Chronic obstructive pulmonary disease is currently regarded as a multisystem disorder accompanied by chronic inflammation, oxidative stress, hypoxemia, and endothelial dysfunction. These mechanisms may potentially lead to ocular involvement, primarily affecting the retina, choroid, and optic nerve. Objective. To analyze current literature   data on the association between chronic obstructive pulmonary disease, ophthalmological diseases, and morphofunctional changes in the organ of vision. Materials and methods. A narrative literature review with elements of a systematized search was performed. The search was conducted in PubMed, Google Scholar, eLibrary, CyberLeninka, and on official   journal websites for the period from 2020 to 2025. Russian- and English-language search queries related to chronic obstructive pulmonary disease, the retina, choroid, optic nerve, age-related macular degeneration, cataract, optical coherence tomography, and optical coherence tomography angiography were used. Original clinical studies, systematic reviews, meta-analyses, and relevant Russian-language publications were included in the review. Results and discussion. Current evidence indicates that chronic obstructive pulmonary disease is associated with changes in the retina, choroid, and optic nerve. The most consistently reported findings include thinning of the retinal nerve fiber layer, reduced vascular density of the retina and peripapillary region, and choroidal changes. These abnormalities are more pronounced in patients with more severe disease and lower oxygen saturation. In addition, patients with chronic obstructive pulmonary disease have an increased risk of age-related macular degeneration, while long-term corticosteroid therapy is associated with a higher likelihood of cataract development. Conclusion. Chronic obstructive pulmonary disease should be regarded as a systemic disease with potential involvement of the organ of vision, which justifies the need for an interdisciplinary approach and ophthalmological monitoring of patients at risk.

A comparative analysis of the effects of two tuftsin derivatives, Thr-Lys-Pro-Arg-Pro-Gly-Pro (Selank) and Met-Thr-Lys-Pro-Arg-Pro-Gly-Pro, on the levels of pro- and anti-inflammatory cytokines (IL-ip, IL-4, IL-6, IL-10, TNF-a) in the hippocampus of the rat brain was performed using a model of “social” stress in rats. Modeling of chronic social stress in rats was accompanied by pronounced dysregulation of the cytokine profile in the hippocampus: concentrations of proinflammatory cytokines (IL-ip, IL-6, TNF-a) exceeded control values by 2,0–3,8 times (p < 0.001), while the levels of anti-inflammatory mediators (IL-4, IL-10) decreased by 32–37 % (p < 0.001). Prophylactic administration of the Selank peptide (Thr-Lys-Pro-Arg-Pro-Gly-Pro) significantly limited the stress-induced increase in proinflammatory cytokines and restored the levels of anti-inflammatory mediators in both aggressive and submissive animals. The decrease in proinflammatory cytokine concentrations reached 33–45 % (p < 0.001), and the increase in antiinflammatory cytokines was 30–42 % (p < 0.05) relative to the stress group, confirming its moderate immunomodulatory and protective activity under conditions of “social” stress. Peptide Met-Thr-Lys-Pro-Arg-Pro-Gly-Pro demonstrated greater efficacy compared to Selank: in aggressive animals, it reduced proinflammatory cytokine levels by 45–56 %, and in submissive animals by 50–60 % (p < 0.001). Simultaneously, a more significant increase in anti-inflammatory cytokines was observed: IL-4 by 58–63 % and IL-10 by 43–50 % relative to the stress group (p < 0.001), indicating its enhanced ability to stabilize cytokine balance. These data support further study of Met-Thr-Lys-Pro-Arg-Pro-Gly-Pro as a potential therapeutic agent for the correction of stress-induced neuroinflammatory conditions. Given its ability to suppress proinflammatory activity and enhance the anti-inflammatory response more effectively than Selank, further preclinical studies are warranted, including an assessment of the peptide's long-term effects, pharmacokinetics, and potential molecular targets.

