Background. Mycosis fungoides is a primary epidermotropic T-cell lymphoma of the skin, characterized by the proliferation of small and medium-sized T-lymphocytes with cerebriform nuclei. According to the US National Cancer Institute Surveillance, Epidemiology and End Results (SEER), the development of mycosis fungoides occurs predominantly over the age of 50 years, which makes it difficult to diagnose mycosis fungoides in young people.

   Objective. The authors present a case of mycosis fungoides verified in a 26-year-old patient who consulted a dermatovenerologist at the State budgetary institution of the Sverdlovsk region "Ural Research Institute of Dermatovenereology and Immunopathology" with complaints of rashes on the skin of the back, accompanied by tingling and periodic itching, as well as hair loss and a burning sensation on the scalp.

   Materials and methods. From the anamnesis it was revealed that the patient considered herself sick for about 10 years, when at the age of 16 she began to experience short-term (up to 2-3 weeks) episodes of itching and redness of the skin of the back. Over the previous 2 years, he has noted a significant progression of the disease: the appearance of a focus of hair loss on the scalp, an increase in the intensity of skin itching and an increase in the size of existing spots on the skin of the back. Based on the medical history, clinical data, results of pathomorphological and immunohistochemical studies of skin biopsies, the patient was diagnosed with primary skin lymphoma, mycosis fungoides, stage IB-IIA (T2NxMxBx). The patient was referred to an oncologist at her place of residence for additional examination and specialized therapy.

   Сonclusion. Despite the well-known clinical and pathomorphological criteria of mycosis fungoides in adult patients, doctors have difficulties in diagnosing this disease in children's practice, since dermatovenerologists are less alert to mycosis fungoides and therefore the manifestations of the disease are mistaken for atopic dermatitis, psoriasis, pityriasis and other dermatoses that are often registered in children. The presented clinical case confirm the possibility of the development of mycosis fungoides in young people, shows the importance of oncological alertness dermatovenerologists and pediatricians.

   Background. According to the Ministry of Health of Russia in the Russian Federation, the prevalence and incidence of atopic dermatitis in the population in 2021 were 390.4 and 155.4 per 100 thousand population, respectively. The prevalence of atopic dermatitis among children aged 0-14 years reaches 1444, the incidence is 644 per 100 thousand of the corresponding population, among children aged 15-17 years – 1047 and 329 per 100 thousand of the corresponding population. Among the adult population of the Russian Federation, the prevalence of atopic dermatitis was 129.2, the incidence was 39.4 per 100 thousand of the corresponding population.

   Objective. This paper presents a review ofcurrently available methods of improving the treatment of atopic dermatitis via digital technology means.

   Results. As is the case with other chronic diseases, atopic dermatitis significantly affects quality of life of patients and their families. This impact is directly influenced by patient knowledge of the disease, their adherence to treatment (i.e. willingness to thoroughly followphysician’s prescriptions and instructions)as well as proper skin care during both acute and remission phases. Improving patients’ or their caregivers’ knowledge of atopic dermatitis can thus improve their quality of life. Vast majority of international as well as Russian clinical guidelines for the management of atopic dermatitis place special emphasis on the patient and family education: traditional treatment is to be supplemented with educational programs. A prime example of such program would be an online school, as it is not time consuming for physicians. Wide spread of mobile technologies allowed patients to accessinternet from their smartphones and in this way presented another opportunity to involve them in the treatment. This is commonly done through mobile applications for patient education, assistance and support, and such applications have already been developed in Russian.

   Conclusion. Modern digital and internet technologies thus give patients access to not only structured educational programs, but also to mobile applications forself-control that motivate patients to adhere to the treatment, especially basic skin care routine.

   Background. Listeriosis is a widespread natural focal infectious disease in humans and animals, characterized by a variety of sources of the causative agent of infection, as well as variability in clinical course and outcomes. The clinical manifestations of the disease are diverse, the most dangerous are the generalized forms – septic and nervous (meningitis, meningoencephalitis), which often develop with generalization of the gastrointestinal form. Constant monitoring allows you to monitor the emergence of new foci of the disease and their spread in the countries of the world, including Russia. Given the emergence of listeriosis outbreaks around the world and the significant severity of the disease, the World Health Organization is actively developing preventive measures.

