Introduction. Cold airway hyperresponsiveness (CAHR) is common in patients with asthma. The effect of inhaled corticosteroid/long-acting β2-agonist therapy (ICS / LABA) on its severity, and the role of IL-8, and the eosino-philic profile of bronchial inflammation have not been studied.

   Aim. To study the dynamic relationship between the level of IL-8 and eosinophilic inflammation in the bronchi of asthma patients with CAHR using anti-inflammatory combined therapy with ICS / LABA.

   Materials and methods. Patients with asthma (n=59) received ICS / LABA for 24 weeks. The level of disease control (ACT, points), cellular composition of induced sputum (IS), bronchial response (ΔFEV1IHCA, %) to 3-minute isocapnic hyperventilation with cold (-20ºС) air (IHCA) was assessed. Exhaled breath condensate (EBC) was collected before and after the IHCA, in which the concentration of IL-8 (pg/mL) was determined.

   Results. Group 1 included 28 patients with CAHR (ΔFEV1IHCA = -14.1 ± 1.7%), group 2 included 31 patients with no response to cold bronchoprovocation (ΔFEV1IHCA = - 3.0 ± 2.4 %, p < 0.0001). Initially, patients of groups 1 and 2 had no differences in ACT (16.8±0.6 and 15.7 ± 0.8 points), FEV1 (92.5 ± 3.6 and 87.8 ± 2.2%), the number of eosinophils in sputum (8.0 ± 2.4 and 4.7 ± 1.3%, respectively, p > 0.05). The concentration of IL-8 before and after the IHCA test in group 1 was 131.2 ± 18.0 and 146.3 ± 23.5 pg/mL, respectively (p > 0.05), in group 2 it was 130.5 ± 8.8 and 149.9 ± 18.4 pg/mL, respectively (p>0.05). After treatment, the airway response to the IHCA significantly decreased in group 1 (ΔFEV1IHCA = - 8.8 ± 1.5 %, p < 0.01), in group 2 it remained unchanged (- 3.6 ± 1.3 %, p > 0.05). The level of asthma control in group 1 increased to 20.7 ± 1.6 ACT points (p < 0.01), in group 2 – up to 19.7 ± 1.7 (p < 0.05). The lung function did not change. After treatment, the level of IL-8 before and after the IHCA in group 1 did not change (89.8 ± 11.7 and 85.5 ± 7.8 pg/mL, p > 0.05), as did the number of eosinophils (8.0 ± 2.4 and 6.2 ± 3.1 %, p > 0.05). In group 2, the level of IL-8 before and after IHCA decreased from 89.2 ± 7.7 to 73.9 ± 10.3 pg/mL (p < 0.01), the concentration of eosinophils decreased from 4.7 ± 1.3 up to 1.5 ± 0.57 % (p < 0.05).

   Conclusion. 24-week therapy with ICS/LABA in patients with CAHR leads to improved asthma control, a decrease in the severity of cold bronchospasm, without being accompanied by changes in the level of IL-8, which affects the dynamics of the concentration of eosinophils in the bronchi.

   Introduction. The search for hihly effective methods for the treatment and control of asthma remains an urgent task of modern pathophysiology and pharmacology. N-acyl-ethanolamines of arachidonic acid (NAE 20: 4) are promising biomolecules for the regulation of the immune processes.

   Aim. To investigate the in vitro influence of NAE 20: 4 on the immune cells' ability from patients with asthma to synthesize pro-inflammatory cytokines and oxylipins.

   Materials and methods. The objective of the study was the blood of 11 patients with mild controlled asthma and 10 healthy volunteers. The in vitro experiment was carried out in stimulated and not stimulated by lipopolysaccharide (LPS) blood for 6 hours. NAE 20: 4 was added at 1.0 µM, 3.0 µM or 10.0 µM doses. The levels of cytokines (TNFα, IL-8), thromboxane
B2 (TXB2) and leukotriene B4 (LTB4) were analyzed by the ELISA method.

   Results. We found an increase in TNFα, IL-8, TXB2, LTB4 in the blood of persons with asthma before in vitro NAE 20: 4 exposure, which indicates systemic chronic inflammation. Incubation of blood cells without LPS did not affect the change in the spectrum of mediators studied. Whereas the treatment of NAE 20: 4 at a 10 µM reduced the synthesis of TNFα, IL-8, LTB4, TXB2. In vitro blood cells stimulation by LPS led to hyperproduction of cytokines and oxylipins. NAE 20: 4 at a dose of 1 µM in LPS-stimulated blood had no effect on the production of signaling molecules, while NAE 20:4 at a concentration of 3 µM reduced the level of TNFα, IL-8. NAE 20:4 at a dose of 10.0 µM inhibited the cytokines and LTB4 synthesis. The level of TXB2 under
the influence of NAE 20: 4 at 10.0 µM did not change.

