Atherosclerosis (AS) is a multifactorial disease leading to increased cardiovascular risks. Currently, the diagnosis of AS is limited to imaging methods of atherosclerotic plaque assessment and laboratory methods of dyslipidemia diagnosis, which do not provide an understanding of the activity of processes occurring in the atherosclerotic plaque. The aim of this review: to generate potential markers of AS activity. Macrophages play an important role in atherogenesis. Macrophages have several phenotypes, determining which can be concluded about the activity of the inflammatory process in the plaque. Genetic markers, such as microRNAs, circular RNAs and factors regulating their expression, play an important role in the development of atherosclerosis. Methods of flow cytometry, PCR and sequencing are promising for studying these markers. Markers of atherogenesis activity are essential in diagnosis, as well as in the choice of personalized treatment of patients.

The use of the method of visualization of multidimensional connections, as an auxiliary method in the analysis of the obtained laboratory data, significantly increases their informativeness. At the same time, it becomes possible to identify the leading factors that influence the overall structure of the ratios of the indicators of the selected panel and their «relationship» with each other. This paper presents the results of a discussion of the connections obtained using the method of visualization of multidimensional connections inside the panel of electrolyte ratios, demonstrating the possibility of identifying functional relationships of bone metabolism and hypocalcemia. At the same time, the authors, including, provide individual observations in which, against the background of normal calcium indicators, relationship are recorded indicating a marked decrease in its functional activity. The authors suggest that a highly significant negative (correlation coefficient) effect of calcium in the integral panel of the electrolyte ratio at its normal values reveal the manifestation of intense individual adaptive adjustment in the network of factors supporting the physiological values of the ion. However, it prolonged predominance can lead to the occurrence of certain disorders, including bone metabolism. It is concluded that the definition of a complex of multidimensional relationships in individual cases will allow not only to personalize the differential diagnosis of hypocalcemia, but also to choose targets for targeted therapy and subsequent monitoring of the effectiveness of the treatment.

The increased level of CA-125 in the vast majority of cases is associated with the pathological process of both oncological and non-oncological etiology. Encouraging data on the clinical informativeness of CA-125 and the simplicity of its laboratory determination are the reason for a long-term discussion about the use of this marker not only for assessing the dynamics of ovarian cancer, but also in population screening, as well as in personalized monitoring of women’s health. The article substantiates the inclusion of CA-125 in algorithms for personalized monitoring of women’s health and modern aspects of post-analytical evaluation of test results: assessment of measurement uncertainty, identification of reliable dynamics between successive results and the use of multiple boundaries of clinical decision. The form of a detailed report on the performed laboratory study is proposed.

Retinal vascular occlusion is a severe vascular condition of the retina, leading to a significant decrease in vision and blindness. Endothelial dysfunction plays a pathogenetically important role in the development of thrombosis. The aim of this study was to quantify biomarkers of endothelial dysfunction. The content of VEGF tear fluid and serum homocysteine was studied in 3 groups – in group I (patients with occlusion of the central retinal vein), group II (patients with occlusion of the central retinal artery) and control group (patients without vascular disorders). The groups were comparable in gender and age. The results showed an increased content of VEGF and homocysteine in patients with the central artery of the retina occlusion. The content of markers in patients with the central artery of the retina occlusion was significantly lower than group I, but significantly higher than the control group. The results show the involvement of the endothelium in the local thrombotic process.

