The review presents an analysis of current literature data on the role of iron-dependent regulated cell death (ferroptosis) in the pathogenesis of acute myeloid leukemia (AML). The molecular mechanisms of SLC7A11/GPX4-dependent resistance of leukemic cells to ferroptosis induction are discussed, including transcriptional regulation of anti-ferroptotic genes by NRF2, p53, ATF4 factors, as well as epigenetic modifications. Special attention is paid to the role of leukemic stem cells in maintaining resistance through activation of alternative defense pathways (FSP1–CoQ10, DHODH) and regulation of iron homeostasis. Experimental data obtained on AML cell lines (HL-60, KG-1, MOLM-13, MV4-11, THP-1) and therapeutic strategies for pharmacological blockade of the SLC7A11–GSH–GPX4 axis using ferroptosis inducers (erastin, RSL3, ML162) are analyzed. The prospects of combination therapy with targeted drugs, hypomethylating agents, and lipid metabolism modulators are discussed. Molecular markers (SLC7A11, GPX4, ACSL4, FSP1, NRF2, lipid peroxidation level) for patient stratification and personalization of treatment for resistant forms of AML are highlighted.

The review systematizes current concepts of the molecular, cellular, and neuroendocrine mechanisms underlying age-related thymic involution and its role in the development of immunosenescence and oncopathology. Key transcription factors (Foxn1, E2F3, Myc), signaling pathways (Notch/DLL4, PPARγ), and epigenetic regulators (miR–181a) coordinating the degradation of thymic epithelial cells and the replacement of parenchyma with adipose tissue are analyzed. Particular attention is paid to the role of sex steroids in inducing organ atrophy, the physiological characteristics of gestational involution (RANK/progesterone axis), and the protective effects of caloric restriction and the somatotropic axis (GH/IGF–1). From a clinical perspective, the impact of medullary compartment degradation on the distortion of negative selection and the accumulation of suppressive pools of regulatory T–cells (tTreg) that block antitumor surveillance in old age is characterized. The prospects of using T–cell receptor excision circles (TRECs) as a precision biomarker of true functional thymic senescence are substantiated.

The article addresses the problem of infectious complications associated with the use of mesh hernia prostheses, which are caused by the formation of microbial biofilm on the prosthesis fibers. The aim of the study was to evaluate in vitro the antibacterial activity of various polymer coatings based on chitosan with glycerol against S. aureus and E. coli. The study demonstrated that all samples impregnated with antibiotics (ciprofloxacin and gentamicin) exhibited 100% bactericidal activity within 2 hours. Without antibiotics, the coating containing 10% glycerol showed the best effect, with a bactericidal index of 57,2% for S. aureus and 80,7% for E. coli. The developed coating, especially with 10% glycerol, is promising for the prevention of infections in herniology.

A study was conducted on segments of the pulmonary artery retrieved from donors following the confirmation of brain death. The pulmonary artery allograft was preserved in «Custodiol» solution and stored under conditions of moderate hypothermia (+4°C) for up to 60 days. Histological sections 3–6 μm thick were prepared and stained with haematoxylin and eosin, and with the Movat–Russell pentachrome stain. The condition of the muscular-elastic layer of the pulmonary artery wall was assessed.
Histological examination showed that after 1–2 days of preservation, the structure of the muscular-elastic layer of the donor pulmonary artery was preserved; by days 3–4, nuclear hyperchromia, oedema of the intercellular matrix and thinning of the internal elastic membrane had appeared. From days 5–6, the first signs of smooth muscle cell death and delamination of the muscular layer were observed. By days 8–10, the disorganisation of the elastic framework, oedema and swelling of the muscular-elastic layer of the pulmonary artery wall had intensified, and clear signs of smooth muscle cell death were evident. By days 16–18, the elastic fibres had become fragmented. By day 30, necrobiotic changes in the cells were increasing, and homogenisation of the internal elastic membrane was observed. By days 50–60, only isolated groups of smooth muscle cells remained; the elastic framework was condensed and fragmented.
Consequently, changes in the muscular-elastic layer of the pulmonary artery allograft are characterised by the gradual death of smooth muscle cells, accompanied by oedema and disorganisation of the stroma, against a background of relative preservation of the elastic framework. The structural integrity and viability of the donor pulmonary artery tissue are maintained for up to 6 days of preservation in «Custodiol» solution at +4°C.