   Objective. To draw the attention of practitioners of various profiles to the nervous form of listeriosis, which occurs in the form of meningitis and/or meningoencephalitis.

   Materials and methods. The article presents a clinical case with a favorable outcome, describing damage to the central nervous system due to listeriosis in a 67-year-old patient who was admitted to Infectious Diseases Clinical Hospital No. 2 in Moscow in serious condition. The diagnosis of listeria meningoencephalitis was established on the basis of epidemiological, clinical, laboratory and instrumental data; when examining the cerebrospinal fluid using PCR, Listeria monocytogenes DNA was detected. Damage to the central nervous system with the development of meningoencephalitis was caused first by listeria, and then by the addition of secondary flora (Streptococcus species group G, detected by culture of cerebrospinal fluid). After the treatment, the patient was discharged in satisfactory condition with subsequent follow-up by an infectious disease specialist and a neurologist.

   Conclusion. The clinical case demonstrates the difficulties in diagnosis and draws the attention of practitioners to the need for caution against listeriosis in the differential diagnosis of meningitis and meningoencephalitis of various etiologies.

   Background. Malaria remains a serious health problem in the Russian Federation with deaths reported annually. Tropical malaria is a severe form of the disease due to the development of severe complications, one of which is cerebral coma. In the Omsk region, only isolated imported cases from endemic countries are registered. The disease is caused by protozoa of the genus Plasmodium. Human infection occurs through the bite of a female mosquito belonging to the genus Anopheles. It is believed that 1 % of children infected with Plasmodium falciparum develop a more severe form of malaria, which can eventually lead to cerebral complications, including cerebral malaria. The pathogenesis of the development of cerebral coma is due, for example, to certain P. falciparum proteins that attach to the surface of infected red blood cells. Subsequently, adhesion of the endothelial layer occurs, which leads to widespread sequestration of infected red blood cells
and the development of proinflammatory and procoagulant reactions.

   Objective. To analyze cases of tropical malaria registered in the Omsk region in the period 2021-2022, who were treated at the Clinical Infectious Diseases Hospital No. 1 named after D. M. Dalmatov.

   Materials and methods. The medical record of an inpatient patient, form 003/у, was used. The team of authors presented two clinical cases of tropical malaria with different disease outcomes.

   Results. The patients were crew members of sea vessels, who periodically face the need to use medications for malaria. The WHO global malaria control strategy recommends Artemether + Lumefantrine for prevention and treatment.

   Conclusions. The importance of timely seeking medical help and prescribing effective antimalarial drugs is shown. At the prehospital stage, information from the epidemiological history and the clinical manifestations of malaria were significant, which made it possible to predetermine the outcome of the disease.

   Objective. The aim of the study was to study the features of the central nervous system (CNS) lesion in patients with HIV infection in the Novosibirsk region.

   Materials and methods. 204 adult patients with HIV infection were examined, hospitalized with CNS lesion, the average age was 39 ± 3.82 years. Clinical symptoms and laboratory parameters, the level of CD4+ lymphocytes were evaluated. A molecular genetic analysis of HIV-1 was carried out on the basis of the State Research Center of Virology and Biotechnology ″VECTOR″.

   Results. Among 204 patients, the etiology of CNS lesion was verified in 75.6%, including CNS tuberculosis in 21.1 %, cerebral toxoplasmosis in 17.2 %. The disease was severe – 68.9 %; extremely severe with fatal outcome – in 17.5 %. The highest mortality was among patients with primary CNS lymphoma (100 %), CMV encephalitis (80 %) and PML (44.4 %). The lowest CD4+ values were observed in patients with PML (78.6 ± 30.1 cl/mcl), cryptococcal meningitis (53.8 ± 19.4 cl/mcl) and CMV encephalitis (32.8 ± 10.3 cl/mcl). Headache was more often observed in cryptococcal meningitis (100 %), motor disorders – in cerebral toxoplasmosis (94.3 %), cognitive and mental disorders – in PML (88.8 %) compared with other nosologies (p < 0.001). Inflammatory changes in the cerebrospinal fluid were more often observed in CNS tuberculosis (95.3 %) and cryptococcal meningitis (80 %), less often in cerebral toxoplasmosis (37.1 %) and PML (11.1 %), p < 0.001. Genotyping of HIV-1 in 36 patients revealed two genetic variants of the virus: subtypes CRF63_02A6 (91.7 %) and A6 (8.3 %). All patients with subtype A6 had a moderate course of the disease.