This study assessed treatment adherence in children with asthma, revealing that up to 90 % of patients exhibit low adherence associated with poor disease control. A single, individualized training session was shown to significantly reduce inhalation technique errors, especially when using metered-dose inhalers and nebulizers. The authors emphasize the need for comprehensive measures, including regular training and digital monitoring, to improve this situation. The aim of the study was to comprehensively assess treatment adherence in children with asthma, identify clinical, demographic, and organizational factors influencing it, and evaluate the effectiveness of educational interventions to correct inhalation technique errors. Materials and methods: A cross-sectional study included 30 children with bronchial asthma. Clinical and anamnestic data were collected, disease control was assessed using Asthma Control Test and the Morisky – Green adherence scale. Inhalation technique was analyzed using metered-dose inhalers, metered-dose powder inhalers, and nebulizers, followed by individual training and reassessment. Results: Most patients had low adherence (up to 90 % according to the Morisky – Green scale), and this indicator was practically independent of age and asthma severity, but was associated with an increased frequency of uncontrolled disease according to the results of asthma control tests, especially in moderate and severe asthma. Before training, the highest frequency of critical errors was observed with metered-dose powder inhalers and aerosol inhalers, whereas after a single individual training session, the proportion of patients without inhalation technique errors significantly increased, especially among users of metered-dose inhalers and nebulizers. Conclusion: Low adherence to asthma therapy in children is almost universal and requires comprehensive interventions, including regular inhalation skill assessment, individualized age-appropriate training, and the use of digital monitoring technologies.

Gerbils have been used as an object of biomedical research since the mid-20th century. These animals are easy to handle and care for, and their anatomy and physiology, with a few exceptions, are similar to those of other rodents most widely used in scientific researches: rats and mice. Due to a number of physiological and anatomical features, the gerbils can reproduce pathophysiological conditions that are difficult (or impossible) to model in rats and mice. The aim of this study was to evaluate the anxiety level and exploratory activity of female great gerbils (Rhombomys opimus) after a vital stress in the “Open field” test of the Multi Conditioning TSE 2.0 system. Materials and methods. For this study, 50 female great gerbils were captured using live traps in the Central Karakum Desert 6 months prior to the experiments. During the 6-month adaptation period of the gerbils to laboratory conditions, 5 of them died for various reasons. The animals were divided into 4 groups of 10 rodents each. Ten intact great gerbils, not subjected to the stress, served as controls. The average weight of the great gerbils was 115.0 ± 7.3 g. The animals were kept under standard vivarium conditions in the accordance with rules for the care and maintenance of laboratory rodents outlined in the book “Guide to the Care and Maintenance of Laboratory Animals” (Eurasian Council for Standardization, Metrology and Certification, Minsk, 2014). Results. Analysis of behavioral data in the “Open field” test showed that the orientation-exploratory response, expressed as the number of stance and horizontal motor activity, the stability of neural processes reflected in the number of reverse turns, the time spent visiting the central brightly lit squares, the vegetative and emotional response determined by the time of grooming in the experimental animals under stress, are significantly reduced, which reflects the natural restructuring of the activity level of brain processes under the stress. Conclusion. The exploratory behavior and the anxiety level of the great gerbils in the “Open field” test to various stimuli causes stress, which may impact cognitive functions of animals.

Liver cirrhosis is a pressing problem in clinical gastroenterology. It is characterized by a prolonged, asymptomatic course, frequent sudden decompensation, and high mortality. Objective. To present a clinical case of decompensated cryptogenic liver cirrhosis and to review current data on its possible causes, natural history, diagnosis, treatment, and outcomes. Materials and methods. A 42-year-old female patient underwent clinical, laboratory, and instrumental assessment, including abdominal ultrasonography, computed tomography, and oesophagogastroduodenoscopy; current Russian and international literature was also analysed. Results. The patient had ascites, portal hypertension, splenomegaly, hypersplenism, oesophageal varices, and grade II hepatic encephalopathy. Viral hepatitis, alcohol misuse, autoimmune liver disease, and hereditary liver disorders were excluded, which allowed the diagnosis of cryptogenic liver cirrhosis to be established. Conclusion. Cryptogenic liver cirrhosis is a diagnosis of exclusion and often represents the end stage of previously unrecognised metabolically associated steatotic liver disease. Early comprehensive diagnosis and timely correction of complications are crucial for prognosis.