The aim of the study was to assess changes in the microbial landscape in patients of an infectious disease hospital during the pre-pandemic and pandemic periods, taking into account the respiratory tract, sterile sites, and gastrointestinal tract, as well as to trace the dynamics of antimicrobial resistance of key clinically significant pathogens. A retrospective-prospective analysis of microbiological studies performed in 2019–2024 was conducted. Clinically significant isolates recovered from respiratory samples, blood, cerebrospinal fluid, and intestinal contents were studied. The dynamics of antimicrobial resistance of the main nosocomial pathogens were analyzed separately. The COVID–19 pandemic was accompanied by a significant restructuring of the microbial landscape. In the respiratory tract, the proportion of gram-negative hospital pathogens, primarily Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, increased. In the intestinal biotope, a statistically significant decrease in pathogenic enterobacteria was observed, with a simultaneous increase in opportunistic and hospital flora. In sterile sites, a marked increase in the number of isolates was noted, mainly due to K. pneumoniae, Escherichia coli, and A. baumannii. At the same time, a deterioration in antimicrobial resistance profiles was observed, including an increase in carbapenem resistance of A. baumannii, the emergence of colistin–resistant K. pneumoniae, MRSA, and VRE. The obtained data substantiate the need for regular microbiological monitoring, local antimicrobial resistance audits, and revision of empirical antibacterial therapy regimens.

A comparative evaluation of topical diagnostic methods and the effectiveness of various surgical approaches was conducted in 34 patients with secondary hyperparathyroidism (SHPT). Preoperative diagnosis included radionuclide studies (RS) (scintigraphy with 99mTcsestamibi), ultrasound, CT, and MRI. Patients in Group 1 (n=10) were operated on using the Kocher approach in the neck. In patients in Group 2 (n=11), surgery was performed through a central mini-approach with bilateral revision of the parathyroid glands, using confocal laser microscopy (CLM) intraoperatively. In Group 3, the intervention was performed through a central mini-approach without ipsilateral revision. In patients with SHPT (n=34), according to the results of preoperative (ultrasound, RS, CT, MRI) and intraoperative (visually and using CLM) topical diagnosis, in 29,4% of cases (n=8) the involvement of 4 parathyroid glands is detected, simultaneous involvement of 2 glands occurs in 23,5% of cases (n=8), pathology of one parathyroid gland was detected in 47,1% (n=16) of patients. The presence of false-positive or false-negative results of using preoperative diagnostic methods from 9,1 to 63,5% of cases depending on the localization of pathological changes in the parathyroid glands and the type of instrumental method (ultrasound, RS, CT, MRI) justifies the need for additional intraoperative visualization of the glands by CLM. Parathyroidectomy from a central mini–access on the neck using CLM as a method of revision of the parathyroid glands shows advantages over the Kocher access in the treatment of SHPT due to the reduction of the time of surgical intervention from 77,5 (70,0; 120,0) minutes to 35,0 (20,0; 45,0) minutes, the exclusion or minimization of the time of stay in the emergency room and radiology department, and a reduction in the duration of the postoperative period from 13,0 (11,0; 18,0) days to 6,0 (5,0; 7,0) days.

Disorders of the gut-brain interactions (DGBI) and metabolic liver diseases (MASLD/ MASH), including their end–stage cirrhosis, are included in a pathogenetic continuum, within which each component can be a significant driver of progression. A key link is systemic subclinical inflammation (low–grade inflammation) induced by portal endotoxemia and neuroimmune dysregulation. Objective. To systematize current data on the mechanisms of interactions and treatment methods for DGBI and liver diseases. The article presents the concepts of Bottom–Up and Top–Down signaling modulation, as well as current data on microbiota changes in DGBI and liver diseases. Particular attention is paid to diagnostic capabilities and therapeutic methods for targeting significant pathophysiological links. Conclusion. Understanding the role of the relationship between DGBI and liver disease underscores the need for interdisciplinary teams focused on comprehensive treatment of disorders of the gut–liver–brain axis. Future research should focus on identifying biomarkers of microbiota imbalances and developing pharmacotherapeutic interventions targeting the key mechanism of progression – systemic inflammation.

Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) requires particular attention during pregnancy because of the unpredictable effects of hormonal changes on disease activity, the risk of potentially severe attacks, and the need to select treatment that is safe for both the mother and the fetus. This article summarizes current evidence from the literature and up-to-date recommendations for the management of women with C1-INH-HAE during pregnancy, delivery, and breastfeeding. The available evidence demonstrates that HAE is not a contraindication to pursuing reproductive plans. In addition, we present the results of a survey of 8 Belarusian women with C1-INH-HAE who had a total of 19 pregnancies, 14 of which resulted in delivery. Disease course in this cohort was highly variable: an increase in attack frequency was reported in 6/14 (42,9%) of pregnancies, near-complete cessation of attacks in 5/14 (35.7%), and no substantial change in 3/14 (21,4%); moreover, the course of the disease could differ between successive pregnancies. In one case, an abdominal HAE attack was misdiagnosed as an acute surgical condition, resulting in appendectomy at 26 weeks of gestation, followed by pregnancy loss. Most deliveries occurred vaginally (12/14, 85,7%), while HAE attacks within the first 72 hours after delivery occurred in 3/14 cases (21,4%). The current approaches to the treatment and prophylaxis of C1-INH-HAE presented in this article may serve as a practical guide for healthcare professionals involved in the management of patients with HAE, facilitating timely diagnosis and treatment of attacks, rational selection of therapy, and improvement of patients’ quality of life.

Skeletal radiography remains the primary imaging method for multiple myeloma (MM) included in the clinical protocol of the Republic of Belarus, but its low sensitivity increases the risk of false–negative results and delayed therapy initiation, which is associated with additional costs of treating progressive disease.
Objective: to evaluate the economic efficiency of whole–body low–dose computed tomography (LDCT) compared with skeletal radiography in patients with MM.
The study included 189 patients: 131 with confirmed MM (main group) and 58 with monoclonal gammopathy (comparison group), all of whom underwent whole–body LDCT. Economic efficiency of LDCT versus skeletal radiography was assessed using methodologies of the Ministry of Health of the Republic of Belarus: direct unit and annual cost savings, a costeffectiveness ratio, and a medical efficacy coefficient (Km) were calculated.
A full skeletal radiography protocol includes 17–23 images, takes 60-90 minutes, and requires 15,6 conventional staff time units; whole–body LDCT is performed as a single 8–12 min study requiring 7,0 conventional time units. Whole-body LDCT outperforms skeletal radiography in diagnostic accuracy (sensitivity 78,6% vs ~50% per the literature) and economically justified compared with skeletal radiography: it provides higher medical efficacy (Km 0,61 vs 0,22), a 5,86–fold lower cost per unit of medical effect, a 55,1% reduction in staff workload, and an approximately 7,5–fold reduction in examination time, along with avoidance of costs associated with treating advanced MM complications. Timely detection of MM complications by LDCT was noted in 62 MM patients (47,3%), and clinically significant comorbidity in 69 MM patients (52,7%).

Endothelial-to-mesenchymal transition (EndMT) represents one of the key mechanisms underlying endothelial cell transformation and contributes to the development of pulmonary fibrotic remodeling. The regulation of this process may involve alterations in the expression of bone morphogenetic proteins (BMPs); however, the expression dynamics of BMP family members during EndMT remain insufficiently characterized. The aim of this study was to investigate the temporal changes in BMP2 and BMP7 gene expression during the induction of endothelial-to-mesenchymal transition in human umbilical vein endothelial cells (HUVEC). The study was performed using primary HUVEC cultures at passage 3. EndMT was induced by treatment with recombinant TGF-β1 (0,5 ng/mL). Functional alterations in cell behavior were assessed using the scratch wound healing assay. The expression levels of BMP2, BMP7, α-SMA, and TGF-β genes were determined by quantitative real-time polymerase chain reaction (qRT-PCR). Statistical analysis was performed using the nonparametric Mann–Whitney U test and Kruskal–Wallis test. TGF-β1 stimulation resulted in a significant reduction in endothelial cell migratory activity. The progression of EndMT was accompanied by a gradual increase in BMP2 and α-SMA expression, along with a pronounced suppression of BMP7 expression. The most prominent molecular changes were observed after 48 h of stimulation and reached their maximum intensity by day 7. These findings demonstrate the differential regulation of BMP2 and BMP7 during EndMT and suggest that an imbalance in BMP gene expression contributes to the acquisition of a mesenchymal phenotype by endothelial cells.

