Atherosclerosis is increasingly recognised as an inflammatory disease. The concept of residual inflammatory risk has been confirmed in the CANTOS, COLCOT, and LoDoCo2 trials, which demonstrated a reduction in cardiovascular events through targeted suppression of key inflammatory pathways. However, the largest trial of colchicine in acute myocardial infarction — CLEAR SYNERGY — conducted predominantly during the COVID-19 pandemic, did not demonstrate a reduction in cardiovascular events despite significant suppression of systemic inflammatory markers, underscoring the need for further clarification of the optimal therapeutic window and conditions for anti-inflammatory interventions. Unlike existing reviews that typically address individual innate immune cell populations in isolation, the present review systematically integrates key innate immune effectors — inflammasomes (NLRP3, AIM2), monocytes and macrophages, neutrophils, mast cells, basophils, eosinophils, and natural killer (NK) cells — into a unified phase-specific model based exclusively on human clinical data.

A literature search was performed using PubMed, Scopus, and Web of Science databases. Original research articles and systematic reviews/meta-analyses from Q1/Q2 peer-reviewed journals were included. Only human studies or in vitro studies using human-derived material were eligible; animal model studies were excluded.

The NLRP3/caspase-1/interleukin-1β/interleukin-18 inflammasome cascade functions as a central integrator of signals from cholesterol crystals, oxidised low-density lipoproteins, and damage-associated molecular patterns. Intermediate monocytes (CD14++CD16+) independently predict cardiovascular events. M1-macrophage predominance in plaque shoulder regions is associated with instability, while M2-macrophages facilitate efferocytosis and repair. Neutrophil extracellular traps (NETs) provide a prothrombotic scaffold in coronary thrombi, with citrullinated histone H3 and myeloperoxidase-DNA complexes correlating with infarct size. Mast cell density predicts adverse cardiovascular outcomes, whereas basophils and eosinophils demonstrate phase-dependent protective or detrimental roles. NK cell cytotoxic activity is systemically reduced in coronary artery disease, while CD56bright NK cells selectively accumulate in unstable plaques.

The phase-specific contribution of individual innate immune cell populations — from chronic inflammation through plaque destabilisation, post-infarction remodelling, and heart failure decompensation — provides a rationale for the development of personalised anti-inflammatory strategies in patients with various clinical manifestations of coronary artery disease.

The review presents the chronology of the development and introduction into clinical practice of direct oral anticoagulants (POAC) — dabigatran, rivaroxaban, apixaban and edoxaban.

The pharmacokinetic differences of drugs (bioavailability, half-life, renal clearance, drug interactions), as well as the influence of age, gender, body weight, and genetic factors on response variability were analyzed in detail. A step-by-step algorithm for choosing an anticoagulant is proposed, taking into account the absolute indications for warfarin (mechanical valves, antiphospholipid syndrome, severe chronic kidney disease), contraindications for OAC and the clinical features of their use..

The aim of the study was to evaluate the possibility of reducing doses of systemic glucocorticosteroids in patients with severe bronchial asthma receiving standard stage V therapy in combination with genetically engineered biological therapy.

Methods and materials. An open observational, single-center prospective study was conducted in the conditions of the pulmonary allergy center of the KKB Krasnoyarsk, which included 66 patients with severe bronchial asthma. Among the studied patients, women were found in 75% (46 people), men in 25% (17 people) of cases; the average age was 55 [48; 62] years, the duration of the disease was 21 [14.5; 34] years, and the age of onset corresponded to 34 [30.5; 50] years. The duration of treatment with the immunobiological drug Dupilumab was 4 years in 6 (9%) patients, 3 years in 13 (20%) patients, 28 (42%) patients received genetically engineered biological therapy for 2 years, and 19 (29%) patients had an allergic phenotype of asthma for 12 months. 49 (74%) patients, non-allergic phenotype was determined in 17 (26%) patients.

