Collagen is a primary structural protein of connective tissue, accounting for over a quarter of all body proteins. Among 29 known collagen types, type II collagen is particularly significant as it forms the foundation of articular cartilage. Unlike hydrolyzed forms, native type II collagen (UC–II) maintains its original chemical structure, enabling it to function as an oral tolerance inducer. Clinical studies demonstrate effectiveness of UC–II in reducing inflammation, alleviating pain, and improving joint function in osteoarthritis and rheumatoid arthritis. A promising development direction involves marinederived collagen preparations with enhanced safety profiles. Large-scale studies are needed to optimize dosage regimens and administration methods.

The aim of the study. To determine the efficacy and safety of using the metabiotic biologically active food supplement «Bactimunal», including a combination of biologically active metabolites of Bacillus subtilis (B. subtilis) strain SA44 and short-chain fructooligosaccharides (scFOS, polyfructosans), prescribed additionally in treatment regimens for patients with inflammatory bowel diseases (IBD).

Materials and methods of the study. 80 patients with IBD were examined, the average age was 41.1±11.14 years, of which 40 (50%) patients with UC, and 40 (50%) with CD, 38 (47.5%) men, 42 (52.5%) women. All patients underwent assessment of clinical symptoms of the disease, venousblood and fecal samples were collected to assess the serum level of trefoil factor (TFF), lipopolysaccharides (LPS), fecal zonulin (FZ) and fecal calprotectin (FC). 40 patients with IBD (20 patients with UC and 20 patients with CD) received basic therapy. 40 patients with IBD (20 patients with UC and 20 patients with CD) received the metabiotic Bactimunal 1 capsule 2 times a day in addition to the basic treatment regimens for 28 days. The observation period for patients in both groups was 28 days, at the end of the observation, the severity of clinical symptoms and intestinal permeability markers (TFF, LPS and FC) were re-evaluated. Statistical data processing was performed using the SPSS (Statistical Package for the Social Sciences) program. Values of p<0.05 were accepted as statistically significant.

Results of the study. In UC, abdominal pain syndrome in the group of patients taking Bactimunal was noted by 15 (75%) patients before the start of adjuvant therapy, after – 9 (45%) (χ2 =2.604, p=0.05), in the group without Baсtimunal, abdominal pain was noted by 12 (60%) patients before treatment and 7 (35%) patients after (χ2 =0.004, p=0.48). In the group of patients with CD who additionally received Bactimunal, all 20 (100%) patients noted abdominal pain at the beginning of the observation, after 28 days, abdominal pain was felt by only 11 (55%) patients (χ2 =9.176, p=0.002). At the beginning of the observation, in the group without Bactimunal, abdominal pain was felt by 19 (95%) patients, and after 28 days it persisted in 18 (90%) patients. In patients with IBD who did not receive the metabiotic, the average pain intensity score before treatment was 2.55 points, after – 1.39 points (p>0.05). In IBD patients who received adjuvant therapy with Bactimunal, the average pain scores statistically significantly decreased – from 2.65 points at the beginning of the observation to 0.68 points after 28 days (p=0.025). During dynamic control after 28 days, the frequency of bowel movements decreased in both groups (mean frequency 2.74±0.84 bowel movements/day), statistically significant differences between the groups receiving and not receiving Bactimunal were not revealed (p>0.05). In patients who additionally took Bactimunal, the decrease in the scores of urgencies to defecate in both UC and CD was statistically significantly greater than in patients who did not receive the dietary supplement. In patients with IBD from the group receiving additional therapy with Bactimunal, a statistically significant decrease in the frequency of occurrence and severity of flatulence was noted after 28 days compared to patients in the group not receiving the dietary supplement. In all patients with IBD laboratory markers reflecting the state of the mucosal barrier of the gastrointestinal tract were significantly elevated upon inclusion in the study. In IBD patients additionally receiving Bactimunal in their treatment regimens, a decrease in the average TFF level was registered after 28 days of observation. When assessing the LPS indicators, multidirectional changes were obtained. Normalization of FC concentration occurred in 32 (80%) IBD patients taking Bactimunal, compared with 8 (20%) patients who did not receive Bactimunal as adjuvant therapy (OR=1.5; 95% CI 1.4–3.7; p=0.05) (Table 5). In patients with mild IBD, a decrease in the FC level was observed in 62.5% patients taking Bactimunal, in another group of patients, a decrease in the FC level was noted in 38.5% patients (OR=1.6; 95% CI 1.1–2.49; p=0.03).

Conclusions. Metabiotic therapy, prescribed in addition to the basic one, is promising in patients with IBD. The results of the study suggest that in the case of mild IBD additional therapy with Bactimunal can contribute to modulation of the permeability of the intestinal barrier and reduction of the inflammatory process.

