Diabetes mellitus is a chronic disease with a growing prevalence worldwide, however, the prevalence of its complications, including gastroenteropathy, is also increasing. The pathophysiology of diabetic gastroenteropathy (DH) combines hyperglycemia, vagus nerve dysfunction, decreased expression of nitric oxide synthase in the myenteric plexus, changes in the interstitial Cajal cell network, as well as oxidative stress. Clinical signs of DH are gastroesophageal reflux, gastroparesis, constipation, abdominal pain and diarrhea. Among the diagnostic methods are manometry with pH measurement (assessment of esophageal motility), gastric emptying scintigraphy, respiratory test (to assess gastroparesis), aspiration and cultivation of the contents of the jejunum (to diagnose bacterial overgrowth syndrome). To date, there is no definitive treatment for DH — an interdisciplinary approach is aimed at slowing the progression of the disease, relieving symptoms and restoring gastrointestinal function. Patients are recommended a diet low in simple sugars and high in fiber; optimization of glycemic control with a target glycemia of less than 180 mg/dl. As for drug therapy, the use of prokinetics and antiemetics is justified, and in case of excessive bacterial growth syndrome, antibacterial therapy (rifaximin) is carried out. Modern approaches to the treatment of DH are also accumulating, including the use of botulinum toxin, pyloroplasty and electrical stimulation of the stomach in individual patients. Despite the constant development of new treatments, they are not yet able to completely cure DH in the near future, which makes it necessary to conduct further research in this area.

Alzheimer’s disease (AD) is a neurodegenerative disease that causes dementia in half of the cases. Asthma is usually found in people over 65 years of age. The etiopathogenesis of the disease is multifactorial and includes genetic factors, nutritional disorders, mitochondrial dysfunction, oxidative stress, and aging. Sex hormones have an important influence on the development of AD, as evidenced by a higher incidence in women than in men. Considering the significant influence of T on the maintenance of normal brain function, the present study is aimed at evaluating the impact of androgen deprivation therapy (ADT), as well as testosterone therapy, on the risk of AD development and progression. Although there is some clinical inconsistency between studies, androgens have a significant effect on brain function and are beneficial for AD patients. Low levels of circulating androgens should be considered as a significant risk factor for the development of AD and memory loss. With a reduced level of T in the plasma of men, its administration improves cognitive performance and memory, treatment should be started at an early stage of the disease. In men and women with AD, androgens improve mental state and slow the progression of the disease, providing a protective effect. In the future, it is necessary to conduct studies on a large population, taking into account personality factors and a more specific approach to assessing cognitive functions and the causal relationship of T administration in AD.

There is data on the irrational use of antimicrobial drugs in pediatric population during the COVID-19 pandemic. This could lead to potential development of antibiotic resistance and increased morbidity and mortality among this vulnerable population group. The aim of this review is to study the role of COVID-19 in antimicrobial drugs administration and antibiotic resistance development, as well as to determine a set of measures for its prevention. Recent studies results have shown that COVID-19 pandemic had both direct and indirect impact on antibiotic resistance development in pediatric population. The COVID-19 outbreak has revealed weaknesses in health systems around the world. Antibiotics administration in patients with coronavirus infection during this period exceeded the number of cases with bacterial co-infection or other diseases. Thus, it indicates irrational antibiotic treatment. There were cases of inappropriate antibiotics administration during the crisis caused by the COVID-19 pandemic even in regions with long-term rational antibiotic treatment programs. One of the most viable methods to combat antibiotic resistance is to improve approaches in health care and to increase preparedness to infectious outbreaks. Increasing clinical competence of medical workers, accessibility of medical facilities, permanent supply of high-quality and cheap antibiotics, vaccines, reducing COVID-19 testing time, and adequate administration of antibacterial agents are the measures that can prevent diseases caused by drug resistance. All stakeholders (health authorities, regulating authorities, politicians, scientific community, pharmaceutical companies) have to collaborate and achieve results to implement all the mentioned above protection measures.

No abstract

Известно, что при любом травматическом воздействии происходит ряд изменений в органах иммунной системы, чаще всего развивается иммунная недостаточность, которая обусловлена уменьшением количества клеток, а также дисбалансом в механизмах иммунорегуляции. Цель исследования -изучить динамику изменения гистоморфометрических характеристик селезенки крыс в процессе регенерации кожно-мышечного повреждения при механической травме бедра. В эксперименте нами были использованы 84 половозрелые крысы, которые имели массу тела 250-300 г. Мы разделили животных на 2 группы: 1 -контрольная (n=12), 2 -экспериментальная (n=72). Механическое повреждение, на задней лапе справа в области бедра, наносили с использованием установки, способной дозированно передавать тканям кинетическую энергию, сопоставимую с силой удара винтовки калибра 5,6 мм. Далее животные были разделены на 4 подгруппы в зависимости от времени, прошедшего с момента нанесения механического повреждения: 1 -1 сутки; 2 -3 суток; 3 -15 суток; 4 -25 суток. Полученные нами данные свидетельствуют о том, что в фазах альтерации и острого воспаления происходит опустошение лимфатических фолликул, в частности снижение содержания средних и малых лимфоцитов, что свидетельствует о реакции селезенки на воспалительный процесс и активации гуморального и клеточного иммунитета, а также о состоянии иммунодепрессии. Снижение содержания малых лимфоцитов селезенки свидетельствует об активации пролиферативной активности клеток. Экспериментальная травмафизический стресс, по-видимому, влияет на развитие Т-зон и В-зон белой пульпы селезенки, вызывая их дегенерацию. Увеличение содержания больших лимфоцитов может свидетельствовать об активации лимфоцитарного звена лимфопоэза. Уменьшение объема белой пульпы при воздействии физического стрессора обусловлено дегенерацией Т-и В-клеточных субкомпартментов: уменьшением размеров и числа лимфоидных узелков, редукцией периартериальной и мантийной зон и вокруг лимфоидных узелков, что является проявлением зависимости топографии стрессассоциированных сдвигов в иммуноархитектонике селезенки. Полученные нами данные могут использоваться в судебно-медицинской практике с целью определения давности нанесения повреждений. Ключевые слова: селезенка, давность повреждений, судебно-медицинская экспертиза, гистоморфометрическая характеристика, гистология.