Plasma cell neoplasms (PN) are a group of diseases, the main representatives of which are multiple myeloma (MM) and its asymptomatic predecessor, monoclonal gammopathy of undetermined significance (MGUS). PN are accompanied by various genetic abnormalities that arise at different stages of the disease. The most common of these include alterations in the cell cycle genes of the MAPK signaling pathway and DNA/RNA repair. This study presents the prevalence of KRAS, NRAS, and BRAF gene mutations and ATM and DIS3 gene polymorphisms in patients with newly diagnosed MM and MGUS.

Exercise-guided single-photon emission computed tomography (SPECT) of the myocardium is a promising modern technique for assessing myocardial perfusion. This method allows for the evaluation of regional and global contractility, the identification of perfusion defects, the determination of cardiomyocyte viability in the ischemic zone, and the characterization of metabolic and innervational processes in the myocardium. The objective of this article is to evaluate, based on a clinical case, the role of exercise-guided SPECT for assessing abnormalities in the diagnosis of coronary artery disease in patients with chronic obstructive pulmonary disease. The obtained data show that the use of single-photon myocardial perfusion scintigraphy with stress in patients with COPD is clinically justified: it provides reliable stratification of the risk of coronary heart disease, allows verification of right ventricular dysfunction and can serve as a guide for the choice of revascularization tactics, which is especially important in patients with significant pulmonary pathology.

Hypertension is one of the most prevalent non-communicable diseases worldwide and a leading risk factor for cardiovascular morbidity and mortality. Industrial workers, particularly those exposed to unfavorable working conditions and high work intensity, may be at increased risk. However, evidence on hypertension among industrial workers operating under tropical hot and humid conditions remains limited.
We aimed to determine the prevalence of hypertension and analyze associated factors among steel workers and ceramic tile workers in Vietnam.
A cross-sectional descriptive study was conducted in 2022 among 1 228 production workers from two industrial enterprises, including 836 steel workers and 392 ceramic tile workers. Blood pressure was measured using a standardized protocol. Structured interviews were used to collect information on sociodemographic characteristics, working conditions, job stress, smoking, and alcohol consumption. Hypertension was defined according to Vietnamese Ministry of Health guidelines. Data were analyzed using descriptive statistics and binary analyses to estimate crude odds ratios (ORs) with 95% confidence intervals (95% CIs).
The overall prevalence of hypertension was 22,3%. Ceramic tile workers exhibited a higher prevalence of hypertension (39,8%) compared with steel workers (14,1%) (p < 0.001). Workers aged ≥35 years had a higher likelihood of hypertension than those aged <35 years (OR = 2,2; 95% CI: 1,71–2,95). Similarly, workers with a working duration of ≥10 years were more likely to have hypertension than those with <10 years of employment (OR = 3,6; 95% CI: 2,70–4,85). High proportions of workers reported smoking and harmful alcohol consumption in both occupational groups.
Conclusion. Hypertension represents an important occupational health problem among industrial workers in Vietnam, particularly among older workers and those with longer working duration, highlighting the potential role of prolonged exposure to unfavorable working conditions in tropical industrial settings.

This article presents a review of the literature on the causes and mechanisms of the discrepancy between the degree of narrowing of the internal carotid artery and the severity of visual impairment. A clinical case of preserved visual function in a patient with hemodynamically significant stenosis of the internal carotid artery is presented. The relevance of this study is due to the fact that the degree of stenotic damage to the main arteries of the head does not always correspond to the severity of clinical manifestations in the organ of vision, which complicates the prediction of the functional state of the visual analyzer. Particular attention is paid to the results of a comprehensive ophthalmological examination and an assessment of the vascular bed of the brachiocephalic arteries. This observation demonstrates that even with severe stenotic damage to the internal carotid artery, high visual function can be preserved and significant structural and functional changes in the visual analyzer can be absent. The data obtained demonstrate the important role of individual compensatory mechanisms in maintaining adequate perfusion of the ocular tissues and optic nerve. The results of the study expand our understanding of the mechanisms of preservation of visual functions in pathology of the carotid arteries and confirm the importance of collateral circulation in maintaining the functional capacity of the visual analyzer.