The relevance of the study. In modern realities, Russian medical laboratories often get into a situation where there is a need to replace the analytical system due to a physical deterioration of the equipment or the analytical characteristics improvement, as well as medical devices out of stock [1]. Problems with delivery schedules and timely maintenance, or lack of finances lead to a situation to choose a new supplier of equipment and reagents. As a rule, the main comparison criterion is the cost of analysis in this case. It isn’t easy to determine the relationship between the analytical characteristics (trueness, accuracy, precision) presented by the manufacturer and risk for patient safety.
Objectives. The purpose of the study is to show the importance of precision in the risk of laboratory error, and also to develop a practical approach to use imprecision as a criterion for choosing an analytical system from the point of view of patient safety.
Materials and methods. The manufacturer’s characteristics of real analytical systems were used in the study. For the risks calculations, a mathematical model was developed that allows one to compare the tests imprecision and the expected number of unreal results in the period from the analytical system defect occurrence to the detection of it in the internal quality control (IQC) procedure.
Results. Mathematical modeling has shown that significant disfunction of the studied analytical systems, with a signal shift of 10 %, can be detected in the first control point after defect occurrence in 10–20 % of cases only. It means that the IQC procedure is able to identify an error with a delay of 1–2 weeks. During this time, unreliable results can be reported. The expected number of unreal results for some tests (FT3, FT4, Testosterone, 25-hydroxyvitamin D) can reach up to 50 % of all reported results.
Conclusions. The mathematical modeling in the analytical systems functionality estimation made it possible to calculate the risk of a laboratory error before their implementation in laboratory practice at the procurement planning stage, for example. Test CV published by the Manufacturer were successfully used as an evaluation criterion. The high imprecision of the tests may compromise the patients’ safety of their use.

Introduction. Anemia is the most frequent hematological pathology in patients with liver disease. The combination of pathogenetic factors leads to the iron deficiency anemia (IDA) – the most common type of anemia; anemia of chronic diseases (ACD), B 12 and folate deficiency anemia (ACA), hemolytic and aplastic anemia. Full examination is a necessary component that will make form an algorithm treatment aimed at the leading pathogenetic mechanism of anemia.
Materials and methods. 44 people with cirrhosis were examined: 15 women, 29 men aged from 30 to 70 years. All patients were divided into groups in accordance with the established type of anemia: iron deficiency anemia (IDA), anemia of chronic diseases (ACD) and a combination of IDA and ACD), as well as by the type of therapy performed (therapy with iron preparations, therapy with B vitamins and treatment only of the underlying disease).
Results. A comparative analysis of blood parameters was performed before and after the treatment. A clinically significant increase in hemoglobin and erythrocytes was not observed in any of the studied groups. A statistically significant increase in hematocrit and erythrocyte indices in the IDA group was revealed as a result of the use of iron preparations. When comparing oral and parenteral types of iron preparations in patients with IDA, the effect of therapy was similar without advantages in any of the groups. In the groups of ACD and ACD + IDA were no significant changes in the indices of the red hematopoietic line were revealed in any of the therapy options.
Conclusion. Treatment of the underlying disease alone is not enough to restore hemoglobin. Iron therapy, regardless of the form of administration, can be effective in patients with IDA. Vitamin therapy can only be used as an adjunct in the treatment of anemia. Further monitoring is needed to develop a more effective therapy protocol.

Drug resistance to Plasmodium falciparum is a leading cause of ineffective etiotropic therapy for tropical malaria in non-immune individuals returning from regions endemic for this infection. Genetic markers of resistance to major antimalarial drugs are single nucleotide polymorphisms of genes such as PfCRT, PfMDR 1, PfDHFR, PfDHPS, PfATP6, and PfKelch 13, which encode key proteins involved in the metabolism parasites cells. PCR-based methods using alternative primer technology and real-time PCR were used to examine venous blood samples from 63 tropical malaria patients treated in infectious diseases hospitals in St. Petersburg during 2018–2023. The study found that the most frequently detected genetic markers of P. falciparum drug resistance in patients blood samples with imported tropical malaria were S 1034C (58.7 %), A578S (55.56 %) and S 108N (49.21 %). The D 1246Y (4.76 %) and A630S (6.35 %) mutations were less frequent. The majority of cases showed mutations in the PfMDR 1 gene (over 76 %). Polymorphisms in the PfATP6 and PfCRT genes were detected in 32 % and 14 % of cases, respectively. In most cases, markers of parasite resistance to mefloquine and its derivatives were present (about 80 %). The proportion of P. falciparum resistance markers to artemisinin and its derivatives was about 63.5 %, and to sulfadoxine-pyrimethamine, less than 10 %. The study found that 39 % of cases showed genetic markers of resistance to both mefloquine and artemisinin, while 35 % of cases showed resistance to both mefloquine and sulfadoxine. Therefore, it is recommended to prescribe combination drugs with different mechanisms of pharmacological action for the treatment in each specific case of tropical malaria. Combining this approach with laboratory methods for early determination of the malaria drug resistance will reduce the latal cases.

