Objective. To evaluate the contribution of genetic variability in the proinflammatory cytokine system to the development of druginduced long QT syndrome (LQTS).
Materials and methods. 129 patients with cardiac arrhythmias taking Class III antiarrhythmic drugs (amiodarone or sotalol) were examined. Depending on the presence or absence of drug-induced LQTS, patients were divided into 2 groups: group 1 (n = 64) – with QT interval prolongation; group 2 (n = 65) – without QT interval prolongation. Forty individuals without a history of cardiac arrhythmias served as a control group. All patients underwent polymerase chain reaction analysis for the T31C and C3953T polymorphisms in the IL-1b gene, C3872T in the CRP gene, G308A in the TNF-α gene, and G174C in the IL-6 gene. Statistical analysis was performed using Statistica 12.0.
Results. The most pronounced effect was demonstrated by the combination of the CT genotype of the IL-1b gene C3953T polymorphism, the GC genotype of the IL-6 gene G174C polymorphism, and the GA genotype of the TNF-α gene G308A polymorphism. These genotypes increased the risk of developing LQTS by 5.26 times (95 % CI (1.42–19.50), p = 0.013). Using the Fruchterman – Reingold algorithm, the G308A polymorphism of the TNF-α gene (9.16 %), the C3953T polymorphism of the IL-1b gene (8.95 %), and the G174C polymorphism of the IL-6 gene (6.31 %) had the greatest predictive potential for the development of LQTS. The greatest genegene interaction effect was demonstrated by combinations of the G308A TNF-α gene and C3872 CRP gene polymorphisms (5.22 %), as well as the G308A TNF-α gene and T31C IL-1b gene polymorphisms (3.49 %).
Conclusion. The obtained data support the possible involvement of the proinflammatory cytokine genetic polymorphism system in the regulation of drug-induced LQTS development. A putative mechanism for this association may be the varying degrees of activation of potassium and calcium ion channels in response to the causative drug, which depends, among other things, on the patient's blood cytokine concentration.

Objective. To characterize the clinical and laboratory characteristics of patients aged 60–74 years with stage 2–3 cardiorenometabolic syndrome (CKM) and a retrospective assessment of 15-year follow-up.
Materials and methods. Anthropometric, laboratory and instrumental examination data of patients contained in the medical records of 73 overweight/obese patients with arterial hypertension aged 60–74 years without clinical cardiovascular clinical diseases (CKM stage 2 and 3).
Results and discussion. The incidence of diabetes/prediabetes was 20.5 % (95 % CI (12.9–31.2)), metabolic syndrome was 64.4 % (95 % CI (52.9–74.4)). The TyG index in patients with metabolic syndrome ranged from 7.78 to 11.83, median (Me) and interquartile interval [Q1; Q3] were 8.84 and [8.53; 9.13] and exceeded the results of patients without metabolic syndrome (Mann – Whitney test z = 4.018413, p = 0.0001). In 44.9 % of patients, the serum uric acid level was equal to or greater than 360 μmol/L. The growth rate over 15 years was 106 % for obesity (6 % increase), 202 % for hypertension (102 % increase), and 500 % for diabetes mellitus (400 % increase). Over a 10-year period, the structure CKD-EPI ≥ 60/˂ 60 mL/min/1,73м² ranged from 80/20 % to 65/35 %.
Conclusion. The study gives an idea of the frequency and 15-year dynamics without progression to CKM stage 4 in the elderly under the conditions of observation by the media service of an industrial enterprise.

Objective. To determine the prognostic risk factors for recurrence in patients with respiratory tuberculosis and quantify their impact.
Materials and methods. The study was based on data from 224 patients with respiratory tuberculosis of working age. For the first time, all patients were referred to the Minsk City Medical Rehabilitation Expert Commission to determine disability, and in difficult expert cases to the consultative and polyclinic department of the Russian National Research Center for Medical Examination and Rehabilitation to clarify the severity of existing disability, as well as the clinical and labor prognosis for the period from 2017 to 2024. The average age (SE) of patients in this cohort was 47.4 (0.71) years.
Results. In the course of the study, indicators were identified that have a statistically significant effect on the risk of disease recurrence in the study cohort of patients with respiratory tuberculosis. The risk of developing the disease increases statistically significantly in the presence of the following negative factors: male gender (OR = 2.33), age > 51 years (OR = 2.31), living in rural areas (OR = 3.27), basic level of education (OR = 1.96), social category – not working (OR = 5.81), the presence of professional technical education (OR = 7.5), harmful working conditions (OR = 1.79), low skill level (OR = 2.23), unskilled labor (OR = 4.12) and BMI < 22 kg/m² (OR = 2.17).
Сonclusion. The identified prognostic risk factors for recurrence in the study cohort of patients with respiratory tuberculosis will be used to assess their combined impact, build a mathematical model of their combined impact, and develop a comprehensive methodology for assessing the risk of recurrence in patients with respiratory tuberculosis.

