Treatment strategies based on the combined action of light waves and photosensitive compounds (PS) on tumor cells are highly promising. However, their widespread application is hindered by the penetration depth of infrared waves into body tissues and the “imperfect” design of drugs used in medical practice. The PS activated by electromagnetic waves can be used for non-invasive treatment of deep-seated tumors. The combination of conventional radiotherapy and photodynamic therapy (PDT) can potentially reduce the toxic effect on normal tissues while maintaining the effectiveness of these methods. The action mechanism of radiophotodynamic therapy (RPDT), as well as the experimental models and protocols for its implementation, remain poorly understood. In this review, we present information on the evolution of the RPDT method and the main scientific achievements in this area. These also include the results obtained by joint efforts of the Pacific State Medical University and the Institute of Chemistry of the Far Eastern Branch of the Russian Academy of Sciences, supported by the Priority-2030 strategic academic leadership program.

For local control after breast-conserving surgery for breast cancer, radiation therapy is an integral component of treatment. To reduce damage to the surrounding tissues, both modern modes of intensive modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), as well as postoperative marking of the wound cavity with radiopaque clips or planning according to the visualized volume of postoperative seroma, are used. Existing methods for visualizing the volume of a postoperative wound are not sufficiently accurate, which dictates the need for their further improvement.

The skin is a complex organ closely related to the other organs and systems. These relationships, which are referred to as viscerocutaneous in dermatovenereology, can have various mechanisms, in some cases not fully recognized. In this regard, a significant role in the pathogenesis of most skin diseases belongs to pathological processes that occur in internal organs and systems. Physical examination of the skin helps diagnose different somatic diseases, including diseases of the digestive organs. Depending on the gastric or intestinal disease, the skin changes can manifest themselves quickly or durably, though rarely having any characteristic signs. Nevertheless, certain changes affecting the skin can indicate a failure in one or the other part of the gastrointestinal (GI) tract.

In this work, we carry out a review of scientific literature in the fields of medical dermatology and medical microbiology concerning the etiological factors of palmoplantar warts, i.e., human papillomaviruses (HPV) and marsupial fungi of the Trichophyton rubrum species of the Arthrodermataceae family. A content analysis of the socially significant topic of the most common and often recurrent infectious and inflammatory diseases of the foot and palm skin is conducted. The etiological factor is represented by the resident inhabitants of the human skin microbiome with a ubiquitous distribution, the opportunistic fungi Trichophyton rubrum (Castell.), Sabour., 1911, in symbiosis with non-oncogenic types of human papillomaviruses 1, 3, 27, 29, and 57. The review presents a conceptual analysis of the microbiological properties of symbionts, which are clinically significant in medical microbiology, diagnostic methods, and current approaches to treating the disease. The efficacy, advantages, and disadvantages of chemotherapeutic, physical, and surgical methods are discussed. The problems associated with frequent recurrences of warts and the lack of a unified effective treatment approach are described. A method for non-invasive treatment of plantar warts using silver nitrate, which ensures a reduction in the proportion of relapses to 8% over a 3-year observation period, is presented. Signs of the pathomorphological process develop in the epidermis and dermis with the participation of opportunistic fungi and/or HPV viruses against the background of immunodeficiency, such as HIV infection.

Aim. To study the efficiency of compression microvibration method for correcting structural and functional skin changes in women with gynoid lipodystrophy by analyzing the dynamics of blood microcirculation parameters.

Materials and methods. The study involved 27 women aged 40 to 69 years with mild and moderate gynoid lipodystrophy. The Endospheres Therapy course included 12 procedures, 2 times a week for 60 minutes. Before and after the course of therapy the dynamics of microcirculation compartments was evaluated by laser Doppler flowmetry using LAZMA PF, a portable laser blood microcirculation analyzer.

Results. The perfusion parameters after the 12th procedure of compression microvibration showed statistically significant increase in basal blood flow parameters and amplitude-frequency spectrum of perfusion oscillations reflecting active and passive mechanisms of microcirculatory channel regulation.

Conclusion. The results of positive dynamics of the microcirculatory channel parameters testify to the high efficiency of Endospheres Therapy in the treatment of gynoid lipodystrophy. The method of laser Doppler flowmetry allows objectifying the level of dysfunction of the microcirculatory system and provides personalized control over the adequacy and effectiveness of treatment.

Aim. An analysis of the structure of concomitant pathology in patients with widespread psoriasis vulgaris.

Materials and methods. An open, uncontrolled, single-center retrospective study of the case histories of 100 patients with widespread plaque psoriasis who received medical care in a dermatology department of Irkutsk State Medical University clinics was carried out. Concomitant pathology was established on the basis of anamnesis and physical examination, as well as laboratory tests and consultations with a physician and related specialists.

