The review deals with the stages of antiviral therapy of chronic viral hepatitis C. Using different schemes of combined treatment with genetically engineered interferon drugs with ribavirin that makes the treatment so expensive, we observed the successes and failures in the effectiveness of the antiviral therapy, especially in patients with genotype 1 of C virus. The dependence of the efficiency of virologic response on many factors - liver fibrosis and cirrhosis, C virus genotype, ethnicity, as well as the genotype of the IL 28B gene and its loci - has been found out. Therapy with interferon drugs was carried out parenterally for 24 to 48 weeks and longer. In 2012-2014 direct-acting antiviral drugs (DAAs) - NS3/4A protease inhibitors boceprevir and telaprevir - came into use, followed by simeprevir, in combination with pegylated interferon-α and ribavirin for the treatment of patients with chronic viral hepatitis C with 1B and 1A virus genotype. In 2015, the Ministry of Health of the Russian Federation registered the first fully interferon-free combination for the treatment of genotype 1 chronic viral hepatitis, with the trade name of Viekira Pak consisting of 3 direct-acting antiviral drugs: dasabuvir, ombitasvir, paritaprevir, and pharmacological booster ritonavir. Such therapy has shown high efficiency, safety, convenience of use of tablet formulations, a short course of treatment, which contributed to a greater commitment of patients to treatment. Later, registered direct-acting antiviral drugs - daclatasvir and asunaprevir - found their use. The prospects are obvious, although there is still a lot of work to be done in selecting the best approaches to the treatment of all categories of patients with chronic viral hepatitis C.

We have analyzed the problem of preserving and supporting breastfeeding. Based on a review of literature, the article deals with the issue of benefits of breastfeeding for both the child and the mother, reveals the concept of “lactation dominant”. The problems of the lactation period, including the possible manifestations of lactational crises, are discussed. At the same time, special attention is paid to hypogalactia, its causes, manifestations, prevention and treatment. Various methods of preserving, supporting and restoring lactation in women are described, including such a method of restarting breastfeeding, as relactation. We have assessed the possibilities of using the relactation even after cessation of lactation and the transition to a formula.

Information on iron metabolism has been significantly supplemented and changed in recent decades. The review provides data on the main proteins involved in iron metabolism in humans. The mechanisms of iron acquisition in bacteria from the macroorganism and their importance in the development of infectious and inflammatory process in patients with cystic fibrosis are described. Data on the significance of Burkholderia cepacia complex and Pseudomonas aeruginosa siderophores in the processes of binding and transport of iron to bacterial cells are presented. The result of complex interactions of bacteria and macroorganism in cystic fibrosis can be the development of severe exacerbations, including “cepation-syndrome”, which, taking into account the above data, should be considered not only as direct damage to the lung tissue by bacteria, but also as a factor in the formation of a “vicious circle”: viscous sputum leads to infection of the lower respiratory tract with microorganisms that need iron and release it from the tissues, which can stimulate not only lung damage, but also lead to the growth of virulence of bacteria.

In our study we tested blood serum and adrenal gland tissue cortisol levels and investigated the possibility of correction of changes found with Garcinia Cambogia extract. In the experiment we used white male rats distributed into three age groups - immature, adult, and old. Alimentary obesity was modeled by means of dietary refined palm oil in dosage of 30 g per kg of body weight for six weeks. Intragastric administration of Garcinia extract (in dosage of 0.25 g per kg of body weight a day) was started after six weeks of palm oil intake had passed. Palm oil excess resulted in cortisol levels increase both in blood serum and adrenal gland tissue. Elevation of cortisol level progressed with the duration of the experiment. Use of Garcinia Cambogia extract in the dosage of 0.25 g per kg a day lead to a decrease of cortisol levels both in serum and adrenal gland tissue in experimental obese animals.

The article presents the results of the study of the concentrations of two proteins of lactoferrin and lysozyme in the blood serum and peritoneal exudate of rats when simulating purulent or aseptic peritonitis in them. Aseptic peritonitis was modeled by intraperitoneal injection of carrageenan, while purulent peritonitis was simulated by injecting monoculture of gram-positive (Staphylococcus aureus, Streptococcus pyogenes in doses of 108 microbial cells) and gram-negative bacteria (Proteus vulgaris, Pseudomonas aeruginosa, Klebsiella oxytoca in doses of 107 microbial cells) with carrageenan. It has been established that when a rat is infected with a monoculture of bacteria, purulent peritonitis of varying severity develops, and in the blood and peritoneal fluid of rats concentrations of lactoferrin and lysozyme are increased, the level of the proteins in the peritoneal exudate being about 1,5 times higher than in their own serum. In the serum of rats, the levels of lactoferrin and lysozyme were always higher with bacterial peritonitis than with aseptic peritonitis. 2-3 days after the infection, it is the level of lactoferrin, but not lysozyme, in the peritoneal fluid of rats that allows differentiating gram-positive abdominal infection from gram-negative one. Determining the lactoferrin and lysozyme by express method in two biological fluids and calculating the ratio of the concentrations of lactoferrin and lysozyme in the blood and the peritoneal fluid, it is possible with a certain degree of probability from the first days of abdominal infection to suggest the nature of bacterial contamination of the abdominal cavity.

