Background. Hypertension is currently recognized as a major health problem in young and middle-aged adults and is associated with a substantial deterioration in prognosis, underscoring the importance of early diagnosis and timely risk factor control.

Objective. To assess the clinical, laboratory, and instrumental characteristics of naive young and middle-aged patients with essential hypertension in real-world outpatient clinical practice.

Methods: study included 73 patients with essential hypertension (median age, 41.0 [37.0; 48.0] years; women, 53.4 %) with stage I-III, grade 1-2 hypertension who had not previously received antihypertensive therapy. Clinical characteristics, office blood pressure (BP), ambulatory blood pressure monitoring (ABPM), echocardiography, and routine clinical and biochemical blood test parameters were evaluated.

Results. Most patients had grade 1 hypertension and stage I hypertension (93.1 % in both cases). Obesity and overweight were identified in 46.4 % and 37.2 % of patients, respectively. Elevated total cholesterol (>4.9 mmol/L) was observed in 53.4 % of patients, and low-density lipoprotein cholesterol >3.0 mmol/L in 71.2 %. The predominant ABPM phenotypes were day-time systolic-diastolic hypertension (45.2 %) and day-time isolated systolic hypertension (27.4 %). An increased rate of morning BP surge (systolic and diastolic) was recorded in 91.7 and 97.3 % of patients, respectively. Left ventricular hypertrophy was detected in 6.8 % of patients. Increasing body mass index was associated with unfavorable changes in laboratory and echocardiographic parameters, as well as with higher mean daytime systolic BP.

Conclusions. In young and middle-aged adults, hypertension is associated with a high prevalence of cardiometabolic risk factors, prognostically unfavorable 24-hour BP profile abnormalities, and progressive structural and functional cardiac changes with increasing body weight.

Cardiovascular diseases (CVD) are a leading cause of death in all industrialized countries. Coronary heart disease (CHD) occupies a leading position among CVDs. The relevance of CHD is determined by its role in disability and mortality in the population, as well as the financial costs associated with the treatment and rehabilitation of patients. The goals of treating patients with CHD are to improve quality of life by reducing the frequency of angina attacks and preventing acute myocardial infarction. In addition to lipid metabolism disorders, hemostatic disorders play a significant role in the development and progression of CHD. In particular, increased platelet activity leads to changes in blood rheology and an increased tendency to thrombosis, which leads to impaired microcirculation. Therefore, the inclusion of agents that target pathogenic mechanisms in rehabilitation programs for such patients appears promising. One such agent is the bioflavonoid dihydroquercetin (DHA), obtained from Siberian larch wood. It stimulates tissue blood flow, stabilizes microvascular barrier function, reduces capillary wall permeability, improves blood rheology, and thereby helps reduce microvascular congestion.

The aim of this study was to evaluate the effectiveness of the dietary supplement «Dihydroquercetin» (Evalar, JSC) in the comprehensive treatment of patients with coronary heart disease. The study demonstrated the positive effects of dihydroquercetin on cardiovascular disease (CVD): significant improvement in peripheral microcirculation hemodynamic parameters, a tendency toward normalization of cerebral hemodynamics, and a positive effect on lipid metabolism. This opens up new possibilities for the use of plant-based antioxidants in practical medicine.

The article describes the history of the use of hyperbaric oxygenation in medicine. It presents the therapeutic effects, indications for use, and contraindications, as well as possible complications. The article also discusses experimental studies and clinical experience. It analyzes the literature on the effectiveness of hyperbaric oxygenation in treating traumatic brain injuries and strokes, as well as in anesthesiology, resuscitation, emergency medicine, and the treatment of respiratory, cardiovascular, and endocrine system diseases. The article provides detailed information on the mechanisms of hyperbaric oxygenation’s impact on endothelial vascular function. It has been shown that hyperbaric oxygenation improves collateral circulation, inhibits the development of atherosclerosis, improves endothelial function, increases the expression of various fibrinolytic factors, and reduces blood viscosity, improves myocardial perfusion, reduces inflammation and vascular endothelial dysfunction, and stabilizes atherosclerotic plaques.