Results. Diseases of the gastrointestinal tract accounted for 81%, of which non-alcoholic fatty liver disease was detected in 43%. Endocrinopathies were noted in 72% of patients, a third (30%) had obesity of varying degrees, and 14% had type 2 diabetes mellitus. Pathologies of the circulatory system was diagnosed in 34% of patients, including hypertension in 29%. Psoriatic arthritis was detected in 11% of cases. In patients under 40 years of age, an average of 1–2 comorbid conditions were noted, while the number of concomitant diseases increased to 4–5 by the age of 60. Only 17% of the patients had no comorbidities.

Conclusions. In the majority of patients, psoriasis is associated with certain diseases, being a harbinger of their development. This fact should be taken into account when determining personalized treatment tactics.

Aim. To study the serum concentrations of adiponectin and leptin in patients with varying degrees of severity of chronic obstructive pulmonary disease (COPD).

Materials and methods. The study included 116 patients divided into two groups: the main group (n = 96) consisting of COPD patients and stratified into four subgroups and a control group (n = 20). The concentration of adiponectin (ng/ml) and leptin was determined by solid-phase enzyme immunoassay (ELISA).

Results. Statistically significant differences in serum adiponectin contents were revealed between the control group and COPD patients in stages B, C, and D (p = 0.0004); however, its concentration did not correlate with the body mass index and adipose tissue content. No differences were detected in the concentration of leptin between the groups (p = 0.1288); however, its content correlated with the body mass index (R = –0.710871) and adipose tissue content (R = –0.677900). No noticeable correlation was found between the serum concentrations of adiponectin and leptin (R = –0.098481).

Conclusions. The content of individual adipokines demonstrated a different dependence on the anthropometric indicators in COPD patients.

Aim. To study to the frequency of alleles and genotypes of the leptin receptor polymorphism (Arg223Gln) in comorbid patients with asthma and type 2 diabetes, as well as determine the association of leptin receptor genotypes with clinical, laboratory, and instrumental data.

Materials and methods. Patients with asthma and type 2 diabetes were divided into three groups for comparative analysis, with 80 people in each group. All groups were subjected to the following procedures: clinical examination, determination of disease control using Asthma Control Test in patients with asthma, laboratory examination (determination of fasting blood glucose, glycated hemoglobin), spirometry, molecular genetic analysis of polymorphism of the leptin receptor (LEPR) Arg223Gln by PCR using kits for determining in the human genome. Nonparametric statistical methods were used to process the data obtained.

Results. Patients with a combination of diabetes type 2 and asthma were found to have a higher incidence of G-allele polymorphism of the leptin gene (Arg223Gln) as compared to those with these diseases in isolation. The G-allele of the LEPR polymorphism (Arg223Gln) is associated with a higher incidence of diabetes type 2 in patients with asthma. The association of the G-allele in the LEPR gene was found in patients with a combination of asthma and diabetes type 2 with a failure to achieve the target value of fasting blood glucose, a lower parameter of respiratory function FEV1 and a lower control of asthma.

Conclusion. The influence of the leptin receptor polymorphism on the combined course of asthma and type 2 diabetes mellitus is noted. An analysis of the leptin receptor polymorphism (Arg223Gln) is useful when identifying asthma patients at a higher risk of developing diabetes type 2.

Aim. To conduct a genetic analysis of Pseudomonas aeruginosa strains to determine changes in their antibiotic resistance from 2012 to 2023.

Materials and methods. In total, 174 strains of P. aeruginosa isolated from patients treated at a multidisciplinary hospital in Vladivostok (Russia) were investigated. The patients were divided into three groups depending on the year of strain isolation: 2012 and 2019 (prior to the coronavirus pandemic) and 2023 (following the pandemic). PCR was conducted using the OXA23, ISAbaI, IMP, VIM, TEM, and NDM antibiotic resistance genes.

Results. The detection frequency of all studied genetic determinants of antibiotic resistance was found to increase over time. The highest growth was detected during the pandemic period (from 2019 to 2023) for ISAbaI (from 69 to 100%), VIM (from 50 to 70%), IMP (from 28 to 48%), and TEM (from 24 up to 96%).

