Recombinant proteins from lactobacilli were obtained in purified soluble form. These proteins were subsequently screened for activity against a range of pathogenic microorganisms. Ribonucleoside hydrolase C (RihC) and cysteine synthase A (CysK) were shown to exhibit activity against biofilms of certain ESKAPE microorganisms. RihC also exhibited synergistic activity with certain antibiotics. In some cases, protease M23 has demonstrated intrinsic activity against pathogenic microorganisms, as well as synergism with a number of antibacterial drugs — meropenem, aztreonam, and ceftazidime.

Background. The article examines the presence of the steroid hormone testosterone in drinking water in the KabardinoBalkarian Republic (KBR). Testosterone is a difficult-to-remove micropollutant originating from wastewater from populated areas, agricultural runoff, pharmaceutical waste, as well as other sources.

Materials and methods. Testosterone was quantified using high-performance liquid chromatography with tandem mass spectrometric detection (HPLC-MS/MS) according to EPA Protocol 539-2010 on a HELICON 1800 HPLC instrument with solid-phase extraction of water samples.

Results. Data on testosterone concentrations in surface and drinking water from 11 populated areas of the KBR were obtained. Testosterone levels in the region's surface waters were found to reach 1.1–1.9 ng/L, while all drinking water samples analyzed had testosterone concentrations below the limit of quantification ( 1.0 ng/L). At such low concentrations, no direct impact of testosterone on aquatic ecosystems or human health was observed.

Conclusion. The article highlights the environmental significance of the findings and the need for enhanced monitoring of endocrine-disrupting contaminants in water resources.

Background. The development of short, safe, and effective chemotherapy regimens for drug-resistant tuberculosis in children and adolescents — based on the introduction of new drugs — remains a pressing issue. The aim of the study was to evaluate the effectiveness and safety of short-course chemotherapy regimens incorporating delamanid (Dlm) in children and adolescents with tuberculosis caused by multidrug-resistant, pre-extensively drug-resistant, or extensively drug-resistant (MDR/pre-XDR/XDR) strains.

Materials and Methods. A prospective, open-label, non-comparative study has been conducted since March 2022. The study enrolled 37 patients (aged 2–17 years) with various forms of respiratory tuberculosis who received Dlm in combination with a standard regimen consisting of at least three drugs. The primary efficacy analysis was performed upon completion of the main course of chemotherapy, involving an assessment of treatment outcomes; the secondary analysis consisted of a follow-up visit at one year to monitor for tuberculosis recurrence. The assessment of Dlm tolerability was based on: cardiotoxic reactions (ECG monitoring); neuropsychiatric reactions (patient interviews, observation of behaviour and sleep).

Results. The treatment outcome recorded was «clinically cured» for 100% of patients across all age groups. Short-course chemotherapy regimens were administered to 83.0% (29/35) of patients (70.4–95.3%, 95% CI). Of the 29 patients treated with short-course regimens: 3 received a 6-month regimen, 9 received a 9-month regimen, and 17 received a 12-month regimen. Follow-up was conducted one year after the completion of shortcourse treatment regimens in 16 patients; no relapses were detected. An association between the administration of Dlm and the development of adverse reactions was established in 8% (3/37) of cases — specifically, neuropsychiatric adverse reactions.

Conclusion. The use of Dlm in combination with other drugs within short-course chemotherapy regimens for tuberculosis — specifically, cases involving MDR, pre-XDR, or XDR Mycobacterium tuberculosis — demonstrates a high success rate when administered as part of a comprehensive treatment strategy.

Ovarian cancer is a pressing issue in modern oncology. According to statistics, ovarian cancer ranks 9th in the structure of oncological diseases among the female population of Russia, and 7th in terms of mortality. Chemotherapy protocols used to treat this disease often lead to cardiovascular toxicity. Cardiovascular events associated with the use of taxane-based drugs develop in 12– 13% of cases. Therapy with platinum-based drugs increases the risk of myocardial infarction and coronary artery disease by 3.1 and 5.7 times, respectively. Surgical intervention is associated with high anesthetic risks in the presence of concomitant somatic diseases in the decompensation stage. This article presents the experience of successful treatment of locally advanced serous ovarian adenocarcinoma against the background of severe cardiac pathology.

The irrational use of antimicrobial agents in hospitals is a key factor in the development of antibiotic resistance. Regular monitoring of antimicrobial use makes it possible to optimize pharmacotherapy and identify factors contributing to the rise of antibiotic resistance.