Hereditary predisposition is one of the risk factors for arterial hypertension. The renin-angiotensin-aldosterone system plays a key role in the pathogenesis of arterial hypertension. Previous studies have shown a correlation between the AGT and AGTR genes and the risk of developing arterial hypertension. The genes of the renin-angiotensin system are considered candidates for predisposition to preeclampsia. In our study, we examined the relationship between arterial hypertension (AH) and polymorphisms of the renin-angiotensin-aldosterone system genes: AGT: 704 T>C, AGT: 521 C>T, AGTR 1: 1166 A>C, and AGTR 2: 1675 G>A, among the European population of Moscow. The presence of the T allele of the AGT gene (T704C) has a protective effect on the development of AH. The CT and TT genotypes of the AGT gene (C 521T) are significantly more common in hypertensive patients, which may indicate a negative effect of the T allele on the development of hypertension. Carrying the CC genotype of the AGTR 1 gene (A1166C) may predispose to hypertension. It has been established that the presence of the G allele and the G allele.

Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver pathologies worldwide, affecting more than a quarter of the global population. The disease is closely associated with obesity, insulin resistance, and metabolic syndrome. Although the Mediterranean diet has proven effective, adherence to it remains challenging, driving interest in combination therapy that includes dietary supplements. Omega-3 polyunsaturated fatty acids (EPA and DHA) are of particular importance, with a deficiency rate of 68.5 % in the Russian Federation and even lower levels observed in NAFLD patients.

Objective. To evaluate the efficacy of the dietary supplement «Triple Omega-3 950 mg» (ZAO “Evalar”) as part of nutritional correction in patients with NAFLD at the steatosis stage.

Materials and methods. An open-label comparative 6-month study enrolled 74 patients with NAFLD. The main group (n=50) received dietary therapy plus the supplement «Triple Omega-3 950 mg» (ZAO “Evalar”) (1 capsule/day: 950 mg omega-3 PUFAs, including not less than 550 mg EPA and not less than 230 mg DHA). The comparison group (n=24) received dietary therapy alone. Biochemical blood parameters, lipid profile, HOMA-IR index, liver enzymes, and abdominal ultrasound were assessed.

Results. The main group demonstrated a significant reduction in triglycerides (from 1.29±0.06 to 1.08±0.08 mmol/L) and LDL cholesterol (from 116.3±5.04 to 103.96±3.3 mg/mL) compared to the comparison group (p<0.05). Glucose levels decreased by 19.4 % (vs. 10.6 %), and the HOMAIR index decreased by 29.5 % (vs. 18 %). A marked reduction in ALT (by 76.3 %), AST (by 51.9 %), and GGT (by 57.9 %) activity was recorded. The supplement was well tolerated, with no adverse events reported.

Conclusion. The inclusion of the dietary supplement «Triple Omega-3 950 mg» (ZAO “Evalar”) in comprehensive dietary therapy for patients with NAFLD at the steatosis stage significantly improves lipid profile, reduces insulin resistance, alleviates cytolysis and cholestasis, and enhances patients’ quality of life. This product can be recommended as adjunctive therapy for NAFLD in combination with diet and physical activity.

Purpose. To evaluate the association between the severity of hepatic steatosis, quantitatively determined by the mean whole-liver proton density fat fraction on magnetic resonance imaging (MRI), and body mass index (BMI) in the examined patients.

Materials and methods. A retrospective observational study included 776 patients who underwent multiparametric abdominal magnetic resonance imaging on Magnetom Vida (Siemens) 3 T and Ingenia Ambition S (Philips) 1.5 T scanners. BMI was calculated using the standard formula and considered a systemic anthropometric indicator of obesity. Quantitative assessment of hepatic steatosis was performed using the mean whole-liver proton density fat fraction. Steatosis severity was classified as S 0-S 3. Nonparametric statistical methods were used, including Spearman correlation analysis, intergroup comparisons with Benjamini-Hochberg correction for multiple testing, and ROC analysis.

Results. A statistically significant positive correlation was found between hepatic proton density fat fraction and BMI (p=0.569; p<0.001). At the same time, for identical BMI values, a wide range of proton density fat fraction values was observed, with substantial overlap between steatosis grades. Hepatic steatosis was detected in 9 % of patients with BMI <25 kg/m2, whereas 36 % of patients with BMI >30 kg/m2 had no signs of steatosis. The area under the ROC curve for BMI was 0.793 for detecting steatosis >S 1, 0.761 for >S 2, and 0.706 for >S 3, corresponding to moderate to low discriminative performance.

