroxysmal tachycardia) were significantly more frequent and had higher values in the main group. A specific type of early atrial extrasystole (“P on T”) was observed in 97.9% of the main group, compared with 4.0% of the control group (odds ratio, 8461.648; 95% CI, 382.1983–187336). The number of supraventricular extrasystoles (isolated, paired, grouped) was significantly higher in the main group. Interval durations were also significantly longer in this group. No significant differences between groups were found in the frequency of ventricular extrasystoles or ST-segment depression. A logistic regression model was developed based on the most significant predictors: sex; number of atrial and atrioventricular supraventricular extrasystoles; number of isolated and paired ventricular extrasystoles; presence of allorhythmia in ventricular ectopy; and presence of early “P on T” ectopic beats. The model yielded an area under the curve (AUC) of 0.996, with an optimal risk threshold of 0.5 and prediction accuracy of 97.45%.

CONCLUSION: A predictive tool for paroxysmal atrial fibrillation in patients with sinus rhythm was developed, demonstrating high predictive performance.

This article presents a rare case of coexisting vascular anomalies and developmental variants of the brachiocephalic vessels in a female patient who reported headaches triggered by food intake. The anomalies included: arteria lusoria, an aberrant right subclavian artery arising directly from the aortic arch and passing posterior to the esophagus; origin of the right vertebral artery from the right common carotid artery; origin of the left vertebral artery from the aortic arch; high vertebral artery entry points with hypoplasia; and excessive S-shaped tortuosity of the left internal carotid artery. This case is of particular interest due to the exceptional rarity of coexisting vascular anomalies and developmental variants in a single patient, qualifying it as a clinical curiosity. Variations in the origin and course of aortic arch branches may lead to altered cerebral hemodynamics and be associated with cerebrovascular disorders or neurological symptoms. Identifying atypical courses of the brachiocephalic vessels is crucial during preoperative assessment, as anomalous vascular anatomy may result in serious complications during surgical or endovascular interventions.

This article is dedicated to Professor Vladimir Onisimovich Kler, a prominent physician-histologist, regional geographer, biologist, geologist, and paleontologist—a remarkably versatile scholar. A well-known figure in Yekaterinburg (called Sverdlovsk from 1924 to 1991), he also made a notable contribution to the scientific and academic life of Kazan, where he worked from 1915 to 1921 as an assistant at the departments of zoology and histology at Kazan University. His first known publications, focused on determining the age of fish from bone structures, appeared during this period. It was in Kazan that he developed a strong interest in medical histology and chose to devote his life to it. In 1931, Professor Kler established the Department of histology, cytology, and embryology at the newly founded Sverdlovsk Medical Institute (now Ural State Medical University) and headed it for 20 years. A series of outstanding works in medical histology earned him recognition as one of the leading Russian morphologists. This article was written as a tribute to Professor Kler, not only as a prominent scientist, educator, and organizer of science, but also as an exceptionally remarkable individual, and to honor his contribution to the development of Russian medicine.

This article presents biographic data of the employees of the Department of Microbiology at Kazan State Medical University who took part in the Great Patriotic War. It describes their military and labor feats, their scientific contributions, and work in the post-war peacetime. The aim of this article is to highlight the backgrounds of microbiologists and epidemiologists, employees of the Kazan State Medical University, veterans of the Great Patriotic War as perfect examples of their devotion to duty and patriotism. The article describes the feats of doctors providing qualified medical care to the wounded at the front, conducting diagnostic microbiological research and epidemic control measures, and eliminating outbreaks of infectious diseases in military units. The article was prepared using the primary sources such as autobiographies, memoirs of employees, archives of the Department of Microbiology, personal files from the archives of the Personnel Department of Kazan State Medical University, documents from the archives of the Kazan Research Institute of Epidemiology and Microbiology, as well as the website Memory of the People presenting documents from the archives of the Ministry of Defense of the Russian Federation.

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Wang GM, Li LJ, Fan L, Xu M, Tang WL, Wright JM. Renin inhibitors versus angiotensin receptor blockers for primary hypertension. Cochrane Database of Systematic Reviews. 2025. Issue 2. Art. No.: CD012570. DOI: 10.1002/14651858.CD012570.pub2