   Conclusion. Secondary diseases of the central nervous system in HIV infection are more often associated with a severe degree of immunodeficiency. The established features of their manifestations contribute to early diagnosis and therapy.

   Background. Using soy formulas in infant nutrition goes back more than 100 years. They have evolved from simple mixtures based on ground roasted beans to high-tech modern products based on soy protein isolate. Due to their high nutritional value, soy formulas remain a popular alternative when it comes to choosing a dairy-free diet. But there is still an ongoing debate about their safety, with particular attention being paid to the content and activity of phytoestrogens. In 2021, an international consensus of experts recognized soy formulae as safe for growth and development based on available scientific evidence. However, research continues, and with the growing popularity of plant-based diets, soy continues to be a focus of attention for scientists around the world. From the uncontrolled use of soy formulas in the past, the trend has long since shifted to using them as a specialized product for indications under medical supervision. Soy formulae are included in major international recommendations as second-line dietary therapy for cow's milk allergy. Allergy prevention with soy formulae, however, remains open and requires further research. Soy formulae are the product of choice for galactosemia and can also be used for diarrhea. They remain in the pediatrician's practice, but require certain prescribing guidelines.

   Objective. This article reviews the recommendations of leading experts and regulators on the use of soy protein isolate-based infant formulas.

   Background. The first year of a baby's life is a unique period. Growth rates at this age are very high. There is also intensive formation of the entire body, including the gastrointestinal tract; under these conditions, the process of formation of microbiota also occurs, which has a decisive influence on the digestibility of nutrients, the state of the immune system, nervous and other systems. This period of time provides the greatest opportunity to provide optimal nutrition for the normal development of the child, being, in fact, an open ″window of opportunity.″ The most important epigenetic factors that determine the expression of certain genes and, accordingly, human health are nutrition, stress, physical activity and the environment. Epigenetics is the science of the inherited properties of an organism that are not associated with changes in the actual nucleotide sequence of DNA and can be encoded not directly, but indirectly in the genome. Within the framework of the concept of nutritional programming, normalization of the body weight of the expectant mother and nutritious nutrition with sufficient amounts of macro- and micronutrients are extremely important factors determining the health of the child. Breastfeeding provides the best nutrition for the infant in terms of proper development and epigenetic effects. Breast milk has an optimal composition and maximum bioavailability of all its constituent substances. Unfortunately, there are a number of objective reasons that limit or make breastfeeding impossible. In such cases, the child is fed with adapted milk formulas based on cow's or goat's milk. For artificial feeding, it is necessary to choose modern, high-quality formulas that are as close as possible in composition to breast milk and selected individually, taking into account the child’s condition.

   Results. According to many studies, goat's milk has some features that make it more similar to human milk, unlike cow's milk, and make the use of mixtures based on it attractive. Goat's milk, like human milk, contains exclusively A2 β-casein. The existing difference in the protein components of cow's and goat's milk contributes to easier digestion of mixtures based on goat's milk, facilitating the absorption of epigenetically significant nutrients. The milk formulas of the mixture based on goat's milk are enriched with a unique fat complex containing 42 % β-palmitate, which makes the digestibility of the mixtures even closer to breast milk. The process of metabolic programming is influenced by the state of the infant's intestinal microbiota. High levels of β-palmitate have a beneficial effect on the development of microbiota in formulafed infants and promote healthy metabolic programming. The most important prebiotic, substrate and carbon source for the growth of normal microflora in the infant’s intestines are breast milk oligosaccharides. The content of oligosaccharides in goat's milk is significantly lower than in women's milk (about 0.25-0.3 g/l), but higher than in cow's milk (0.03-0.04 g/l). Goat milk contains at least 14 oligosaccharides, some with molecular similarities, and 5 of them are completely identical to the oligosaccharides of breast milk and have similar beneficial effects. Thus, goat milk is an attractive natural source of oligosaccharides for the production of quality infant formulas.