Shrapnel wounds to soft tissues of the extremities predominate in the structure of combat trauma during the Special Military Operation. These injuries are often combined with bone fractures and rupture of the vascular-nerve bundles. Optimally selected treatment tactics at the early stages of medical care allow for a positive prognosis for the course of the pathology. The aim of the study. To demonstrate the results of surgical treatment of a serviceman with a shrapnel blind wound to the right shin, a gunshot comminuted fracture of the fibula, and rupture of the shin vessels at the military field hospital stage. Materials and Methods. A 47-year-old serviceman received a shrapnel blind wound to the right shin as a result of a shell explosion. He was evacuated to the military field hospital (level 2). On examination, signs of acute ischemia of the right lower extremity of stage 2b were revealed. Radiographic data revealed a comminuted fracture of the upper third of the right fibula. Ultrasound examination of the right leg vessels revealed a pulsating hematoma with a volume of 30 ml; rupture of the anterior tibial artery (by bone fragments), posterior tibial artery (by a metal fragment), and popliteal vein. Results. Due to the presence of a pulsating hematoma, severe pain, progression of acute ischemia symptoms, and the risk of external bleeding, a decision was made to perform surgical intervention: removal of the pulsating hematoma of the right leg, suturing of the popliteal vein wall defects, autogenous popliteal-posterior tibial grafting, and fasciotomy. The postoperative period was uneventful. The serviceman underwent rehabilitation and returned to military duties 3 months after the injury. Conclusion. Revascularization of the lower extremity at the stage of military field hospital with ruptured leg vessels as a result of a shrapnel wound made it possible to preserve the limb and return the serviceman to duty.

Combat-related trauma to peripheral arteries, including the formation of false aneurysms, remains one of the most challenging issues in military surgery. High-energy shrapnel wounds often result in injury to major vessels, requiring staged surgical management. The aim of the study. To present a clinical case of successful treatment of a thrombosed false aneurysm of the axillary artery following a shrapnel wound. Materials and methods. This report describes a case of a right shoulder injury in a 36-year-old serviceman. Two days after the injury, upon admission to a Level 2 military field hospital, a through-and-through shrapnel wound was diagnosed, complicated by axillary artery rupture with the formation of a thrombosed false aneurysm and compensated collateral circulation. Results. The multidisciplinary team decided to perform reconstructive surgery. Under endotracheal anesthesia, axillary artery reconstruction was performed using a reversed autologous great saphenous vein graft from the thigh. Intraoperatively, a thrombosed false aneurysm was noted. The postoperative course was uneventful, and arterial flow was restored. The patient was discharged 30 days later with restored limb function. Conclusion. This case demonstrates the efficacy and safety of delayed reconstructive interventions on major arteries, provided that circulation is compensated via collaterals and there are no infectious complications.

Late diagnosis of infectious endocarditis in drug-dependent patients is not only the cause of an unfavorable outcome, but also the delayed provision of surgical care. The literature contains isolated publications on the surgical treatment of infectious endocarditis in these patients. In this regard, it is of interest to study and systematize demographic, anamnestic, clinical and instrumental data to determine the optimal amount of surgical intervention and predict the course of the early postoperative period. The aim. To study demographic, anamnestic, clinical and instrumental data of drug-addicted patients with infectious endocarditis. Materials and methods. A retrospective analysis of the data of 25 drug-dependent patients with infectious endocarditis who were treated at the Federal State Budgetary Institution Federal Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation (Astrakhan) from 2019 to   2023 was carried out. Results. The median age of the patients was 37,0 [29,0; 47,0] years. Male patients predominated over females. In their medical history, 100,0 % of the patients had chronic viral hepatitis C, with 12,0 % having it in combination with hepatitis B; 32,0 % had arthralgia; and 24,0 % each had iron-deficiency anemia, bilateral polysegmental pneumonia, liver cirrhosis, and hepatomegaly. Tuberculosis of the lungs was present in 12,0 % of cases, while hepatorenal failure and portal hypertension were observed in 8,0 % of patients each. Complications of infective endocarditis included meningoencephalitis in 16,0 % of patients, sepsis in 20,0 % of patients, and pulmonary embolism in 24,0 % of patients. The infective endocarditis was primary and had a subacute course. Clinical manifestations of infective endocarditis included fever, weakness, fatigue, weight loss, arthralgia, and pulmonary embolism; no peripheral signs of the disease (such as rash) were detected. Instrumental findings of infective endocarditis included vegetations and regurgitation on the heart valves; in 40,0 % of cases, there was isolated involvement of the tricuspid valve. Conclusion. Drug-dependent patients with infectious endocarditis had polymorbid pathology, which was accompanied by immune disorders (HIV, hepatitis, iron deficiency anemia) and could affect the outcome of infectious endocarditis, which requires further study.