Background. A literature search of various databases revealed mixed and largely contradictory results regarding the etiology, pathogenesis, prevalence, and diagnostic criteria of cerebral amyloid angiopathies and iatrogenic amyloid angiopathies, which prompted the writing of this literature review.

Aim of the review. To analyze current literature on the etiology, pathogenesis, prevalence, and diagnostic criteria of cerebral amyloid angiopathies and iatrogenic amyloid angiopathies.

Research methods. A comprehensive literature search strategy was developed in PubMed/Medline and the Cochrane Central Trials Register. The search strategy included a randomized control option. Studies were searched from July 2010 to September 2025 without restrictions on the level of evidence or publication status. Both English-language articles and Russian publications were analyzed.

Results. Iatrogenic amyloid angiopathy is a late complication following neurosurgical procedures, primarily involving cadaveric dura mater transplantation in children with traumatic brain injury. Cases of Iatrogenic amyloid angiopathy following cerebral vascular embolization using lyophilized dura mater have been described, as well as a late complication of red blood cell transfusions and growth hormone therapy. Iatrogenic amyloid angiopathy encompasses a wide range of clinical manifestations, from intracerebral hemorrhages with transient neurological impairment to seizure activity. Iatrogenic amyloid angiopathy diagnosis is based on the Boston criteria 2.0 and neuroimaging data.

Conclusion. Despite a significant increase in awareness of Iatrogenic amyloid angiopathy, further study of this nosological entity remains highly relevant. More research is needed to update and expand our understanding of the etiology, pathogenesis, and clinical picture of the disease, and to modify diagnostic criteria for a more accurate clinical diagnosis.

Background. Connective tissue dysplasias are quite common among the population and are often accompanied by developmental disorders of the skeleton, visual organs, the dental system, neuromuscular and cardiovascular pathologies, etc. The prevalence of hereditary elastinopathies in some populations averages from 10 to 30 %. Clinical and molecular genetic diagnostics are key aspects in recognizing elastinopathies. Underestimating abnormalities in elastin fiber development leads to long-term complications and a reduced quality of life for patients.

Aim: To analyze the molecular genetic and clinical manifestations of elastinopathies.

Materials and methods. An analysis of literature and scientific citation databases was conducted (online Mendelian Inheritance in Man, Database of Genotypes and Phenotypes, GeneCards (an integrated database providing detailed genomic, proteomic, transcriptomic, and genetic information about human genes), and GenBank (an open database containing all annotated gene sequences).

Results. It was shown that diseases associated with impaired elastin tissue development are caused by a number of genes, such as ELN, FBN1–FBN3, FBLN1–FBLN7, TGF-β, TGFBI, TBP1–LTBP4, MFAP1–MFAP4, LOX, LOX1, EMILIN1–EMILIN2, VCAN and HSPG2. Elastinopathies typically have a polymorphic clinical picture and are systemic in nature. Most hereditary diseases of elastin fibers manifest as skeletal dysplasias. Cardiovascular anomalies, eye and skin diseases. The clinical presentation of these diseases often has similar symptoms and requires differential diagnosis. Therefore, molecular genetic confirmation of the diagnosis is an important aspect in the diagnosis of elastinopathies.

Conclusion. Disorders of elastin fiber development often remain undifferentiated. Clinical and molecular genetic diagnosis of elastinopathies is an important aspect of providing medical care to patients with this pathology. Systematization of the phenotypic manifestations and molecular genetic basis of elastinopathies is necessary for the successful prevention of the long-term consequences of these diseases.

Relevance. Hypertension is a leading global health burden and a major risk factor for cardiovascular disease and premature mortality. Prehypertension, particularly in young adults, often goes unrecognized but predicts future hypertension. Both modifiable factors – diet, physical activity, tobacco use, and stress – and non-modifiable factors – age, sex, and family history – affect blood pressure. Early detection is essential for prevention.

Aim. To assess the prevalence of normotension, prehypertension, and hypertension, and their associated risk factors among adults in a tertiary medical institution in Jaipur, India.

Materials and methods. A cross-sectional study was conducted over 6 months among 700 participants aged 18–60 years at Rajasthan University of Health Sciences College of Medical Sciences and Associated Hospitals, Jaipur. Blood pressure was measured according to Ministry of Health and Family Welfare guidelines. Socio-demographic, anthropometric, and lifestyle data were collected. Statistical analysis was performed using SPSS v16, with p < 0.05 considered significant.