The article analyzes the basic requirements for organizing post-marketing surveillance of medical devices for in vitro diagnostics in the Russian Federation. The author’s position on the key roles of participants in the surveillance, including the manufacturer of medical devices, medical laboratories and medical organizations, is given, and the main issues that need to be addressed when developing a post-marketing surveillance program are identified.

For the purpose of studying the diagnostic effectiveness of the Sedimentum lateritium phenomenon, known since the XVI century, on the basis of a formed laboratory model for registering the formation of sediment in urine during cooling – a cold urine sample (CPM), by methods of dynamic light scattering and Z-potential measurement, the mechanism of formation of “cryogel” in urine during polymerization of pathological isoforms of uromodulin (UMD) was verified, characteristic of patients with urolithiasis.
As a result of the analysis of a “non-core” cohort of individuals with cardiological and pulmonological profiles, the described sol-gel phase transition was detected with a frequency of 21–31 %, respectively. A hypothesis has been put forward about comorbidity due to the metabolism of various UMD isoforms: in urolithiasis, as a result of violations of apical posttranslational processing of oligo-polymer isoforms of UMD and, as a result of exposure to xenobiotics and damage to intracellular metabolism with destruction of the basement membrane and the release of monomeric isoforms of UMD into the interstitium of the kidneys, initiating inflammation and subsequent fibrosis with increased intrarenal pressure, reducing GFR, i. e. the development of CKD.
Conclusion: the described biophysical technology can be considered as a screening method for preclinical verification of the cascade of metabolic consequences along the “cardio-hepatorenal” continuum that forms the comorbidity of diseases in the population.

It is assumed that the formation and persistence of immunity to SARS-CoV-2 may depend on the immune status of other infections caused by human coronaviruses (HCoV), called seasonal: HCoV-OC 43, HCoV-HKU 1, HCoV-229E, HCoV-NL63. These viruses are ubiquitous and typically cause mild to moderate seasonal respiratory illness. A comparative analysis of the main structural, functional, clinical and epidemiological characteristics of seasonal HCoV and SARS-CoV-2 is presented in the review. Systematization of this information in combination with data on cross-immunity to different HCoV may make it possible to identify factors of immunity to SARS-CoV-2 and take them into account when improving the strategy for sanitary and epidemiological control of COVID-19.

Purpose. To evaluate the effect of comorbidity on annexin A5 levels in patients with SARS-CоV-2 associated viral pneumonia.
Materials and Methods. We examined 90 patients diagnosed with coronavirus infection COVID-19 (virus identified), who were treated as inpatients in an infectious disease hospital. According to the results of computed tomography of the chest organs, 76 (84.4 %) patients had III degree of lung lesions, 14 (15.6 %) – IV degree. 84.4 % of patients were comorbid. The level of annexin A5 (ng/ml) in serum was studied by enzyme immunoassay method using ELISA Kit for Annexin A5 immunoenzyme reaction analyzer, produced by Cloud-Clone Corp. (USA). Statistical processing of the data was performed using the SPSS 26.0 program package.
Results of the study. 84,4 % of patients with SARS-CоV-2 associated pneumonia had significant cardiovascular, pulmonary or endocrine pathology. 50 % of the subjects had type II diabetes mellitus. Annexin A5 levels were statistically significantly higher in comorbid patients than in patients without comorbidities. The level of annexin A5 in those with multiple comorbidities was significantly higher than in those with 1–2 comorbidities. A direct correlation of moderate strength between the level of annexin A5 and the number of pathologic conditions present in the patient was revealed (0,437, p<0,001).
Conclusion: The obtained results indicate the necessity to take into account the presence of comorbidity and its nosologic forms when studying apoptotic processes in patients with SARS-CоV-2-associated pneumonia.  

The study of the properties of vitamin D and its properties in the human body continues to pose new challenges for clinicians and researchers. In the modern world, the optimal dose of vitamin D should ensure not only the maintenance of the skeletal system and mineral metabolism, but also prevent a large number of other nosologies that are not “classical” for vitamin D. The article discusses controversial issues of selection of preventive and therapeutic doses, measures to maintain the general health of the population of all age groups.