The objective was to analyze the possible reasons for the failure of surgical treatment of carpal tunnel syndrome.

One of the most common forms of compression mononeuropathy of the upper extremity is carpal tunnel syndrome. Despite being widely studied, the topic remains relevant due to the fact that this pathology makes up the majority of occupational diseases and its treatment is associated with significant healthcare costs. Carpal tunnell release is the «gold standard» for surgical treatment of carpal tunnel syndrome, but despite its high level of effectiveness, from 2 to 10 % of patients require revision surgery for recurrent carpal tunnel syndrome.

Introduction. The article presents a comparison of simulation models for financing an inpatient emergency department and a therapeutic department using the example of an emergency therapeutic flow of patients.

The objective was to analyze the economic aspects in an inpatient emergency department for the treatment of emergency therapeutic conditions such as hypertension.

Methods and materials. Based on a retrospective analysis of the flow of incoming patients for emergency and urgent indications, a simulation model of the load and economic calculations of the work of the inpatient emergency department was developed.

Results. According to the results of the study, it was revealed that with a three-fold increase in the flow of patients entering the department, the inpatient emergency department copes with this flow more effectively in comparison with the therapeutic one. Despite this funding, the medical institution receives significantly less.

Conclusion. Based on the study, the need to create a special tariff plan for the work of such units as the inpatient emergency department was identified, because the capacity in this department is many times greater.

The objective was to study the effectiveness of fish oil (FO) and ozonated fish oil (OFO) on the intensity of lipid peroxidation (LPO) processes and the antioxidant system of the blood during physical activity «to failure».

Methods and materials. The animals were divided into 4 groups of 12 rats. Saline was administered orally to control animals (group 1). Rats (group 2) were fed fish oil (dose 35 mg/kg), rats of group 3 – ozonated fish oil (dose 35 mg / kg, ozonide number 3000), group 4 – ozonated fish oil (dose 35 mg/kg, ozonide number 1500). Physical activity was modelated the method of forced swimming of rat «to failure» with a load of 10 % of body weight. The state of the LPO system was assessed by the concentration of malondialdehyde (MDA) in erythrocytes and the level of diene conjugates (DC), triene conjugates (TC) and Schiff bases (SH) in the blood plasma. The state of the antioxidant system was determined by the activity of catalase in the blood plasma.

Results. Physical activity had an increase in DC, TC, OR in the blood plasma, an increase in the MDA content in erythrocytes, which was accompanied by a gradual increase in catalase activity in the blood plasma. The administration of FO against the background of physical activity determined less pronounced lipid peroxidation, while the introduction of OFO with an ozonide number of 3000 determined the most pronounced lipid peroxidation compared to the control. The lowest oxidative effect of physical compounds was recorded with the introduction of OFO with an ozonide number of 1500.

Conclusions. Oral administration of OFO with an ozonide number of 1500 during physical exercise of significant intensity inhibited the development of oxidative stress against the background of high antioxidant activity of the blood to a greater extent than the use of FO.

Introduction. Serological diagnosis of inflammatory bowel diseases (IBD) is an additional tool not only for differential diagnosis, but also for individual prediction of the clinical course and long-term outcomes of Crohn’s disease (CD) and ulcerative colitis (UC).

The objective was to assess the occurrence and capabilities of determining antibodies to Saccharomyces cerevisiae (ASCA) and antineutrophil cytoplasmic antibodies (ANCA) in predicting the clinical outcomes of IBD.

Methods and materials. The study included 71 patients with CD, 26 with UC, and 21 with and 21 with IBD unclassified (IBDU). The comparison group consisted of 35 patients with other gastrointestinal diseases (irritable bowel syndrome with diarrhea (IBS-D), celiac disease, autoimmune gastritis (AIG)); the control group consisted of 24 apparently healthy individuals. The level of antibodies to ASCA IgA and IgG was measured by the ELISA method (ORGENTEC Diagnostika GmbH, Germany), ANCA IgG was determined by the IIF method of the Granulocyte Mosaic test system (EUROIMMUN AG, Germany).

Results. The occurrence of ASCA IgA and IgG in patients with CD was 25 % and 38 %, which is significantly higher compared to patients with UC (0 % and 3.8 %), IBDU (5 % and 5 %), AIG (0 % and 5.3 %) respectively (p<0.05). Seropositivity for ANCA IgG in patients with UC was 54 %, which is significantly higher than in patients with CD, IBDU, AIG – 9.9 %, 9.5 % and 5.3 %, respectively (p<0.05). In patients with IBS-D and the control group, ASCA IgA and IgG and ANCA IgG were not detected. The combination of ASCA IgA and/or IgG seropositivity with a negative ANCA IgG result is more sensitive in differentiating CD from UC than the isolated determination of ASCA IgA (39.5 % vs. 25.3 %) with a specificity of 95.8 % and 96.5 %, respectively. The sensitivity of the combined detection of ANCA IgG with negative ASCA IgA and IgG results was comparable to the isolated detection of ANCA IgG – 52.5 % vs. 53.8 %, while the specificity increased to 94.6 %. ASCA IgA/G seropositivity serves as an unfavorable prognostic marker for the onset of CD before the age of 40, the stenotic and penetrating behavior, as well as the need for surgical treatment of the disease. Higher ANCA IgG titers were observed in patients with severe attack of UC (320 [320;640]) compared to mild attack (40 [40;80], p<0.05).