Cerebral stroke is one of the most significant causes of persistent disability in the population. Upper limb dysfunction as the most common consequence of stroke significantly limits the social adaptation of patients and their quality of life. Despite the availability of valid tools for assessing motor disorders (FMA-UE, WMFT, ARAT) and household activity (Bartel, Katz, FIM scales), existing methods do not allow for an adequate assessment of patients' social maladaptation outside their usual home environment. The analysis revealed a gap in the rehabilitation examination system: standard scales mainly record basic self-service skills, but do not reflect the difficulties of performing socially significant actions such as using ATMs, electronic devices, public transport, and financial transactions. This problem is particularly important in patients with mild to moderate disabilities, who may maintain domestic independence but experience serious limitations in social interaction. The article substantiates the need to develop a specialized questionnaire focused solely on the assessment of social functioning. Such a tool will make it possible to improve the rehabilitation process by identifying “hidden” disability and developing targeted social reintegration programs, which is a key factor in improving the quality of life of patients after a stroke.

Objective. To develop a clinical management algorithm for pregnant women with Wernicke encephalopathy based on a comprehensive literature review and the authors’ own clinical experience.
Materials and methods. This article presents data from both international and domestic sources, as well as the authors’ personal clinical observations on the subject.
Results. Both clinical cases of Wernicke encephalopathy in pregnant women occurred in the context of severe hyperemesis gravidarum, accompanied by thiamine deficiency and characteristic neurological manifestations, including elements of the classic triad: oculomotor dysfunction, ataxia, and mental status changes. Timely administration of high-dose thiamine combined with comprehensive intensive care led to stabilization and complete resolution of symptoms. In both cases, pregnancy was successfully prolonged to full term, resulting in favorable outcomes. These observations underscore the importance of early diagnosis and immediate initiation of therapy when Wernicke's encephalopathy is suspected in pregnant patients, most commonly in the setting of excessive vomiting.
Conclusion. The proposed clinical management algorithm for Wernicke encephalopathy in pregnancy may improve maternal and perinatal outcomes and help prevent long-term neurological sequelae.

Objective. To analyze research findings on the primary definitions of functional pain syndromes in pediatric practice and to determine possible approaches for managing patients in this group.
Materials and methods. The search was conducted using the MEDLINE, PubMed, Google Scholar, and eLIBRARY search engines with the keywords “functional neurological disorders,” “children,” “pain syndrome,” “headaches,” and “nonspecific dorsalgias”. Publications related to literature reviews, randomized controlled trials, and clinical case series descriptions were selected. A total of 22 literature sources covering the period from 1970 to 2025 were analyzed.
Results. Based on the experience of foreign colleagues, it is considered that the development of functional pain syndromes is rooted in psychogenesis features, evaluated within the sociopsychobiological model. This concept accounts complex neurobiological cognitive processes responsible for the perception of life events, the function of attention to them and to one's own symptoms, as well as mnestic functions involved in forming previous experiences. Furthermore, the model incorporates complex cognitive processes of self-awareness and self-control, including mechanisms of experiencing the significance (meaning and sense) of perceived information. We also believe that a number of genetic factors underlie the development of functional pain syndromes, which is supported by current research.
Conclusion. A key aspect in the management of patients is the exclusion of an organic substrate in the development of pain syndrome, preventive measures aimed at avoiding chronification, as well as relevant and timely comprehensive therapeutic support. The effectiveness is achieved through the interaction of medical specialists within multidisciplinary teams using both drug and nondrug methods, as well as behavioral and cognitive-behavioral therapy.

Multiple endocrine neoplasia syndrome type 1 (MEN 1, Wermer syndrome) is a group of heterogeneous inherited diseases, caused by hyperplasia or neoplastic transformation of several endocrine glands. MEN 1 syndrome is characterized by variable combinations of endocrine disorders. Cancer awareness in patient with diagnosed and genetically confirmed multiple endocrine neoplasia type 1 syndrome relatives plays an important role.
This case demonstrates a non-classical manifestation of the disease with neuroendocrine tumor of the pancreas, accompanied by hiperinsulinemic hypoglycemia, and the subsequent detection of primary hyperparathyroidism.

The article is devoted to the problem of polymorbidity of systemic lupus erythematosus (SLE). A clinical case of SLE with a chronic course, which at a certain stage of the disease occurred with peripartal cardiomyopathy and acute kidney injury, is described in detail. The presence of SLE in the patient made it difficult to diagnose concomitant pathology timely, since the development of peripartal cardiomyopathy was initially regarded as lupus carditis, as well as acute hemodynamic and medicinal kidney injury as lupus nephritis.