Results. At the time of the appointment of genetically engineered therapy, all patients had daily ASTHMA symptoms, which ensured a regular need for CDBA. Clinical symptoms were objectified by the AST and ACQ-5 tests, the results of which also confirmed the absence of AD control (Median ACQ-5 – 3 points, AST-test – 15 points). After 12 months of additional therapy, the number of seizures and the need for short-term medications decreased (p < 0.005). When studying the functional parameters, a significant increase in the FEV1 index and the FEV1/FVC ratio was noted against the background of 12 months of Dupilumab therapy, it is worth noting that the increase in FEV1 was 390 ml. When assessing the volume of basic therapy, it was determined that all respondents received high-dose ICS/DDBA therapy. Additional therapy with Tiotropium bromide was detected in 34% of patients, and antileukotriene drugs were used in 21% of patients. 12 people registered regular intake of SGCS. Against the background of immunobiological therapy with Dupilumab, it was possible to reduce 

Introduction. The intestinal flora is considered by modern medicine as a separate system that performs a wide range of important functions in the human body, primarily regulatory and protective. Its role is particularly significant in older age groups.

The aim of the study: to study the influence of the diet of elderly people on the development of small intestinal fibroids, the dependence of biological age and quality of life of older people on the severity of SIBR.

Materials and methods. A total of 227 elderly people aged 67 to 85 years living in various regions of the North-Western region of Russia were examined. An assessment of the actual nutrition content (food diary) was carried out. A specific diagnosis of SIBR was performed using a hydrogen-methane breath test. The biological age was calculated using the method of L.M. Belozerova. The quality of life study was conducted using a non-specific SF-36 questionnaire.

The results of the study. It was found that in the elderly, whose diet corresponded to modern principles of gerontodietology (WHO, 1988), SIBR was detected in 14 (26.9%) people, in the control group - 89.3%. The biological age in the study group exceeded the calendar age by 16.5± 3.2%, in the control group – by 22.3±4.1%. In elderly people with SIBR, compared with elderly people without SIBR, there was a significant negative difference in the characteristics of the elements of quality of life. The most significant negative differences were found in the analyses of role functioning (-15.7%), mental health (-23.3%), vital activity (-17.0%), and social functioning (-10.4%).   

Resume. It is concluded that a diet that does not correspond to the age-related physiology of an elderly person in the northwestern region of the Russian Federation significantly contributes to the occurrence of SIBR, which in turn significantly reduces the gerontoprotective capabilities of intestinal microbiocenosis, increasing the indicators of biological age, significantly reducing the quality of life of the elderly.

Introduction: liver percussion is a traditional physical method for the diagnosis of hepatomegaly. This method is accessible, simple, and convenient, but its results highly dependent on numerous factors: the air content of the adjacent tissues, the position of the liver behind the thoracoabdominal wall, and the quality of percussion. The percussive liver size according to M.G. Kurlov does not match with ultrasound data that use other criteria for the diagnosis of hepatomegaly.

Objective: to compare the accuracy of determining the boundaries and dimensions of the liver by percussion with ultrasound data, as well as the usefulness of topographic percussion for the diagnosis of ultrasound-verified hepatomegaly.

Materials and methods: 32 people were examined: 19 patients with several internal diseases and 13 healthy individuals (control). All underwent palpation and liver percussion. The percussion boundaries of the liver, the values of the 1st, 2nd and 3rd Kurlov’spercussion sizes of the liver  were compared with the corresponding ultrasound data. The cranio-caudal and oblique vertical dimensions, anterior-posterior dimensions of the right and left lobes, and transverse size of the liver were also measured during ultrasound. Based on them, the volume of the liver was calculated according to the formulas of M.Zoli and D.Childs.

Results: The magnitude of the 1st and 3rd sizes of absolute liver dullness did not significantly differ from that measured by ultrasound, the 2nd size was significantly smaller. The range of values of all sizes during percussion was higher than during ultrasound. Percussion liver sizes significantly correlated with ultrasound dimensions, but not with liver volumes. The diagnosis of hepatomegaly as a consequence of liver diseases according to percussion data using various criteria was characterized by high sensitivity (71-86%), but very low specificity (5-31%). The calculated volume of the liver according to D. Childs (sensitivity 71%, specificity 95%) and the oblique vertical size of the liver (sensitivity 71%, specificity 84%) had the highest diagnostic accuracy.

