The objective of the article was to fill in some gaps in the information about the fate of teachers and students of The First Medical Institute of Leningrad during the Great Patriotic War. The source base of the research was the new archival material discovered by the authors, sources of personal origin in the form of recollections of eyewitnesses of the described events, as well as a set of previously published documents and materials related to the topic of the article. The results of the study added the picture of the functioning of the Institute under the Leningrad Blockade, its partial evacuation to the rear areas of the country, clarified the fate of a number of employees and students of the Institute.

This review presents the last literature data, concerning prevalence, clinical profile, diagnostic and treatment of apical hypertrophic cardiomyopathy (HCM), as less known among «classical» variants of HCM. It is also discussed the rare form of apical HCM — mid-ventricular HCM with apical aneurism formation.

Background. The article considers with the current problem of cryptogenic stroke and embolic stroke of undetermined source.
The objective was to analyzed the results of follow-up of patients with embolic stroke of undetermined source in a specialized outpatient center.
Methods and materials. The data of 169 patients who completed a two-year follow-up period with embolic stroke of undetermined source (ESUS) and cardioembolic stroke were analyzed.
Results. We presented comparative results on the structure of incidence rate, age differences, comorbid pathology, as well as on the frequency of repeated cardiovascular events in groups with cardioembolic stroke and embolic stroke of undetermined source.
Conclusions. Patients with ESUS are an extremely difficult category of patients for diagnostic search, for whom the actual task is to develop an examination algorithm for the earliest possible detection of the cause of stroke and to determine the optimal methods of secondary prevention.

Introduction. The development of metabolic syndrome (MS) in patients with abdominal obesity (AO) may be associated with a low level of the adiponectin (AN) - protective adipocytokine. AN circulates in the blood in various molecular forms.
The high molecular weight AN is assumed to have greater metabolic activity. It is currently not clear what level of high molecular weight adiponectin (HMWA) in women with AO is associated with MS and its components.
The objective was to study the role of high molecular weight adiponectin in the development of metabolic syndrome in women with abdominal obesity.
Methods and materials. 302 women with AO and 161 women without AO were examined. MS was diagnosed in 62.3 % of patients.
Results. The concentration of total adiponectin (TAN) and HMAN in the blood serum in women with MS was lower than in patients without MS (p<0.05). According to logistic regression analysis, the most significant factors influencing the risk of MS were low concentration of HMAN in the blood, age, and body mass index (p <0.05).
Conclusions. It was found that women with AO and HMAN concentration of less than 1.96 μg/ml in the blood had an increased risk of metabolic syndrome.

Introduction. Lengthening over the nail (LON) combines the advantages of external and internal fixations.
The objective was to compare the effectiveness of the application, to assess the structure and frequency of complications in patients treated with lengthening by Ilizarov technique and lengthening over the nail.
Methods and materials. We analyzed 55 LON cases and 64 cases lengthening by Ilizarov technique. The duration of the external fixation period, complications and quality of the patient life were compared.
Results. The external fixation period in LON group was 4 times less than in the Ilizarov technique group. There were 25 complications (45.5 %) in LON group and 54 complications (84.4 %) in the Ilizarov technique group. Femur lengthening was associated with a greater number of complications in both groups. Pin infections were 2.5 times less frequently in the femur LON group. Knee contractures were only in Ilizarov technique group (11.4 %). Ankle joint contracture was noted with the same frequency during tibial lengthening in both groups. Disorders of the consolidation were 2 times more often in the femur LON group and 5 times more often in the tibial lengthening with Ilizarov technique. Premature fusion was observed only in the LON group. There were 2 times less fractures of the half-pins and wires in the LON group.
Conclusions. A reduction of external fixation period in LON group correlates with the 2-fold decrease of complications and an increase of the treatment comfort. LON is promising for wider clinical applications.

The objective was to study the factors associated with inappropriate reduced doses of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (AF) in real outpatient practice.
Methods and materials. 10663 case histories of patients hospitalized to the therapeutic clinic of the university for 5 years (2014 — 2018) were studied, 1307/10663 (12,3 %) case histories of patients with AF were selected. Factors associated with inappropriate low doses of anticoagulant therapy (ACT) with NOACs at prehospital treatment were studied.
Results. NOACs received 57.7 % (384/665) of patients with AF at the outpatient stage: rivaroxaban — 180/384 (46.9 %) patients, dabigatran etexilate — 110/384 (28.6 %) patients, apixaban — 94/384 (24.5 %) patients. Inappropriate reduced doses of NOACs were revealed in 68/384 (17.7 %) patients: apixaban — 22/94 (23.4 %), dabigatran — 18/110 (16,4 %) and rivaroxaban — 28/180 (15.6 %) (p>0,05). Patients who received inappropriate reduced doses of NOACs as compared to those who received standard doses of NOACs had higher frequency of major bleedings in the past (7.4 and 1.0 %; p=0.014) and had higher risk of bleedings (HAS-BLED 1.7±1,1 and 1.2±1.0; p = 0.0002). Proportion of patients who had HAS-BLED≥3 in these groups were 19.1 % and 8.6 % (p=0.033). All patients who received inappropriate reduced doses of NOACs had modifiable risk factors of bleedings. 85.3 % of patients with AF who received inappropriate reduced doses of NOACs had high risk of stroke according to CHA2DS2-VASc scale.
Conclusion. In real outpatient practice, NOACs were recommended to 57.7 % of patients with AF. 17.7 % of patients received NOACs s in inappropriate reduced doses. Frequency of major bleedings in the past and bleeding risk in AF patients with inappropriate reduced doses was higher than in patients with standard doses.

No doubts that shigellosis severity directly depends on the spread of the gut specific lesion. There are some data published on the basis of autopsy records and pointing to shigella caused lesion spreading both to colon and ileum in adult cases especially in those older than 60 y.o. or with any immunosuppressive premorbid background. Obviously, the gut mucosa condition determines the local resistance potential and moreover it's shown that in shigellosis cases, the histologic pattern of gut mucosa depends on quantity and quality of neutrophils, extremely important to control the intensity of agent invasion. Viral infections with concomitant neutropenia are commonly considered as immune suppressive conditions. As to Herpes virus infection, it's well known as the large mucosa lesion disease that can subsequently lead to aggravation of any forthcoming acute bacterial infection. The paper suggests the description of shigellosis case confirmed with the use of PCR test (PCR kit Amplisens All-bacto-screen-FL Lab, Interlabservice) and developed by young woman with unfavorable premorbid condition. The disease course turned to be severe and complicated by the peritonitis development. The aggravating factors in the proposed case were likely such immune modulating concurrent conditions as Herpes virus infection and pregnancy. The clinical example demonstrates that young people can develop severe complicated shigellosis course given burdened premorbid background availability.