   Conclusion. The results of the study revealed a dose-dependent anti-inflammatory effect of NAE 20:4, characterized by its ability to influence the synthesis of pro-inflammatory cytokines and oxylipins by the immune cells of individuals with asthma in vitro. Further study of NAE 20: 4 opens up new prospects for the development of targeted methods for regulating immune processes in asthma.

   Aim. To identify the features of the association between the clinical-functional conditions and lipid markers of systemic inflammation (fatty acids, eicosanoids, plasmalogens) of patients with mild asthma and obesity.

   Materials and methods. Obese (n=80) and nonobese (n = 55) adults with mild, partially controlled asthma aged 28 to 65 years, and nonobese (n = 30) healthy controls had venous blood samples analysed. The ACQ-5 test, spirometry were evaluated. Serum thromboxane B2 (ТХВ2) and leukotriene B4 (LTB4) were analyzed by the enzyme immunoassay method. Fatty acids
as methyl esters (FAMEs) and plasmalogens in the form of dimethyl acetals (DMA) were estimated in blood plasma by gas chromatography-mass spectrometry.

   Results. In obese patients with asthma, the ACQ-5 test was lower in comparison to nonobese patients. FEV1 decreased by 8 %, FVC by 12% (p < 0.05). A decrease in the level of DMA16: 0 by 17.5 % and DMA18: 0 by 25 % was established in obese asthma patients. The ratio of DMA16:0/FAME 16: 0 declined by 21 %, DMA18:0/FAME18: 0 − by 28 %. A fall in eicosapentaenoic acid (20: 5n3) and a change in the 20:4n6/20:5n3 ratio were found. The level of ТХВ2 and LTB4 was increased regardless of body weight. There was a positive correlation between body mass index and levels of LTB4 (r = 0.46), ТХВ2 (r = 0.49); and a negative correlation between ACQ and ТХВ2 (r = - 0.58). Indicators of lung function (FEV1, FVC, VC) had correlative links with DMA18:0, DMA20:0, eicosapentaenoic acid.

   Conclusion. We showed the change in the inflammatory fatty acids and eicosanoids synthesis and plasmalogen deficiency in obese-asthma. Established relationships between clinical and functional parameters and lipid markers of systemic inflammation, plasmalogen deficiency in patients with asthma and obesity reveal new pathogenetic mechanisms of the systemic inflammatory process in chronic respiratory diseases.

   Aim. To evaluate the possibilities of physiotherapeutic syndrome-oriented medical rehabilitation (MR) for lung diseases (LD) in the climatic resort of the Southern Coast of Crimea (SCC).

   Materials and methods. In a single-center retrospective observational study, an analysis was made of the rehabilitation effects of physiotherapeutic interventions in a contingent of 100 patients with LD. Examination and treatment of patients was carried out in accordance with the standard of health resort care for patients with LD. Additionally, psychological studies and therapeutic effects were carried out by transcranial electrical stimulation, dynamic electrical nerve stimulation, mud therapy with Saki therapeutic mud, aromatherapy with sage oil and breathing training with a breathing simulator “New Breath”. The assessment of the values of 23 domains of “International Classification of Functioning, Disability and Health” (ICF) was carried out according to the methodology developed in the “ARI n.a. I.M.Sechenov”. The values of domains at the beginning and at the end of the MR course were evaluated, as well as the dynamics of domains (equal to the result of subtracting the values of the domain at the end of the course from the value at the beginning of the course). Mathematical analysis of the obtained
data was carried out using the methods of multivariate statistics.

   Results. A statistically significant (at p < 0.05) positive dynamics of a number of domains was established, indicating the success of a comprehensive course of MR, including domains b2401, b410, b420, b450, b455, b4552, b4601 and an integrated assessment of the functional state (IAFS). The 18 equations of the positive effect of course doses of physiotherapeutic procedures (alternating magnetic field, DENS, ultrasound therapy, halotherapy, inhalation therapy, aromatherapy, pelopathy, short-wave ultraviolet irradiation and massage) on the effectiveness of MR for 12 domains and for IAFS were obtained.