   Background. Pain in the lower back occupies one of the leading places among the reasons for visiting doctors of various specialties and disability of people of different age categories. Back pain limits life activity, reduces the quality of life of patients, changes the psyche and behavior of people. Only full-fledged rehabilitation allows one to restore previous motor activity and reduce the period of temporary disability among the working part of the population.

   Objective. To investigate the effectiveness of combined hardware thermal and low-frequency therapy in medical rehabilitation of patients with lumbar sciatica.

   Materials and methods. A retrospective analysis of statistical data was carried out on 90 patients in the department of medical rehabilitation of patients with dysfunction of the peripheral nervous system and the musculoskeletal system of the treatment and rehabilitation center of the State Autonomous Healthcare Institution "City Clinical Hospital No. 7 named after M. N. Sadykov" Kazan. Patients were randomly divided into two groups – I main (n = 45) and II control (n = 45). Patients of group I (main), against the background of standard therapy, received combined treatment using a thermotherapeutic personal stimulator massager N4 with accessories, including low-frequency stimulation through a myostimulation belt included in the package of the massager and roller massage with tourmanium rollers, which perform hardware massage of the back and lumbar region at a certain angle of the spine paravertebrally, as well as uniform distribution of heat and massage pressure; Group II (control) received standard treatment (physical therapy, classic massage of the back and lumbar region). The effectiveness of the measures taken was assessed based on the vertebrogenic status of patients before and after medical rehabilitation.

   Results. More pronounced statistically significant positive dynamics at the end of the course of medical rehabilitation were noted in patients of group I (main): a decrease in pain syndrome on the VAS scale, the severity of scoliosis, and tension in the paravertebral muscles; increased range of motion in the lumbar spine. The level of anxiety on the HADS scale and Lasegue's symptom also decreased statistically significantly in patients of group I compared with group II (control).

   Conclusion. The effectiveness of the use of the thermotherapeutic personal massager-stimulator N4 with accessories in the treatment of patients with lumbar ischialgia is supported by the results of a study showing that patients in group I (main) had a more significant improvement in the statodynamic function of the spine, a decrease in pain, the severity of scoliosis, anxiety and depression, an increase amplitude of movements in the lumbar spine compared to patients in group II (control) who received a course of treatment without a combined low-frequency thermal stimulator (p < 0.1).

   Background. Constipation is one of the most common complaints and reasons for seeking medical help. Difficulties in bowel movements, pain and discomfort experienced during this process, and rare and scanty stools significantly reduce the quality of life of patients. The variety of causes that cause constipation requires a balanced and consistent approach to diagnosing and treating the problem. In everyday outpatient practice, so-called simple constipation is more common, the main cause of which is a lack of foods rich in fiber in the diet, therefore, in the system of therapeutic measures, substances containing dietary fiber play an important role, stimulating an increase in the volume of feces, improving intestinal transit, reducing intraintestinal pressure and normalizing the motor-evacuation function of the colon.

   Results. The article discusses the characteristics of constipation, modern approaches to their diagnosis in patients, as well as treatments for constipation belonging to various groups – osmotic laxatives; agents that cause chemical irritation of receptors in the intestinal mucosa; drugs that cause an increase in volume and dilution of intestinal contents; agents that soften stool and facilitate its movement through the intestines; drugs that cause an increase in stool volume.

   Conclusion. Effective remedies in this group include psyllium, a preparation made from the seeds of plantain oval, which, when taken regularly, provides patients with daily and painless soft stools. The drug is effective both for chronic constipation and for pathology of the anorectal area in the postoperative period, for hemorrhoids, anal fissures, inflammatory bowel diseases and infectious enterocolitis. The drug can be used for a long time and, if necessary, combined with other laxatives. The status of a medicinal product guarantees the use of high-quality raw materials, pharmaceutical psyllium, that meets the requirements of pharmaceutical control.