The article presents the author's own data on the determination of predictors of phenotypes of recurrent wheezing in children of early and preschool age, taking into account the instability of the phenotype after the expiration of time and transformation into bronchial asthma (BA). The study included 83 children with the diagnosis of recurrent bronchitis (RB) at the age of 1 to 6 years. Based on the follow-up study which lasted for a six-year period, the children under study were divided into 2 groups, taking into account the phenotypic characteristics. The first group included 39 (46,9 %) children with a favorable outcome of the disease, the second one - 44 (53,1 %) children diagnosed with bronchial asthma (BA) over the past period. When assessing risk factors for recurrent wheezing, it was revealed that food sensitization (p = 0,021), drug allergy (p = 0,021), eosinophilia (p = 0,034), increased IL-1β (p = 0,003), IL-4 (p = 0,034), IL-6 (p = 0,009), IL-8 (p = 0,008) significantly affect the formation of the persistent wheezing phenotype. For the transient phenotype, the most significant predictors were comorbidities of the upper respiratory tract: rhinosinusitis (p = 0,008), adenoiditis (p = 0,008). The discovered predictors make it possible to identify the phenotypes of recurrent wheezing in children of early and preschool age, which will allow personalizing therapy and predicting the outcome of the disease.

Among young children, there is a tendency to growth of respiratory pathology, accompanied by wheezing, which is one of the most urgent medical and social problems. Today, due to the heterogeneity of wheezing, there is an active search for clinical and laboratory predictors, allowing to predict the further course of wheezing with its transformation into one or another nosological form of diseases of the lower respiratory tract to form a personalized approach to therapy. Of particular interest now is the study of immunogenetic bases with the identification of protective alleles of the genes involved in the inflammatory response (in particular, cytokine genes and their receptors) and allowing for the formation of a long-term prognosis of the disease. In this work, the effect of the C-590T polymorphism of the IL-4 gene on the realization of such diseases as bronchial asthma in children and recurrent bronchitis with wheezing was studied. The influence of these alleles and polymorphisms on the phenotypic characteristics of wheezing and clinical and anamnestic features of the course of the diseases is considered. The results can serve as additional criteria for diagnosis and prediction of the disease course.

In the study that involved 240 rats with the initial body weight of 180-200 grams we investigated the influence of intragastric sodium benzoate in quantity of 1500 mg per kg administered daily for 60 days and exposure to ionizing radiation (total 4 Gr. in 4 sessions) on histological structure of the lower incisor. We also investigated the possibility of prophylaxis and correction of alterations found with intragastric administration of sea-buckthorn oil in quantity of 300 mg/kg daily. Sodium benzoate administration resulted in narrowing of odontoblasts, predentin and dentin layers and diminishing of mesio-distal size of the lower incisor; in the readaptation period histological structure of the lower incisor gradually restored. Exposure to ionizing radiation resulted in similar changes though restoration period was longer. Combined action of sodium benzoate and ionizing radiation resulted in more severe derangement of morphological and functional state of dentin secreting structures and restoration was not observed. Administration if sea-buckthorn oil reduced negative effects of experimental influence on histological structure of the lower incisor which was connected with restoration of functioning of odontoblasts.

Treatment of erosive and ulcerative lesions of the gastroduodenal zone in children is a priority task of modern gastroenterology. Lifestyle changes are associated with transformations in morphogenesis and the nature of the pathological process in the gastroduodenal zone, which leads to a diversification of the clinical picture of the disease. The study proves the transformation of the clinical course of peptic ulcer and erosive gastroduodenitis in children with deviation into asymptomatic and obliterated forms. It has been established that duodenal ulcer disease is significantly more often diagnosed in children living in urban areas. This is due to the availability of highly qualified medical care, the presence of specialized hospitals.

The article discusses the author’s experience with monopolar (M-TURP) and bipolar (B-TURP) transurethral resection (TUR) of the prostate for benign prostatic hyperplasia (BPH) performed in a total of 49 patients, approximately the same number of patients in each group, in three private clinics. Information from modern urological literature on the technical characteristics of operations, indications and complications are given. The main purpose of the article is to give recommendations to general practitioners and novice urologists for adequate preparation of patients with BPH for TUR of prostate surgery, optimization of the choice of endourological instruments and irrigation solutions, taking into account reduction of intraoperative complications. It has been revealed that with a large prostate gland (> 70 g), bipolar resection of the prostate gland is a relatively safe method of resection compared with monopolar resection, taking into account the risk of TUR syndrome. It is confirmed that epidural anesthesia is preferable to spinal one, especially in simultaneous operations, taking into account the control of postoperative pain. Antibacterial treatment 24 hours before surgery reduces the risk of developing postoperative infection in patients with acute urinary retention and / or when handling the Foley catheter in situ. In this study, no significantly higher urethral stricture frequency has been found in the bipolar group. It has also been established that chronic urinary tract infections (chronic epididymitis, chronic prostatitis) in elderly men are not a contraindication for performing surgically “clean” operations in the inguinal-scrotal region.

The emergence of secondary bilateral synchrony phenomenon on the electroencephalogram in focal epilepsy is associated with a worsening of the course of epilepsy and features in the selection of anti-epileptic drugs. There are very few works that study the effectiveness of anti-epileptic drugs in focal epilepsy with the phenomenon of secondary bilateral synchrony on the electroencephalogram, in both domestic and foreign sources. Studying the effectiveness of monotherapy and early polytherapy can improve the prognosis for achieving remission for this group of difficult patients.