Results. Of 700 participants (56 % male; mean age 22.8 ± 6.7 years), 65,0 % were normotensive, 34,9 % prehypertensive, and 0,02 % hypertensive. Prehypertension was more common in males, urban residents, physically inactive individuals, and those with obesity, central obesity, high salt intake, tobacco or alcohol use, or moderate-to-severe stress. Family history of hypertension was more frequent in prehypertensive and hypertensive participants.

Conclusion. Prehypertension is prevalent among young adults and is strongly associated with modifiable lifestyle factors and family history. Early identification and targeted lifestyle interventions are crucial to prevent progression to hypertension and reduce long-term cardiovascular risk.

Background. Thyroid gland pathology is the leading endocrine disease. According to modern requirements of a personalized approach to medicine, there is a need to study the expression of genes involved in immunoregulation and biosynthesis of thyroid hormones.

Aim. To study the features of gene expression of iodothyrone deiodinases types 1, 2, and 3, iodotyrosine deiodinase, thyroid hormone receptor alpha and beta, and acetyltransferases types 1 and 2 in thyroid tissue samples from patients operated on for euthyroid and toxic goiter.

Materials and methods. A study included patients living in the Irkutsk region who underwent thyroidectomy for benign thyroid diseases in 2021–2023: 12 patients with diffuse toxic goiter, 9 with multinodular toxic goiter, and 11 with multinodular euthyroid goiter. The expression of genes was studied using the polymerase chain reaction.

Results. Active expression of the iodothyrone deiodinases types 3 and iodotyrosine deiodinase genes was detected in thyroid tissues for the first time. In multinodular toxic goiter, higher iodothyrone deiodinases types 3 expression was detected in patients with the development of postoperative laryngeal paresis (p=0.05). The thyroid gland sizes are consistent with the expression of receptors that determine iodothyronine metabolism: with thyroid hormone receptor beta expression in toxic thyroid gland, and with iodothyrone deiodinases types 1 in euthyroid thyroid gland (p <0.05). Thyroid hormone receptor alpha expression was absent less frequently in multinodular toxic goiter than in diffuse toxic goiter (p=0.005) and multinodular euthyroid goiter (p=0.0003), indicating a relationship between TRα expression and the development of nonimmune thyrotoxicosis. Acetyltransferases types 2 is expressed in all variants of the disease, while acetyltransferases types 1 expression is detected less frequently.

Conclusion.  The study demonstrates the features of gene expression of iodothyrone deiodinases types 1, 2, and 3, iodotyrosine deiodinase, thyroid hormone receptor alpha and beta, and acetyltransferases types 1 and 2 in thyroid tissue samples of patients operated on for euthyroid and toxic goiter. The relationships of individual genes with the features of the disease course and complications are shown.

Relevance. Intervertebral disc degeneration is a natural process of involutional changes that, in some cases, progresses rapidly and intensely, becoming pathological and accompanied by pain. It is one of the most common causes of disability. Existing methods for visually assessing intervertebral disc degeneration are subjective and dependent on the power of the magnetic resonance imaging scanner.

Aim: to develop a unified quantitative method for assessing intervertebral disc degeneration.

Materials and methods. A prospective, single-center study was conducted involving 20 patients (60 discs) diagnosed with lumbar dorsopathy. Magnetic resonance imaging was performed in DWI mode with the calculation of the degeneration coefficient (X) as the ratio of the measured diffusion coefficient of the nucleus pulposus to the measured diffusion coefficient of the cerebrospinal fluid.

Results. When comparing the obtained X-factor values ​​for degeneration of 60 intervertebral discs with the Pfirrmann classification, degenerated discs had an X-factor value less than 0.8, while no signs of degeneration were detected with an X-factor value greater than 0.8. Consequently, the lower the X-factor value, the more severe the degeneration. A comparison of the obtained values ​​did not reveal a direct correlation, due to the subjective nature of signal intensity assessment in T2 mode during magnetic resonance imaging.

Conclusions. The X degeneration coefficient is an objective, reproducible parameter independent of tomograph power and suitable for pathology stratification and dynamic monitoring.  The proposed method enables quantitative assessment of degenerative changes. The obtained results confirm the fundamental viability and advantages of the proposed degeneration coefficient X. A promising direction for its full validation and implementation in clinical practice is multicenter studies on an expanded cohort of patients.

Background. The method of anterior decompression (discectomy) for monosegmental stenosis of the cervical spinal canal is subjectively assessed as highly effective by both neurosurgeons and the vast majority of patients. However, the objective criteria for the early effectiveness of this intervention have not been sufficiently studied to date.