   Background. It is often believed that gout is an uncommon disease and therefore of little interest to general practitioners. However, the incidence of gout in the world is steadily increasing, which is explained by the increase in the population of persons with hyperuricemia. Allergic reactions, non-compliance with the treatment regimen, drug interactions, and sometimes the ineffectiveness of hypouricemic therapy leads to a severe course of the disease. Gout often occurs in combination with diseases such as obesity, diabetes, arterial hypertension. At present, the course of coronavirus infection against the background of gout is of great interest. Taking into account the Interim Guidelines of the Ministry of Health of Russia, version 17 of December 14, 2022 ″Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)″, patients with immunoinflammatory rheumatic diseases represent special groups of patients. In case of infection of such patients with the SARS-CoV-2 virus, it is necessary to interrupt treatment with standard basic anti-inflammatory drugs (methotrexate, leflunomide, azathioprine), genetically engineered biological drugs (tumor necrosis factor-α inhibitors, IL-6, IL-17, IL-12 /23, IL-23, T-cell co-stimulation blockers, anti-B cell drugs (rituximab, belimumab) Hospitalization should be carried out only for urgent indications with the provision of laboratory data on the absence of SARS-CoV-2 infection.

   Objective. This article discloses the details course of coronavirus infection in a patient with immune-mediated gout with an allergy to all anti-gout drugs and the absence of specific hypouricemic therapy for more than 30 years.

   Results. The severity of the condition was determined by bleeding from a steroid gastric ulcer, adrenal insufficiency secondary to regular and uncontrolled intake of corticosteroids and non-steroidal anti-inflammatory drugs. Also, the condition was regarded as severe due to the symptoms of intoxication, hyperthermia, asthenovegetative syndrome, diarrheal syndrome. The patient was visualized chronic infection of the bloodstream in the form of vegetation on the tricuspid valve, increased markers of sepsis and systemic inflammation, which was interpreted as a manifestation of bacterial sepsis. However, due to the lack of dynamics against the background of ongoing antibiotic therapy – the persistence of fever, an increase in the number of tophi in the area of the hands and feet, the progression of arthralgia, it was assumed that this is due to the underlying disease and the development of an independent immune mechanism for damage to internal organs and the deposition of tophi on the tricuspid valve. Taking into account the clinical picture of the disease and the data of laboratory and instrumental examination, the diagnosis of bacterial sepsis was excluded and the condition was regarded as an immune-mediated sepsis-like severe course of gout in the absence of treatment with secondary amyloidosis of internal organs and deposition of tophi, including on the tricuspid valve. Olokizumab 160 mg/ml – 0.4 ml subcutaneously was prescribed for treatment in order to stop the systemic immune inflammatory response. After the introduction of the drug, there was a gradual normalization of body temperature, a decrease in pain, articular syndrome and an indicator of the level of IL-6.

   Conclusion. Thus, olokizumab therapy brought a significant positive effect and contributed to the stabilization of the patient's condition. It should be noted that in patients with immune-mediated diseases, infectious acute diseases can occur in a sepsis-like form and should be assessed comprehensively and early preventive anti-inflammatory therapy initiated.

   Background. Cerebral palsy is one of the main causes of childhood disability. In this case, the main form of brain damage is periventricular leukomalacia, the preferred diagnostic method for which is ultrasound.

   Objective. Objective of the study: to study the features of the course, the nature of structural changes and the clinical significance of periventricular leukomalacia in the formation of cerebral palsy. The study design wasa prospective, observational, single-center study.

   All patients were initially in the intensive care unit due to the presence of multiple organ failure. Inclusion criteria: newborns with perinatal lesions of the central nervous system in combination with structural changes in the brain according to ultrasound. Exclusion criteria: newborns with perinatal lesions of the central nervous system with no structural changes in the brain according to ultrasound. Clinical observation of patients began in the neonatal period. Subsequently, dynamic observation was carried out with an assessment of the state of the nervous system up to 4 years. For an objective assessment of the psychomotor development of children in the first year of life, the method of quantitative assessment of the child's age development according to the L. T. Zhurba and E. A. Mastyukova.