The aim of the study was to examine the practice of prescribing antimicrobial drugs to hospitalized patients based on the results of the Global Point Prevalence Survey (Global-PPS) conducted in Tashkent hospitals.

Materials and methods. The study covered three inpatient facilities. The analysis included 54 hospitalized patients undergoing treatment at the time of the assessment. At the facility P1 (the clinic of the Republican Specialized Scientific-Practical Medical Center of Epidemiology, Microbiology and Infectious Diseases), 26 patients receiving treatment in the Infectious Disease and Intensive Care Units were examined. At the R3 inpatient facility (City Clinical Hospital), the study was conducted in the Urology Department. At the R4 inpatient facility (Republican Specialized Scientific-Practical Medical Center of Pediatrics), 28 patients hospitalized in two Pediatric Departments were examined.

Conclusion. The results of the study can be used to improve the prescription of antimicrobial agents in each of the participating hospitals, as well as to monitor the effectiveness of antimicrobial stewardship activities.

The relevance of the study is determined by the high prevalence of Helicobacter pylori infection in Russia (50-80% of the population) and the growing problem of antibiotic resistance, which requires constant monitoring of the effectiveness of various eradication therapy regimens.

The aim of the study was to evaluate the effectiveness of various antibacterial therapy regimens for H. pylori eradication in patients of the North-Western Federal District, as well as to identify factors influencing the success of the treatment.

Material and methods. A retrospective analysis of 201 medical histories of patients with H. pylori-associated diseases was conducted. The following methods were used: video gastroduodenoscopy, rapid urease test, histological biopsy specimens, and ¹³C-urea breath test. Statistical processing was performed using the R software environment.

The study results showed an 86.6% overall eradication therapy effectiveness. The best results were demonstrated by regimens containing levofloxacin (96.7%), with the combination of levofloxacin and furazolidone showing 100% effectiveness. A positive impact was observed with double-dose esomeprazole (95.1% effectiveness) and alpha-glutamyl-tryptophan (95.2% effectiveness). Probiotic use did not show statistically significant influence on the outcome. A decrease in the effectiveness of the classical regimen with amoxicillin and clarithromycin to 85.2% was revealed, which may be associated with widespread antibiotic therapy during COVID-19. The practical significance of this study lies in determining the most effective eradication therapy regimens for the region, as well as identifying factors that enhance treatment success. The results can be used to optimize approaches to H. pylori infection therapy.

Background. Gastric outlet stenosis is one of the most frequent and severe complications of gastric cancer; it significantly limits the possibility of antitumor therapy and worsens the prognosis of the disease. Gastric outlet stenosis develops in 15–30% of patients with distal forms of gastric cancer. According to current research, the median overall survival in palliative care for patients with gastric obstruction ranges from 3 to 6 months after stenting and from 6 to 12 months after surgical bypass anastomosis.

The aim of the study was to evaluate the results of treatment of patients with gastric outlet stenosis, taking into account: the timing of the start of chemotherapy, the timing of recovery of enteral nutrition, the duration of hospitalization, the frequency of complications, the frequency of repeated interventions, and overall patient survival.

Materials and methods. A retrospective, single-sample study was conducted. The study included 183 patients. Unlike a number of studies, the evaluation of treatment effectiveness included not only the timing of the start of chemotherapy, but also the timing of recovery of enteral nutrition, the duration of hospitalization, the frequency of complications, the need for repeated interventions, and overall survival rates.

Results. The majority of patients (58.47%) were admitted with stage IV cancer. After endoscopic stenting, the resumption of oral food intake occurred most quickly — on average within 1–3 days, while most patients could take liquid and soft food in the first days after the intervention. The earliest time to start chemotherapy was observed in patients after performing radical surgery — 25.2 days. The shortest period of hospitalization was also observed in patients who underwent stenting and amounted to 5–7 days.

Conclusion. The results obtained demonstrate that despite the use of modern treatment methods, there is still a high proportion of late-stage cases of the disease and the need for further optimization of treatment tactics.

Pancreatic injuries following blunt abdominal trauma, despite their relative rarity, remain a significant problem due to diagnostic difficulties, the specifics of complex therapy, and the high risk of complications. Based on literature data, the article analyzes the postoperative care of patients with blunt pancreatic trauma and how nutritional support can improve treatment effectiveness. A clinical case demonstrates the rationale for incorporating Remaxol (inosine + meglumine + methionine + nicotinamide + succinic acid) into the postoperative care regimen for a patient with pancreatic trauma. The inclusion of Remaxol as a nutritional support agent contributed to a smoother postoperative course and a more rapid recovery.