Aim of the study to evaluate the dynamics of electroencephalography parameters in the preoperative and early postoperative period in patients with monosegmental stenosis of the cervical spine.

Materials and methods. Electroencephalography studies were conducted on 22 patients of the neurosurgery department, before and after surgical treatment under code A16.23.085.001. The spectral composition of the bioelectrical activity of the brain (alpha, beta, delta and theta rhythms), as well as the coherence of oscillations in selected leads, were studied.

Results. In the preoperative period, a disorganized type of electroencephalogramm was recorded in the examined group according to the classification of E.A. Zhirmunskaya; there was a decrease in the index and amplitude of the alpha rhythm in the parietal-occipital leads; predominance of high-amplitude beta activity in the frontal-central leads; presence of diffuse delta activity of the average index and theta activity of the average index, localized in leads P3, P4, C3, C4. On the 5th day after the operation, an organized type of electroencephalography was recorded on the encephalogram; a well-modulated alpha rhythm was observed, with a frequency in the range from 9 to 10 Hz, and an amplitude of 70 to 80 microvolts. Low-amplitude beta rhythm activity was recorded in the frontocentral leads. Low-amplitude delta and theta rhythms were recorded in the parieto-occipital leads and had a low index. Overall, the obtained data indicated positive dynamics in the restoration of cortical rhythms.

Conclusion. The positive dynamics of cerebral cortex biorhythms in the early postoperative period allows the use of the electroencephalography method to objectify the results of surgical treatment, and in the future for the purposes of neurorehabilitation.

Relevance. Degenerative lumbar spinal stenosis is a common cause of chronic pain and neurogenic intermittent claudication in elderly and senile patients. Clinical manifestations often do not correlate with the degree of spinal canal narrowing as determined by magnetic resonance imaging, requiring the use of comprehensive diagnostic methods, including electrophysiological ones.

Aim: was to conduct a comprehensive analysis of the relationships between magnetic resonance imaging data, electroneuromyography parameters, and the severity of clinical symptoms in patients with degenerative lumbar spinal stenosis.

Materials and Methods. A comprehensive clinical and instrumental study was conducted on 71 patients, aged 60 to 82 years, diagnosed with degenerative lumbar spinal stenosis. Pain was assessed using a visual analog scale, functional status using the Oswestry scale, and dural sac area using magnetic resonance imaging. The electroneuromyography study included an assessment of the H-reflex from the peroneal and tibial nerves. Statistical analysis was performed using the Spearman correlation coefficient.

Results. A moderate negative correlation was found between the dural sac area and the H-reflex latency (r = -0.68, p < 0.05). The relationship between the degree of stenosis and pain intensity according to the Visual Analogue Scale was weak and insignificant (r = 0.32, p > 0.05). The highest correlation was observed between an increase in the H-reflex latency and a deterioration in the functional status according to the Oswestry index (r = -0.81, p < 0.01).

Conclusion. Electrophysiological methods, particularly H-reflex testing, are a highly sensitive tool for objectively assessing the functional state of spinal roots and nerves in degenerative spinal stenosis. Electrophysiological measurements demonstrate a closer correlation with the patient's functional status than neuroimaging data, making them a valuable tool for monitoring and informing treatment decisions.

Background. Anti-NMDA receptor encephalitis is an autoimmune disorder of the central nervous system characterized by antibodies directed against the GluN1 subunit of the NMDA receptor. The disease most commonly affects children and young women and often presents with psychiatric and seizure manifestations that can mimic viral encephalitis or acute psychosis. Although considered rare, timely recognition is essential, as early initiation of immunotherapy is closely associated with favorable outcomes and reduced risk of relapse.

Case description. We report a clinical case of a 16-year-old female patient admitted with her first episode of generalized tonic-clonic seizures and marked behavioral changes. The medical history revealed a preceding two-week period of increasing fatigue, sleep disturbances, and episodes of disorientation. Initial clinical suspicion was postinfectious encephalitis; however, infectious causes were excluded after extensive testing. Brain MRI demonstrated bilateral inflammatory changes in the hippocampi, and cerebrospinal fluid analysis revealed the presence of anti-NMDA receptor antibodies, confirming the diagnosis of anti-NMDA receptor encephalitis. The patient received immunotherapy, including high-dose intravenous corticosteroids and intravenous immunoglobulin. This resulted in a rapid clinical improvement with complete recovery of cognitive and motor functions, cessation of seizures, and normalization of sleep.