Arterial hypertension poses a threat to both the pregnant woman and the health of the newborn. Vascular disorders play an important role in the pathogenesis of hypertension. A study of microcirculation in arterial hypertension was conducted with the inclusion of 42 women with newly diagnosed or untreated arterial hypertension of grade 1–2 and a control group. Microcirculation was studied by capillaroscopy of the nail bed. The revealed changes in the microcirculatory system in women with arterial hypertension compared with patients without arterial hypertension included changes in the density of the capillary network in the form of rarefaction, degree of tortuosity, enlargement of the perivascular zone, arterial capillaries, venous capillaries, diameter of the transitional capillaries. The study of the prevalence of complications of pregnancy and childbirth in arterial hypertension of pregnant women, as well as its effect on the condition of the newborn. The analysis of 150 SMADS of pregnant women and information from EMIAS was carried out. The prevalence of hypertensive disorders among pregnant women was 19.3%. 69% of pregnant women with hypertension had this disease before pregnancy. An analysis of the complications of current pregnancy in hypertensive disorders showed a high percentage of the incidence of preeclampsia or a high risk of its development (41.38%). The incidence of preeclampsia and a high risk of its development in women without hypertension was 5.3%. Among the complications of pregnancy with hypertension, the following were identified: gestational diabetes mellitus – 31%, anemia of varying severity – 17.2%, gestational hypertension – 10.3%, toxicosis – 6.9%, threat of premature birth – 3.5%, gestational pyelonephritis – 3.5%. When assessing the relationship between hypertension and complications in childbirth, the following data were obtained: preterm birth – 16.7%, cesarean delivery – 47.4%, premature discharge of amniotic fluid/membranes – 21.1%, ruptures of the cervix/perineum – 21.1%, vacuum extraction of the fetus – 5.2%, fetal distress – 10.5%. the birth of children with a height of less than 45 cm and weighing less than 2500 g – 10.5%. The data we obtained coincided with the results of most studies that revealed a high risk of pregnancy and childbirth complications in pregnant women with hypertension. Prediction of arterial hypertension during pregnancy. it is an urgent task. Methods for studying microcirculation are available and can be used for screening surveillance to identify women at risk of hypertensive pregnancy complications at the planning stage.

Arterial hypotension is widespread among pregnant women. The data of the analyzed scientific literature on the effect of arterial hypotension on pregnancy and birth outcomes are contradictory. Our study revealed the prevalence of arterial hypotension among pregnant women at 28%, with a predominance in the second trimester. Arterial hypotension was independent of age and was predominantly diastolic in nature. The vast majority of pregnant women with arterial hypotension (more than 75%) suffered from anemia of varying severity. The number of specific complications of childbirth, including the need for cesarean section, in patients with arterial hypotension did not significantly differ from patients with normotonia. Conclusions were drawn about the inexpediency of the routine use of SMAD in the diagnosis of arterial hypotension in pregnant women. To assess hypotension, including orthostatic hypotension, office blood pressure measurement and self-monitoring of blood pressure of a pregnant woman at home are sufficient.

Metabolic syndrome (MS) is a combination of risk factors such as abdominal obesity, arterial hypertension, dyslipidemia, and insulin resistance, significantly increasing the risk of cardiovascular disease and type 2 diabetes mellitus. Despite traditionally being associated with older populations, the prevalence of MS is rising among young men, making the issue particularly relevant.

Objective. To evaluate the potential of lipid-lowering therapy in young men with metabolic syndrome.

Materials and methods. A prospective observational cohort study included 46 men aged 25–45 years diagnosed with metabolic syndrome, divided into two comparable groups. The 6-month observation period focused on patients with controlled hypertension and elevated atherogenic cholesterol levels. Group 1 received pitavastatin at a dose of 2 mg/day; Group 2 received omega‑3 polyunsaturated fatty acid ethyl esters (1000 mg capsules containing 46% EPA and 38% DHA), 2000 mg/day. Clinical and laboratory parameters, adherence to lipid-lowering therapy, and psychosomatic status were assessed.

Results. Lipid profile analysis under controlled blood pressure revealed a statistically significant difference in total cholesterol levels between Group 2 (5.31 mmol/L) and Group 1 (4.79 mmol/L). Group 1 also showed lower LDL–C levels (2.37 mmol/L vs. 2.71 mmol/L), though the difference was not statistically significant. High-sensitivity C-reactive protein (hs-CRP) was elevated in both groups (mean ±5.60 mg/L), but was significantly lower in Group 1 after pitavastatin therapy (2.21 mg/L). Glucose levels were significantly lower in Group 1 (4.1 mmol/L vs. 5.5 mmol/L). Adherence was notably higher in Group 1: 66.32% [42%; 82%] vs. 32.18% [45%; 71%]. Subclinical anxiety was prevalent (n = 32), though no statistically significant difference was found between groups.