   Results. 115 patients were under observation (full-term – 31, premature – 84). Forming and formed cerebral palsy was diagnosed in 20 patients. The leading nosological form of damage to the central nervous system in the neonatal period in patients was cerebral ischemia (95 %). In 80 % of patients, structural changes in the brain, according to ultrasound, were in the form of periventricular leukomalacia. Both non-cystic forms (10 patients) and cystic forms (6) were identified. The level of psychomotor development according to L. T. Zhurba and E. A. Mastyukova at the age of 3 months was 6.8 ± 0.65 points; at 6 months – 8.9 ± 0.77 points; at 1 year – 12.2 ± 0.78, which indicated a total gross delay in psychomotor development in the first year of life. In patients with cerebral palsy at the age of 1-year, atrophic dropsy of the brain was recorded with the presence of a pathognomonic sign – expansion of the third ventricle in proportion to the lateral ventricles of the brain, which is associated with a deficiency of oligodendroglia and myelin in periventricular leukomalacia. In 16 surviving children, the following organic lesions of the central nervous system were formed: cerebral palsy, severe double hemiplegia, symptomatic epilepsy (5 children; 31.3 %); cerebral palsy, severe double hemiplegia (5 children; 31.3 %); cerebral palsy, spastic diplegia (6 children; 37.4 %).

   Background. Short bowel syndrome, or short intestine, as a rule, is a consequence of extensive intestinal resection, usually of the iliac and skinny sections, when no more than 115-200 cm remains from the original length (on average in the population of 6.5 meters). Short bowel syndrome is not so much anatomical as functional, since clinical manifestations are often they depend on both the residual length and the level of the lost fragment, the safety of the ileocecal valve, comorbid conditions and the age of the patient. The lethality of such conditions is kept at a high level, due to the loss of the organ of absorption of nutrients and fluid, the rapid development of severe intestinal insufficiency and electrolyte decompensation. Currently, the issue of tactics for managing such patients remains open, clinical studies are actively continuing, new drugs for treatment are being registered, new approaches and the need for routing regulation in order to reduce mortality are emerging.

   Objective. This article was written with the aim of evaluating modern methods of treating patients with short bowel syndrome using the example of a clinical case described in the Republic of Bashkortostan.

   Results. In a patient diagnosed with: "Other intestinal malabsorption: short bowel syndrome, ultrashort variant (35 cm after bowel reconstruction) in the presence of a large intestine. Condition after repeated operations, including autologous reconstruction of the intestine, the use of the drug teduglutide led to an improvement in the processes of adaptation of the residual fragment of the intestine. For 5 years, the patient gained weight, a decrease in the frequency of bowel movements and a decrease in stool volume were recorded. A decrease in dependence on parenteral nutrition was noted. In addition, the patient noted a good tolerability of the treatment and a significant improvement in well-being. Thus, a comprehensive multidisciplinary approach, as well as rational management of patients with short bowel syndrome, can significantly improve the quality of life of patients suffering from this disease.

   Background. Currently, clinicians are facing a large number of patients who have passed a new coronavirus infection. Most of them have various manifestations of post-COVID-19 syndrome, among which numerous neurological and cardiovascular clinical symptoms are most often recorded. For example, fatigue (asthenia) according some authors its frequency can reach 70 %. Nonspecific manifestations of post-COVID-19 syndrome can mask the symptom complex of paraneoplastic syndrome, the prognosis of which is noticeably more serious. Paraneoplastic syndrome is a group of various clinical manifestations from various organ systems in patients with malignant neoplasms, not associated with the primary tumor focus or its metastasis. In most cases, the cause of paraneoplastic syndrome is the activation of tissue-specific autoimmunity, which is the result of an immune response against cancer. Clinical manifestations can be both neurological, endocrine, gastrointestinal, skin, and nonspecific symptoms, the frequency of which, according to recent data, can reach 10-18.5 %. The interaction of a new coronavirus infection and oncopathology is an urgent problem, while data in open sources are scarce. In most cases, a severe course of the infectious process, an increase in the duration of hospitalization, a worse prognosis for recovery and an increase in the frequency of deaths among such patients are reported.

   Results. The article presents a clinical observation of a patient with a tumor lesion of the bladder with history of COVID-19 four months before the diagnosis of oncopathology. Of interest is the diagnostic search for the disease in conditions of minimal symptoms from the affected organ. Given the active examination of patients who have undergone COVID-19, despite the blurred clinical picture and the presence of non-specific clinical manifestations, many of them may suffer from oncological diseases, due to the negative trigger effect of SARS-CoV-2 on the tumor process.