Conclusion. This case illustrates the typical course of anti-NMDA receptor encephalitis in adolescents and emphasizes the need for high clinical vigilance in patients presenting with a combination of psychiatric symptoms and seizures without evidence of infection. Detection of antibodies to the NMDA receptor in cerebrospinal fluid remains the diagnostic gold standard. Early initiation of immunotherapy significantly improves functional outcomes and prevents fatal outcomes. A comprehensive, multidisciplinary approach involving neurologists, psychiatrists, and immunologists is essential for the successful management of patients with autoimmune encephalitis.

Relevance. The differential diagnosis of motor neuron diseases is very difficult in practical medical practice. Early diagnosis of this group of diseases, in particular, progressive supranuclear palsy, is of particular importance. In this case, pathognomonic clinical signs and neuroimaging correlates become crucial in verifying the diagnosis.

Cases descriptions.  Paired clinical observations of progressive supranuclear palsy, differing in signs during magnetic resonance imaging of the brain, are presented. The article describes the clinical observations of two patients with progressive supranuclear palsy (Steele-Richardson-Olshevsky syndrome). Detailed clinical characteristics of each case are presented. The data of a magnetic resonance imaging examination of the brain of each patient are presented. In the first case, the characteristic symptoms of "hummingbird" and "Mickey Mouse" were obtained. In the second case, these signs were not detected. Both patients are under dynamic observation, this allows you to quickly assess changes in the clinical neurological status, the results of treatment and carry out preventive work to prevent dangerous complications of the disease (dysphagia, falls). The discussion presents a differential series for progressive supranuclear palsy and possibilities of quantitative automated and manual planimetry in the analysis of magnetic resonance images of the brain.

Conclusion. These approaches to the management of patients with progressive supranuclear palsy contribute to the early diagnosis of the disease, correction of treatment, and prevention of complications.

Relevance. The problem of post-traumatic diaphragmatic dome defects and abdominothoracic organ displacement remains relevant due to the frequency of combined open and closed chest injuries, late diagnosis, and high latency in cases of intestinal loop strangulation and necrosis.

Aim: To review our experience in the management of post-traumatic massive abdominothoracic dislocation of the right lobe of the liver, small and large intestines, and the greater omentum into the right hemithorax.

Case report. A 63-year-old man presented with a suspected right side post-traumatic diaphragmatic hernia. Five years ago, he had incurred a traffic accident with multiple rib fractures. After a physical examination and computed tomography scan imaging, the diagnosis was confirmed. The operation was performed using abdominal and thoracic approaches.

Results. Postoperative running was uneventful. The patient was discharged with recovery. Examination in 6 months showed adequate physical activity and absence of complaints. Breathing in the lungs was symmetrical. The overall chest roentgenogram demonstrated the consolidation of fractured ribs, and the lungs without visible pathology.

Conclusion. Herniation of the abdominal organs into the right hemithorax induced clinical manifestations of respiratory failure and dyspepsia which progressed. The diagnosis was made immediately after the patient’s presentation. The planned surgery was successful and prevented strangulation of the internal organs.

Relevance. Covering the work of outstanding doctors and scientists plays a significant role in educating the younger generation and preserving Russian medical traditions. This publication explores the life and career of pediatric surgeon and professor at Irkutsk State Medical University, Vsevolod Andreevich Urusov.

Results. It also highlights the wartime years of a very young V.A. Urusov, when he distinguished himself as a dedicated soldier, serving several years on the Eastern Front during the Great Patriotic War as a tank gunner. After the war, V.A. Urusov enrolled at the Irkutsk Medical Institute, and after graduating, he began his career at a district hospital, where he gained valuable practical experience and laid the foundation for his future professional growth. One of V.A. Urusov's most important achievements was the creation and development of a pediatric surgical service in Irkutsk. Under his leadership, specialized departments were established and 24-hour emergency surgical care was introduced, significantly improving the quality of medical care for children. Professor Urusov made a significant contribution to the development of medical personnel, mentoring several generations of talented physicians. He devoted great attention to the education of students and young specialists, sharing his knowledge and experience with them. Thanks to his efforts, pediatric surgery in Irkutsk has become one of the leading specialties in the region and beyond.

Conclusion. Vsevolod Andreevich Urusov left an indelible mark on the history of medicine and education in Irkutsk. His life and professional work exemplify his dedication to his field and his commitment to continuous improvement. Thanks to his efforts, pediatric surgery in the region has reached a high level of development, providing patients with access to highly qualified and specialized medical care from his many talented students.