The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 has become a serious challenge for medicine and science. Analysis of the molecular mechanisms associated with the clinical manifestations and severity of COVID-19 has identified several key points of immune dysregulation observed in SARS-CoV-2 infection. For diabetic patients, factors including higher binding affinity and virus penetration, decreased virus clearance and decreased T cell function, increased susceptibility to hyperinflammation, and cytokine storm may make these patients susceptible to a more severe course of COVID-19 disease. Metabolic changes induced by diabetes, especially hyperglycemia, can directly affect the immunometabolism of lymphocytes in part by affecting the activity of the mTOR protein kinase signaling pathway. High mTOR activity can enhance the progression of diabetes due to the activation of effector proinflammatory subpopulations of lymphocytes and, conversely, low activity promotes the differentiation of T-regulatory cells. Interestingly, metformin, an extensively used antidiabetic drug, inhibits mTOR by affecting the activity of AMPK. Therefore, activation of AMPK and/or inhibition of the mTOR-mediated signaling pathway may be an important new target for drug therapy in COVID-19 cases mostly by reducing the level of pro-inflammatory signaling and cytokine storm. These suggestions have been partially confirmed by several retrospective analyzes of patients with diabetes mellitus hospitalized for severe COVID-19.

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is an ongoing global public health challenge. Current clinical data suggest that, in COVID-19 patients, arterial hypertension (AH) is one of the most common cardiovascular comorbidities; it can worsen outcomes and increase the risk of admission to intensive care unit (ICU). The exact mechanisms through which AH contributes to the poor prognosis in COVID-19 are not yet clear. The putative relationship between AH and COVID-19 may be linked to the role of angiotensin-converting enzyme 2 (ACE2), a key element of the AH pathophysiology. Another mechanism connecting AH and COVID-19 is the dysregulation of the immune system resulting in a cytokine storm, mediated by an imbalanced response of T helper cells subtypes. Therefore, it is essential to optimize blood pressure control in hypertensive patients and monitor them carefully for cardiovascular and other complications for the duration of COVID-19 infection. The question whether AH-linked ACE2 gene polymorphisms increase the risk and/or worsen the course of SARS-CoV-2 infection should also receive further consideration.

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Introduction. Prostate cancer (PC) accounts for about 12% of all malignancies in men. Over the last 10 years, there has been a significant increase in the incidence of this tumor, as evidenced by statistics. Objectives. The purpose of this study was to analyze the dynamics of PC morbidity and mortality rate in Ukraine and its regions in recent years. Materials and methods. The analysis of PC morbidity and mortality rates in Ukraine was performed in accordance with the 1999-2012 Bulletin of the National Cancer Registry of Ukraine. The following indicators were analyzed: raw (average) morbidity and mortality indicators standardized by age, world standard population that is widely used for indicator comparison across countries, Ukrainian standard population calculated based on the age structure of the Ukrainian population. Results. The 1999-2018 analysis of the dynamics of prostate cancer incidence showed its growth both in Ukraine in general and in each region separately. In 1999, the incidence rate (world standard) for prostate cancer in Ukraine was 9.3 and in 2018 it was 22.1. The 1999-2018 analysis of the dynamics of mortality rate due to prostate cancer showed a clear trend towards its growth in Ukraine in general and in each region separately. In 1999, the mortality rate (world standard) due to prostate cancer in Ukraine was 2.7 and in 2018 it was already 4.1. Conclusions. The study showed a clear incremental tendency towards increased morbidity and mortality in patients with PC in Ukraine and its regions in the period from 1999 to 2012. Herewith, some gender differences were observed - both figures were significantly higher among male patients than female. Continuous increment growth of morbidity and mortality rate in patients with PC requires the revision of protocols for diagnostics and treatment of such patients.

Purpose The goal of the study was an assessment of the diagnostic performance of diffusion-weighted images (DWI) and apparent diffusion coefficient (ADC) of magnetic resonance imaging (MRI) in distinguishing local recurrence (LR) of renal cell carcinoma (RCC) from benign conditions after partial nephrectomy. Material and methods Thirty-nine patients after partial nephrectomy for solid RCC were enrolled in the study. Patients were followed up using MRI, which included DWI sequence ( b = 800 s/mm 2 ). All patients with MRI features of LR were included in the main group ( n = 14) and patients without such features – into the group of comparison ( n = 25). Apparent diffusion coefficient (ADC) values of suspicious lesions were recorded. In all patients with signs of locally recurrent RCC, surgical treatment was performed followed by pathologic analysis. Results The mean ADC values of recurrent RCC demonstrated significantly higher numbers compared to benign fibrous tissues and were 1.64 ± 0.15 × 10 -3 mm 2 /s vs. 1.02 ± 0.26 × 10 -3 mm 2 /s ( p < 0.001). The mean ADC values of RCCs’ LR and benign post-op changes in renal scar substantially differed from mean ADC values of healthy kidneys’ parenchyma; the latter was 2.58 ± 0.05 × 10 -3 mm 2 /s ( p < 0.001). In ROC analysis, the use of ADC with a threshold value of 1.28 × 10 -3 mm 2 /s allowed us to differentiate local recurrence of RCC from benign postoperative changes with 100% sensitivity, 80% specificity, and accuracy: AUC = 0.980 ( p < 0.001). Conclusions The apparent diffusion coefficient of DWI of MRI can be used as a potential imaging marker for the diagnosis of local recurrence of RCC.