The introduction of diazabicyclooctane-based inhibitor-protected β-lactams into clinical practice has significantly expanded the treatment options against infections caused by carbapenemase-producing Gram-negative bacteria. Nevertheless, the actual clinical progress has been limited due to the rapid development and spread of resistance to the new drugs. This review summarizes and analyzes current data on the mechanisms of resistance to inhibitor-protected β-lactams.

Currently, mycobacterioses occupy one of the leading positions in the structure of infectious pathology, representing a significant challenge for the healthcare system. In addition to the pathogens of classical infections — Mycobacterium leprae and Mycobacterium tuberculosis — more than 200 species of nontuberculous mycobacteria (NTM) have now been identified and are associated with the development of lesions in various organs and systems. This review presents the epidemiological and clinical characteristics of mycobacterioses, as well as current approaches to standard etiotropic therapy. Particular attention is paid to the key factors limiting treatment efficacy: the structural and functional features of the mycobacterial cell and the phenomenon of acquired antibiotic resistance. The results of using mycobactriophages as an alternative treatment are presented, and the main problems of phage therapy are identified, as well as the possibility of its use as a promising therapeutic strategy, the implementation of which will increase the effectiveness of mycobacteriosis treatment with traditional antibacterial drugs, reduce the risk of developing antibiotic resistance of non-tuberculous mycobacteria, and also combat biofilm-forming and granuloma strains of non-tuberculous mycobacteria.

Penicillin allergy is one of the most frequently reported drug reactions among pregnant women; however, in most cases, the diagnosis is based solely on patient history without objective verification. In obstetric practice, this has substantial clinical implications, as β-lactam antibiotics remain first-line agents for the prevention and treatment of infections, including intrapartum prophylaxis for Group B Streptococcus, antibiotic prophylaxis during cesarean delivery, and treatment of syphilis in pregnancy. An unverified allergy label limits the use of optimal treatment regimens, promotes the prescription of broader-spectrum alternatives, and may be associated with an increased risk of infectious complications. This review analyzes current evidence on the evaluation of penicillin allergy in pregnant patients, including skin testing, direct oral challenges, and risk stratification tools. Clinical studies demonstrate a high rate of penicillin allergy de-labeling and a favorable safety profile of diagnostic procedures when appropriate patient selection is applied. The article also discusses the impact of allergy verification on antibiotic prescribing patterns and obstetric outcomes. Verification of penicillin allergy within routine prenatal care should be considered an essential component of rational antibiotic therapy and antimicrobial stewardship in obstetrics. Expanding targeted diagnostic strategies may increase the use of first-line β-lactam antibiotics without adversely affecting maternal or neonatal outcomes.

In modern rheumatology, the problem of comorbid infections (CI) deserves special attention; their relevance is associated with both immune disorders in the context of background immuno-inflammatory rheumatic disease (IIRD) and the need to use drugs with immunosuppressive effects. The use of innovative biological agents and targeted basic anti-inflammatory drugs has made it possible to achieve great success in the treatment of IIRD. However, with the accumulation of global clinical experience, it has become clear that the use of these drugs is accompanied by an increased risk of developing infectious complications (including severe ones) of various etiologies and localizations. The presentation of up-to-date data on the frequency and localization of major CI in patients with IIRD treated with these drugs is the purpose of this narrative (descriptive) review. The first part of the review describes the issues of infectious complications of therapy with tumor necrosis factor-alpha inhibitors.

In modern clinical practice, stable angina is considered as part of the spectrum of chronic coronary syndromes, in which ischemic symptoms can be caused not only by epicardial atherosclerotic obstruction, but also by microvascular dysfunction or a vasospastic mechanism. The aim of this review was to systematize current data on the diagnosis and treatment of stable angina, focusing on ischemic mechanisms, the choice of instrumental methods, as well as the rationale for treatment strategies. Analysis of the available sources shows that a significant proportion of patients experience persistent anginal symptoms in the absence of hemodynamically significant stenosis, and the most informative tools for clarifying the ischemic mechanism are FFR/iFR, PET stress test, and coronary CT angiography. Optimal drug therapy remains the basis of treatment, while revascularization is indicated only when the functional significance of the lesion is proven. For refractory angina, spinal stimulation may be considered in specialized centres.