Background. Omalizumab, a recombinant humanized anti-IgE antibody, is an effective treatment option for patients with antihistamine-resistant chronic spontaneous urticaria (CSU). 14–36 % of CSU patients have concomitant chronic inducible urticaria (CIndU). However, it is unclear whether CSU patients with comorbid CIndU can benefit from this treatment.

Aim of the study. To assess the efficacy and safety of omalizumab in two patients with CSU and several of types of concomitant CIndU.

Materials and methods. CSU and CIndU were diagnosed as recommended by the international urticaria guideline. Both female patients were treated with omalizumab 300 mg by subcutaneous injection every 4 weeks. Response to treatment was assessed by a carefully determined history, the urticaria activity score, urticaria control test, and results of provocation testing.

Results. Symptoms of both CSU and CIndU decreased dramatically during the first week of treatment. No adverse events were documented.

Conclusions. Omalizumab may be an effective treatment option for patients with combination of antihistamine-resistant CSU and concomitant CIndU. Our findings should be confirmed in larger prospective studies.

The prevalence of latex allergy among representatives of the Russian medical community is estimated lower (1.9 – 3.8 %) than in the world as a whole (9.7 %), although the incidence of skin, respiratory and other symptoms after contact with latex gloves varies in the range from 18.8 to 35 %. Accurate assessment of differentiated reactions in mediators is hindered by the very rare reference of Russian researchers to the topic of latex allergy. Its prevention is not among the priorities of practical public health, as evidenced by the lack of professional pathology of the skin and upper respiratory tract pathways of latex genesis in the list of occupational diseases, as well as the low level of quality requirements for personal protective equipment for doctors when choosing and purchasing medical gloves. It justifies the need to introduce into practice a number of measures for the prevention and management of latex allergy among health workers: identifying risk groups, verifying diagnosis, providing recommendations on safety management, studying differentiated needs and searching for possible options to meet them.

Long QT interval syndrome (LQTS) is a disease that causes life-threatening arrhythmias and sudden death syndrome. Recently, it has been shown that about half of patients with LQTS have normal QTc interval values on an ECG. The purpose of this study was to assess changes in the QT interval in patients with LQTS in orthostasis to identify additional criteria for the disease. Surveyed 64 patients from 4 to 47 years old (13.3 ± 10.0) with LQTIS. The control group consisted of 87 healthy people of 4–20 years (11.0 ± 3.5). An ECG was performed in a lying and standing position. HR, QT and QTc interrvals in both positions and the difference between these indicators were evaluated. In both groups, we noted an increase in heart rate and QTc and a shortening of the QT interval in orthostasis. Distinctions between all parameters were revealed reliably, except for the increase in the QTc interval (∆QTc) in the main and control groups. ROC analysis revealed that the optimal point for identifying patients with LQTS is QTc interval in orthostasis –500 ms with Se 73 % and Sp 93 %. Conclusions. In the early period of orthostasis, an increase in the heart rate, a shortening of the QT interval and a prolongation of the QTc interval occur; lengthening the QTc interval in the early period of orthostasis over 500 ms is highly sensitive and highly specific in identifying patients with the syndrome of prolonged QT-interval.

The article presents the results of a cluster analysis of the contribution of immune inflammationmarkers and endothelial dysfunction (ED) to the cardiovascular complicationsfrequency and severity in cohorts of patients with asymptomatic atherosclerosis (AAS), coronary artery disease (CAD), tyepe 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) during 3 years of prospective observation. A comparative analysis of the spectrum of the examined markers was performed depending on the stage of the development of the disease, the presence of T2DM and the MS. It was revealed that the greatest contribution to the cardiovascular complications development in AAS is provided by such circulating markers of ED and immune inflammation as ET-1, IL-1β, TNF-α, total autoantibodies to type I and III collagen (a-Coll) and to Chondroitine-sulfate (a-ChS). With IHD, the greatest contribution is provided by ET-1, eNOs, antibodies a-Coll and also IL-6 and vWf.In T2DM patients without CAD, a profile of markers associated with the high rate of adverse events includes ET-1, eNOs, IL-6, a-Coll and antibodies against hyaluronic acid (a-HA). In a cohort of patients with chronic CAD in the setting of T2DM, a profile of markers associated with the development of adverse events includes vWf, TNF-α, as well as the level of eNOs, IL-6, a-Coll, a-HA and CRP. In the cases of AAS without concomitant MS, the greatest contribution is due to the increase in the level of ET-1, vWf, a-Coll and a-ChS content; in the presence of MS — IL-1β, TNF-α, a-Coll, anti-ChS, anti-HA and CRP. In CAD without MS profile of markers associated with the development of adverse events, includes ET-1, eNOs and a-HA, the presence of the MS — a-Coll, ET-1 and IL-6 levels.