Conclusion. The efficacy and safety of pitavastatin contribute to improved patient adherence, which is crucial for long-term management of metabolic syndrome and the prevention of complications. Integrating therapy that addresses both metabolic and psychosomatic factors leads to substantial health benefits for young men with MS, reducing atherosclerosis risk and enhancing quality of life.

Cardiovascular diseases (CVD) are the main cause of morbidity and mortality in the population. Medical professions are associated with CVD risk factors and, first of all, it is the influence of psychological stress. Doctors are threatened by behavioral and occupational risks, such as a high level of professional workload and a sedentary lifestyle. A study was conducted on the prevalence of CVD risk factors among 54 medical professionals, 86% of them women, 14%.– men. The average age of those included in the study was 36±8 years. Inclusion criteria: medical profession, age from 18 to 44 years (according to the WHO classification, people aged 18 to 44 years are considered to be young people). The prevalence of CVD among medical respondents was 20%, arterial hypertension prevailed (61.5%). An assessment of lifestyle and nutrition revealed that 63.0% of respondents have the opportunity to eat regularly, 64.3% of medical professionals adhere to a healthy diet. At the same time, most specialists try to lead a healthy lifestyle, monitor their diet, have lunch breaks, and men play sports. However, about a third of employees do not engage in physical activity, and 10.7% do not adhere to a diet. The analysis of the awareness of medical professionals about the norms of indicators that are included in the assessment of cardiovascular risk: BMI, waist size, cholesterol, LDL, glucose, salt intake, fruits, vegetables, physical activity. For almost all indicators, the vast majority of medical professionals know and correctly indicate the normal values, with the exception of fruit consumption per day. The majority (88.5%) of medical professionals agree with the need for preventive conversations with patients about CVD risk factors and a healthy lifestyle, 86.5% of respondents conduct similar conversations with their patients.

More than 80% of children have long-term survival after treatment for acute lymphoblastic leukemia. Antitumor treatment can lead to undesirable effects in the long term, including damage to the urinary system. Nephrotoxicity is an undesirable phenomenon of several types of treatment, including cisplatin, carboplatin, ifosfamide, and radiation therapy. A study of the health status of 100 patients who suffered from acute lymphoblastic leukemia in childhood, according to the EMIAS, revealed that 23 patients had never sought medical help or undergone examinations, 31% had diseases of the urinary system: 7 nephritis (22.6%), 5 urolithiasis (16.1%); cystitis – 13 (41.9%); nephritic syndrome – 4 (12.9%); chronic prostatitis – 2 (6.5%). An analysis of the incidence of urinary tract diseases in patients who had ALL in childhood, depending on the antitumor treatment performed, showed that the majority of cases (93.6%) were detected in patients with antitumor chemotherapy. The prevalence of diseases of the urinary system among adults who suffered from ALL in childhood requires a deeper study of the risks and the relationship of treatment with long-term adverse events. Clinical dynamic monitoring by a urologist of patients who suffered from acute lymphoblastic leukemia in childhood will allow timely detection of long-term adverse events from the urinary system, treatment and preventive measures.

This article presents a clinical case of successful stenting of the right coronary artery using rotational atherectomy and intravascular ultrasound in a patient with severe calcified coronary artery disease and severe clinical symptoms of angina.

An attempt at traditional percutaneous treatment at another clinic was unsuccessful, and the patient underwent endovascular rotational atherectomy followed by stenting of the affected segments of the coronary arteries. The implemented treatment tactics demonstrated its effectiveness and safety; the patient was discharged from the hospital in a stable condition, without symptoms of angina.

Relevance. Investigation of the endometrial immune profile in postmenopausal women receiving menopausal hormone therapy (MHT) is essential for understanding the mechanisms of abnormal uterine bleeding (AUB) and improving treatment safety. While the role of NK cells and T lymphocytes in reproductive regulation has been studied, endometrial lymphocyte subpopulations during MHT remain insufficiently explored.

Objective. To evaluate changes in lymphocyte subpopulations (CD3+, CD3+/CD16+/CD56+, CD3–/CD16+/CD56+) in the endometrium of postmenopausal women receiving MHT and their association with AUB development.

Materials and Methods. A randomized controlled trial included 106 postmenopausal women divided into three groups: control (n=34), MHT without AUB (n=35), and MHT with AUB (n=37). Endometrial pipelle biopsy was performed before and after 6 months of therapy. Flow cytometry was used for immunophenotyping.

Results. After 6 months of MHT, significant increases in CD3+ and CD3–/CD56+/CD16+ cells were observed compared to baseline. The most pronounced changes occurred in the AUB group. Intergroup differences were statistically significant for both absolute and relative lymphocyte counts.

Conclusion. Altered endometrial immune homeostasis may contribute to AUB development during MHT. These findings emphasize the relevance of immune profiling for individualized therapeutic strategies.