Conclusion. The emergence and spread of important genetic determinants of antibiotic resistance, including NDM-1, among P. aeruginosa was identified. This determines general trends in the population and indicates a growing distribution of antibiotic resistance determinants, and, accordingly, an increase in the overall level of resistance to antimicrobial drugs in HAI pathogens

The imaging quality of the adrenal arteries in experimental animals is assessed by the data of angiography for further study of different embolization techniques. The study was performed on the material of sexually mature rabbits (n=5) and pigs (n=5). All animals underwent multispiral computed tomography (MSCT) in angiography mode via Briliance 64 (Phillips) apparatus followed by invasive angiography of aorta and visceral arteries using mobile C-arms apparatus (Siemens). Intergroup analysis, involving the results of MSCT-angiography and invasive angiography of aorta and visceral arteries, revealed unsuitability of rabbits for selective catheterization of the adrenal arteries due to their small diameter. Nevertheless, invasive arteriography in pigs ensures bilateral imaging of the main branches of arteries supplying the adrenal glands to be considered suitable for the study of embolization techniques.

Objective. To study the effect of antibacterial substances on bacteria Enterococcus isolated from the aquatic environment with anthropogenic load.

Materials and methods. Study of 61 strains of Enterococcus isolated from water samples of the Vtoraya Rechka river, the Vladivostok territory, was conducted in the period from January 17, 2018 to September 27, 2020. The antibiotic resistance was determined using the disc diffusion test. Statistical data processing was carried out by the Statistica 10 program. Graphs were performed in Excel 10.

Results. The study into susceptibility of 61 strains of Enterococcus to antibiotics revealed the majority of resistant strains to streptomycin (66%, n=40), 56% (n=33) intermediate strains to erythromycin, 72% (n=44) resistant strains to rifampicin, 87% (n=52) susceptible strains to gentamicin, 25% (n=15) intermediate resistant isolates, and 3% (n=2) resistant isolates.

Conclusion. The study of antibiotic resistance in strains of Еnterococcus isolated from the Vtoraya Rechka river showed high levels of rifampicin and streptomycin resistant strains. The population of enterococci strains isolated from the Vtoraya Rechka river appeared 41%-resistant to two antibiotics (n=25), however, one strain proved multidrug resistance to six antibiotics. Resistance to a combination of streptomycin, rifampicin, and erythromycin antibiotics was most commonly detected.

Aim. To characterize pathogenic phenophiles and genoprophiles, as well as antibiotic c resistance of Enterococcus faecalis strains isolated from prostate secretions in males with chronic bacterial prostatitis (CBP).

Materials and methods. Enterococci were isolated using standard bacteriological methods on the Schaedler broth and identified by mass spectrometry. The genetic determinants encoding pathogenicity and antibiotic resistance factors were determined by PCR. The ability of enterococci to inactivate lysozyme (ALA), form biofilms, exhibit hemolysis and adhesion was determined by the photometric method; the penetrance and expressiveness of sIgA protease and anti-cytokine activities were evaluated by enzyme immunoassay.

Results. The isolated strains E. faecalis had a pronounced pathogenic potential, being characterized by the presence of virulence factors (hemolytic activity, adhesive ability) and persistence (ALA, BPO), the ability to inactivate proinflammatory cytokines and sIgA, variable antibiotic resistance with resistance to amikacin and kanamycin. The determinants responsible for the synthesis of proteolytic enzymes (gelE, sprE) and cytolysin (a complex of cyl operon genes), as well as those responsible for evading macroorganism immunity effectors (esp) and the synthesis of adhesion proteins (asa), were identified in the genotype of E. faecalis cultures. The presence of genetic determinants of antibiotic resistance aph(3’)-IIIa, tetM, vanA was found in all isolates.

Conclusion. The obtained results on pathogenic bioprophiles of clinical enterococcal strains can be used to improve approaches to CBP diagnosis. The data on antibiotic resistance (at the level of phenotype and genotype) should be taken into account in the empirical and personalized choice of drugs for a combined treatment of CBP patients.

In the article, a clinical case of a hormonally inactive tumor of the posterior pituitary is described. The clinical symptoms were caused by mass effect (chiasma compression and hypopituitarism). Transnasal transsphenoidal adenomectomy was performed on the patient. Subsequent morphologic examination revealed a solid neoplasm of large cells with broad oxyphilic granular cytoplasm, presumably originating from adenohypophysis cells. By immunohistochemical examination, pituicytoma, a granular cell tumor of the posterior pituitary, was diagnosed. Hence, the significance of differential diagnostics of pituicytoma is indicated, including clinical and hormonal manifestations, as well as pathomorphologic analysis data.