Conclusion. BMI is statistically associated with the severity of hepatic steatosis but demonstrates high variability and pronounced overlap between steatosis grades. The presence of hepatic steatosis in 9 % of patients with normal BMI and its absence in 36 % of patients with obesity reflect the limited diagnostic value of BMI for assessing the degree of hepatic fat infiltration. Quantitative assessment of proton density fat fraction by MRI provides an objective and reproducible characterization of hepatic steatosis regardless of BMI category.

Impulsive aggression is a widespread behavior problem. The article presents the results of studying the relationship of pathologically aggressive behavior with hereditary factors. The tendency to aggressive behavior is interrelated with serotonin metabolism, which is regulated by the monoamine oxidase (MAO) gene. The research results indicate that aggressive behavior is correlated with the number of tandem repeats of the monoamine oxidase А (MAOA) gene. Reactive aggression is promoted by low-functional variants of alleles. The tendency to aggression is influenced by the presence of abuse, neglect, or traumatic life events in childhood. Alleles of the MAOA gene are associated not only with impulsive aggression in an individual, but also with the influence of the environment on the formation of aggressive criminal behavior. Examples are given when a genetic predisposition to criminal behavior served as an argument in favor of a reduced sentence. Behavioral genetics research requires more serious requirements for research design and methodology in order to obtain reliable and reliable results.

Background. Fluoropyrimidines such as 5-fluorouracil and its oral prodrug capecitabine are widely used in treating gastrointestinal malignancies but are associated with potentially severe cardiotoxicity. Nephrotoxicity associated with platinum-based therapies (Cisplatin, Oxaliplatin).

Case summary. We present the case of a 60-year-old man with resected gastric adenocarcinoma (T3N 2M0) treated with adjuvant FOLFOX (5-fluorouracil plus oxaliplatin). On the first day of the second cycle, he developed tachycardia. Electrocardiogram showed supraventricular tachycardia and on next day-atrial flutter, while echocardiography demonstrated reduced ejection fraction. Troponin I was 2.7. Chemotherapy was discontinued, and a reduced dose of capecitabine was recommended.

Conclusions. This case illustrates the cardiotoxicity of oxaliplatin, with both supraventricular tachycardia and atrial flutter, while echocardiography demonstrated reduced ejection fraction.

Relevance. Currently, there is a need to develop and implement innovative approaches and tools that will help healthcare professionals provide care more effectively and in a timely manner, as well as coordinate their actions to provide comprehensive care. The study was aimed at a comprehensive assessment of the effectiveness of a new program to optimize the activities of doctors providing palliative care to children.

The aim of the work was to identify changes in key indicators of the quality of medical activity after the implementation of the program.

Materials and methods. The sample included 30 specialists from various institutions providing palliative care for children, and the duration of follow up was 3 months from the launch of the program to its interim evaluation. The study was approved by the Ethics Committee of the N. N. Burdenko Voronezh State Medical University of the Russian Ministry of Health (Protocol No. 4 dated 16.10.2025). As part of the study, doctors and children’s parents signed voluntary informed consent forms. The analysis covered 19 standardized criteria, including the speed of informing parents and colleagues, the completeness and accuracy of medical records, the timeliness of appointments, the quality of interdisciplinary coordination and emotional support for families. The program is a comprehensive assessment calculator for children in palliative care. It allows doctors, nurses, and social workers to systematically collect data, identify priority intervention areas, and track the dynamics of a child’s condition over time.

Results. The results showed a statistically significant improvement in all measured parameters: the increase ranged from +0.5 to +1.8 points on a 5-point scale. The most significant increases were recorded in such indicators as the speed of clinical information exchange, the completeness of electronic medical records, and the effectiveness of interaction between doctors, nurses, and social workers. The growth of the integral indicator «Overall results» was particularly impressive from 2.7 to 4.1 points, which corresponds to a significant improvement of +1.4 (p<0.001).

Conclusions. The results confirm that the new program not only improves work organization, but also directly contributes to improving the safety and quality of child care in difficult clinical situations.