Conclusion: the percussion of the boundaries of the absolute dullness of the liver satisfactorily coincides with the ultrasound boundaries, but weakly correlates with the volume of the liver, a key criterion for hepatomegaly. In the physical diagnosis of hepatomegaly palpation is possibly preferable method, which better correlates with ultrasound data and allows to assess the consistency of the organ.

Introduction. A close relationship between oral pathologies and general diseases has been established. Type 2 diabetes mellitus (T2DM) often plays a role in the development of comorbid internal pathology and oral diseases, which is based on metabolic, hemodynamic, and immunological dysfunction. In the oral cavity, T2DM clinically manifests as xerostomia, gingivitis, periodontitis, and rapid caries development.

Objective. To assess the significance of dental status in patients with T2DM and prediabetes in the progression of comorbid oral lesions.

Materials and Methods. A total of 75 individuals were examined. Group 1 consisted of 45 patients with T2DM. Group 2 included 30 individuals diagnosed with prediabetes. The control group consisted of 39 practically healthy people. Dental status was assessed using the caries severity index (CFEt), periodontal indices (PMA, PI, CPITN), and hygiene indices.

Results. The study revealed that both groups had similar complaints, but the severity of these complaints was significantly higher in patients with diabetes. Complaint intensity was assessed on a 5-point scale. Individual oral hygiene indicators in Group 1 corresponded to the Poor Hygiene Index, while those in Group 2 were unsatisfactory. The CFEt index was significantly higher in patients with type 2 diabetes than in Group 2 and healthy controls. Elevated PMA and PI indices in Group 1 compared to Group 2 indicated moderate to severe chronic periodontitis. These same patients in Group 1 had a higher CPITN index and met the criteria for comprehensive treatment.

Conclusions. The caries severity index, hygiene, and periodontal indices in patients with diabetes were significantly worse than in patients with prediabetes. These data highlight the need for regular dental monitoring of patients with both type 2 diabetes and prediabetes.

According to current concepts, immuno-inflammatory rheumatic diseases are similar to COVID-19 in terms of clinical manifestations, immune responses and pathogenetic mechanisms, which is due to the systemic nature of the lesion. In patients with genetic prerequisites, both infection and vaccination against COVID-19 can trigger the immune-inflammatory process. The article presents a clinical observation demonstrating the diagnostic difficulties encountered in the diagnosis of systemic scleroderma and polymyositis that developed after COVID-19. Оnly timely diagnosis and adequate therapy can significantly improve the condition and, consequently, the prognosis of this category of patients. A special feature of this case is the absence of autoimmune markers – immunoblots confirming the diagnosis of systemic scleroderma and polymyositis in the presence of vivid clinical symptoms of each of these diseases. The addition of rituximab to the standard basic therapy increases its effectiveness.

This article provides references and our own data on the methodology for conducting medical telemedicine (remote) consultations with elderly patients with mental disabilities and difficulties in mastering digital interaction skills.

The article is dedicated to the outstanding domestic scientific occupational athologist, hygienist, academician of the Russian Academy of Sciences V. G. Artamonova, the creator of the modern concept of vibration disease, the creator of one of the leading occupational pathology schools of the former USSR and modern Russia.

Vitaly Fedorovich Zhdanov is an outstanding Russian clinician, therapist, and pulmonologist. He is a recognized scientific authority who has made a major contribution to the development of science and the training of scientific and faculty staff, becoming a Teacher for many doctors. He is a well-known clinical scientist in our country and abroad, who has made a huge contribution to the development of therapy and pulmonology. Medical and faculty work was closely combined with administrative work in all posts where he worked. Vitaly Fedorovich is a man of a broad soul and great charm, who has an indisputable authority among the medical community of St. Petersburg and Russian Federation.