Although the incidence of COVID-19 infection is decreasing, the clinical experience gained during the pandemic remains relevant. In this article, we present clinical cases from our own practice to describe non-standard variants of the development of COVID-19-associated skin pathology in patients of different age groups and during different periods of the infectious process. The conducted analysis of the presented cases revealed the following: systemic pathological processes caused by COVID-19 lead to the development of dermatological symptoms; different strains of SARS-CoV-2 can cause different dermatological symptoms in the same patient; skin rashes appeared as a manifestation of post-Covid syndrome may recur in case of COVID-19 reinfection; immune deviations that developed after COVID-19 infection subsequently lead to clinical pathomorphism of skin diseases; vaccination against COVID-19 may trigger relapses of chronic dermatoses. 

Rare cases of cutaneous sarcoidosis without extracutaneous manifestations are presented. Sarcoidosis is a chronic systemic inflammatory disease of unknown cause characterized by noncaseating granulomas and the involvement of various systems and organs. Most often, the present clinical picture is plaques, nodules, patchy-papular changes, scars, or lupus pernio. The histological examination of a biopsy of the affected skin is the gold standard for diagnosing sarcoidosis. However, the process of diagnosing cutaneous sarcoidosis is often complicated by the similarity of its clinical manifestations with other dermatoses, the rare occurrence of the disease, as well as the absence of data in the patients’ history that would indicate this pathology.

Nodal peripheral T-cell lymphomas (PTCL) represent a rare group of lymphoproliferative diseases, with mature (postthymic) activated T lymphocytes as the substrate. Within this group of lymphomas, the most common subtype is peripheral T-cell lymphoma, unspecified. In this article, a clinical case of erythroderma in cutaneous T-cell lymphoma is described. Based on the medical history, clinical picture, and laboratory examination results, the patient was diagnosed with T-cell lymphoma, unspecified with cutaneous manifestations of erythroderma. The analysis of two lines of therapy, including targeted therapy, is also presented. 

We report a clinical case of osteitis in a young child as a complication of TB immunization with BCG vaccine (Bacillus Calmette – Guérin or Bacillus Calmette – Guérin). The differential diagnosis was made based on an immunologic blood analysis with the T-SPOT.TB test. The conducted antitubercular chemotherapy in combination with surgical treatment resulted in a positive clinical and radiologic outcome with the restoration and filling of bone tissue defects. The child continues to be registered with a pediatric phthisiatrist in the VA group of dispensary observation. The recommended period of observation is up to 18 years of age. Timely detection of signs of bone and joint system complications in the BCG postvaccine period is essential for establishing an accurate diagnosis and prescribing adequate treatment and rehabilitation measures.

Thrombotic thrombocytopenic purpura (TTP), also known as Moschcowitz syndrome, is an orphan, life-threatening, acute-onset disease caused by a deficiency of the metalloprotease that cleaves extra large multimers of von Willebrand factor (ADAMTS13). TTP is a difficult pathology to diagnose due to the pronounced polymorphism of symptoms. In this article, a clinical case of successful diagnosis and first stage therapy of a patient with laboratory-confirmed TTP is presented. Afterwards, the patient was safely transported to the National Medical Research Center for Hematology (Moscow).

The article aims to analyze the successful treatment of paraprosthetic infection of a synthetic bypass in the femoral-popliteal position. Although being rare, the development of allograft infection in the infrainguinal position is one of the most formidable complications and an unsolved problem in peripheral arterial surgeries. The operation of choice is removal of the infected prosthesis. The operation of choice is removal of the infected prosthesis. The method and terms of restoration of the main blood flow depend on the prevalence of infection on the prosthesis, involvement of the anastomosis line, preservation or absence of blood flow on the infected prosthesis, and the presence of bacterioresistant prosthesis. The article presents a case of a patient suffering from paraprosthetic infection with the formation of femoral phlegmon in the area of the proximal anastomosis 3 weeks after allograft prosthetics of the femoral-popliteal segment. The patient underwent femoral-popliteal bypass with reversed autovenous graft of the contralateral limb, drainage of the phlegmon, necrectomy of the infected tissues. In the postoperative period, the wounds were healed by primary tension. The observation period covered three years. The observation period covered 3 years. During examination, the femoral skin had no signs of inflammation. Pain-free walking distance was up to 100 meters, pulsation of the bypass and artery distal to the anastomosis was determined. 

Aim. To analyze retrospectively the accuracy and reliability of hygienic diagnostics in seismic disasters.

Material and methods. Data related to the Spitak earthquake during the period of catastrophe, in the closest and distant periods were analyzed. Primary methods of statistical data processing, scientific analysis and comparison were used.

Results. On the basis of modern studies devoted to the problem under consideration, the previously made conclusion is confirmed, namely the water factor was the main threat in the Spitak disaster zone thus causing the health damage risks for both rescuers and population.

Conclusion. Hygienic diagnostics remains an actual method of scientific knowledge, which provides accurate and reliable conclusions, including in seismic disaster zones.