Considering the widespread use of mobile phones, cellular communication systems wide coverage of the territory of the Russian Federation, the free or low cost of mobile applications for assessing motor activity, convenient interface and high accuracy of measurements of the apps; the usage of the modern technologies while involving underwent myocardial infarction patients into rehabilitation programs could increase the percentage of these programs participants and improve the results obtained during the implementation of the programs.

Research goal. assessment of the impact of the usage of mobile applications, that could monitor the level of motor activity, on the results of a six-minute walk test (6 MWT) among the patients with myocardial infarction who were on the second stage of cardiac rehabilitation.

Materials and methods. Materials and methods: 224 patients were examined: 99 (44.2 %) men and 125 (55.8 %) women aged 60.6 ± 11.5 years, who had had myocardial infarction from 6 days to 6 months ago (median 16 [10; 139] days), which passed the second stage of rehabilitation for 11.6 ± 1.4 days in the conditions of the specialized cardiology department of the Resort-hotel ‘Sosnovka’ (Berdsk, Russia). At the time of admission, in the middle of the rehabilitation course (on the 6th day) and before discharge (on the 12th day), a six-minute walk (6 MWT) test was performed (6 MWT1, 6 MWT2 and 6 MWT3, respectively). Changes in these parameters over time were estimated as the difference between the second and first 6 MWT, the third and first 6 MWT test results, and compared in two groups.

Results obtained. The results of 6 MWT1 performed on admission of patients to the department did not differ between the two groups (F = 3.068; p = 0.81). 6 MWT2, conducted on average one week after the start of the second stage of the cardio-rehabilitation program revealed a statistically significant difference between the groups (F = 21.758; p < 0.001), which became more visible when 6 MWT3 was conducted at the end of the second week in the department (F = 66.615; p < 0.001), indicating the advantages of the group using the mobile application.

Conclusion. The active introduction of mobile applications into real clinical practice effectively, non-invasively, does not require additional financial investments from the health care system and personal time of the doctor, being a positive determinant of the preventive behavior of patients.

The work performed on the operating material. A morphological study of the parathyroid glands removed in 128 patients with hyperparathyroidism was performed. For the histological study pieces of the parathyroid gland were taken. The pieces were fixed in 10 % buffered formalin for 10 days, then washed in running water, passed through a processor and embedded in paraffin. From paraffin blocks, sections of 5–6 µm were prepared. Sections were stained with hematoxylin and eosin, pikrofuksin according to Van Gieson, toluidine blue, according to Mallory, used CHIC-reaction. The results of the study showed that primary hypothyroidism is more common in women (82 %) aged 41–50 years (42.2 %). The size of the parathyroid glands ranged from 0.3 to 8.2 cm. Adenomas were found in 51.6 % of patients, hyperplasia in 43.0 %, cancer in 5.4 % of them. In primary hyperplasia, there is an increase in all parathyroid glands, upper pair or lower pair. Upper pairs are increased more. Histological examination indicates lobular structure of the gland, lobular hyperplasia, diffuse proliferation of the main, acidophilic and transitional forms of parathyrocytes, monomorphic structure, reduction or absence of stromal fat, the presence of a large number of vessels. Hyperplasia of the main cells was detected in 67 % of patients, hyperplasia of acidophilic cells in 28 %, hyperplasia of light cells in 3 %, mixed hyperplasia in 2 % of them.

The article discusses the features of the modern legal framework for the use of innovative telemedicine technologies in the country’s healthcare system. The situation with the introduction of telemedicine in clinical practice and educational process is shown. The most priority and effective from the standpoint of evidence-based medicine and economics are the directions for the use of telemedicine technologies.

This paper describes the task of authentication of bone turnover indicators using the developed method of building a decision support system based on an artificial neural network. A method has been developed for the calculation of risk determinants, which helps the physician in early diagnosis to make an informed decision, based on the identification of changes in bone turnover that increased risk of fragility fractures in diabetes mellitus.

Сystic fibrosis is an autosomal recessive hereditary multisystem disease which is characterized by severe exocrine pancreatic insufficiency, chronic lung disease, and protein-energy malnutrition. Some studies have indicated that the body mass index is an independent factor which adversely affected survival of patients with cystic fibrosis. There is a direct correlation between body mass index, lung function and life expectancy. Objective. To determine the effectiveness and tolerability of the product for children’s dietary nutrition ‘NUTRINIdrink with dietary fibre (neutral taste)’ for children over one year of age for enteral nutrition in cystic fibrosis complicated by protein-energy deficiency.