Conclusion. ASCA and ANCA are highly specific markers of CD and UC, the combined determination of which makes it possible to increase the efficiency of serological examination not only in differential diagnosis, but also in personalized prediction of the clinical course of IBD.

Introduction. Cytokine imbalance is a topical issue of researches in the field of comorbid pathology, in particular, chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (DM2).

The objective was to establish the characteristics of serum IL-6 levels in patients with a combination of COPD and DM2.

Methods and materials. In the groups of patients with COPD (51 people), DM2 (42 people), COPD with DM2 (39 people), the control group (39 people), IL-6 was determined by enzyme immunoassay (standard test systems) on a StatFax 303Plus spectrophotometer. Computed tomography of the chest was performed on Optima 660 GE and Optima 540 tomographs using an image processing program on the AW SERVER 2.0. IBM SPSS Statistics software was used for statistical processing of the results.

Results. A negative correlation was found between the level of IL-6 and the duration of COPD in patients with COPD in combination with DM2 (r=–0.373, p=0.033). In this group, there was a positive correlation between the level of IL-6 and the dose of dexamethasone (r=0.802, p=0.030). Among COPD patients, IL-6 levels were significantly lower in the subgroups of patients receiving glucocorticosteroid through a nebuliser (p=0.046), as well as patients receiving antibiotics (p=0.004). An algorithm for radiological methods of examination in patients with a combination of COPD and DM2 is proposed.

Conclusion. The study of the features of the pathogenesis of a combination of COPD and DM2 is of practical interest for the individualization of management tactics in patients of this group.

Introduction. A promising area of application of 1,3,5-triazines in medical chemistry is the development of highly effective anticancer agents. It is noteworthy that a significant cytotoxic effect may occur with 2,4,6-substituted 1,3,5-triazine derivatives containing aziridine rings as substituents. These compounds interact with DNA molecules of tumor cells and they are alkylating agents.

The objective was to synthesize and investigate the cytotoxic activity in vitro of new aziridine–containing 1,3,5-triazine derivatives against tumor cell lines of human lung adenocarcinoma A549 and human hepatocarcinoma Huh7 and to evaluate the effect of the length of the hydrocarbon radical in the dioxane cycle on the cytotoxic effect of the obtained compounds.

Methods and materials. The synthesis of the 1,3,5-triazine derivatives was carried out using 2,4,6-trichloro-1,3,5-triazine (cyanuric chloride) as the starting reagent. The composition and structure of the obtained compounds were proven by elemental CHN analysis and ¹H, ¹³C{¹H} NMR spectroscopy. The cytotoxicity was studied using the MTT colorimetric assay.

Results. Novel 1,3,5-triazine derivatives were synthesized and fully characterized: (5-((4-(aziridin-1-yl)-6-chloro-1,3,5triazin-2-yl)amino)-2-ethyl-2-methyl-1,3-dioxan-5-yl)methanol and (5-((4-(aziridin-1-yl)-6-chloro-1,3,5-triazin-2-yl)amino)2-isobutyl-2-methyl-1,3-dioxan-5-yl)methanol. Also, cytotoxic effect against tumor cell lines of human lung adenocarcinoma (A549) and human hepatocarcinoma (Huh7) was studied using the MTT assay. It has been shown that an increase in the length of hydrocarbon radicals in the dioxane ring at position C2 leads to a decrease in cytotoxic effect.

Conclusion. The synthesized (5-((4-(aziridin-1-yl)-6-chloro-1,3,5-triazin-2-yl)amino)-2-ethyl-2-methyl-1,3-dioxane-5 -yl) methanol and (5-((4-(aziridin-1-yl)-6-chloro-1,3,5-triazin-2-yl)amino)-2-isobutyl-2-methyl-1,3-dioxan-5-yl)methanol cause a dose-dependent decrease against the survival of tumor cell lines A549 and Huh7. 

Observations of pigmented (melanoblastic) and non-pigmented (achromatic) superficial melanomas of the skin are described, for the differential diagnosis of which, along with traditional histological examination, precision (immunohistochemical, molecular genetic) methods of studying the morphological substrate of the tumor were used. Based on the results of Raman spectroscopy of samples of both tumors, their multiplex analysis was carried out, with the help of which a significant number of molecules of various analytes were simultaneously identified in one individual sample of a biological object.

Balo concentric sclerosis is considered a fulminant demyelinating disease that is characterized by the formation of specific concentric foci in the white matter of the brain that resemble sawing trees. This article describes the clinical case of a patient who has come with complaints of weakness and stiffness in the lower limbs, more in the left leg, a feeling of stiffness and tension in the left hand, the inability to walk without aids. Taking into account the complaints, the clinical picture and the pre-test: laboratory examination of blood and liquor, magnetic resonance imaging (MRI) of the brain and thoracic spine with contrast, the patient was diagnosed with multiple sclerosis, secondary-spineprogressive current (Balo variant), reliable according to the 2017 McDonald Criteria. The following is a literature review describing the pathogenesis, clinical profile, diagnostic approaches and treatment options for the disease.