   Conclusion. The use of ICF domains as rehabilitation syndromes is substantiated. The complex of physiotherapeutic influences used in the treatment of patients with LD in the SCC climatic resort has significant potential for successful syndrome-oriented MR.

   Aim. To study lymphocytic-platelet adhesion, eosinophils and IgE concentration in children with acute obstructive bronchitis.

   Materials and methods. 70 children were examined, the first group consisted of children with acute bronchitis (n=38), the second group included healthy children (n=32). All children were examined for the concentration of IgE, the number of lymphocytes and eosinophils, and the count of lymphocyte-platelet aggregates.

   Results. In patients with obstructive bronchitis, there was no difference in the concentration of the relative and absolute number of lymphocytes compared with healthy children. High values of eosinophils were found in children with obstructive bronchitis (9.0 ± 0.7 %) while in children of the control group the same indicator was determined within the limits of normal values (0.9 ± 0.2 %). The level of IgE in children with obstructive bronchitis exceeded the concentration of this indicator in healthy children by 19 times. In children with obstructive bronchitis, the index and degree of lymphocyticplatelet adhesion were 20.0 ± 0.7 % and 10.5 ± 0.09, respectively, statistically significantly higher than similar indices in healthy children (14.0 ± 0.2 %, p = 0.0001 and 3.3 ± 0.1, p = 0.001, respectively).

   Conclusion. In the body of children with obstructive bronchitis, an immune response develops, which is involved in the pathogenesis of recurrence of the disease, the causes of which are infectious agents that stimulate innate immunity due to the presentation of PAMP molecules, as well as adaptive immunity, accompanied by killer reactions, the production of immunoglobulins, including IgE.

   Aim. To establish the relationship of immunological and hemodynamic parameters of the fetoplacental system during exacerbation of chronic bronchitis of cytomegalovirus etiology.

   Materials and methods. A study was carried out of the concentration of TNFα, IgA, IgM in the blood serum and the systolic-diastolic ratio (SDR) in the right uterine artery (RUA) in 80 women in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of cytomegalovirus infection (CMVI). Three groups were retrospectively distinguished. The first group included 30 patients with CMV seronegative physiological pregnancy, the second group included 25 women with exacerbation of chronic bronchitis caused by CMVI reactivation, initiating the development of chronic compensated placental insufficiency (CCPI), in the third group – 25 pregnant women with chronic bronchitis in the acute stage, induced by CMVI, leading to the formation of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.

   Results. In the first group, the concentration of TNFα in the blood serum was Me 16.4 (13.1–33.8) pg/mL, IgA – Me 2.5 (2.23–2.62) mg/mL, IgM – Me 0.99 (0.87–1.56) mg/mL, and SDR in RUA – Me 1.95 (1.87–2.30). In the second group, compared with the first one, there was an increase in the concentration of TNFα by 4.95 times (p=0.000001), IgM − by 2.51 times (p = 0.000001) and SDR in RUA by 1.25 times (p = 0.000001) with a 1.49-fold decrease in the IgA level (p = 0.000001). In the third group, compared with the first one, there was an increase in TNFα by 6.12 times (p = 0.000001), IgM − by 2.98 times (p = 0.000001) and the value of SDR in RUA by 1.70 times (p = 0.000001) against the background of a 2.31-fold decrease in IgA concentration (p = 0.000001). In patients of the third group, in comparison with the second group, higher levels of TNFα (by 1.23 times, p = 0.000001), IgM (by 1.18 times, p = 0.000001) and SDR in the RUA (by 1.35 times, p = 0.000001), as well as lower values of the IgA concentration (1.54 times, p = 0.000001).

   Conclusion. In women with exacerbation of chronic bronchitis caused by CMVI reactivation, leading to the formation of CSPI, in contrast to patients with a similar bronchopulmonary pathology of cytomegalovirus origin and the development of CCPI, a more pronounced activation of the systemic inflammatory response and an imbalance in the humoral component of immune system lead to an increase in vascular resistance in the RUA pool.

   Aim. To study the fetal inflammatory response and endothelial dysfunction in newborns from mothers with an exacerbation of cytomegalovirus infection (CMVI) in the second trimester of pregnancy.

   Materials and methods. We examined 90 newborns with an antenatal history, uncomplicated and aggravated by the acute phase of chronic CMVI, diagnosed in their mothers at 21-24 weeks of gestation. The concentration of TNFα, IL-6, and endothelin-1 was determined in cord blood serum. The control group consisted of 30 newborns whose intrauterine development proceeded against the background of physiological pregnancy seronegative for cytomegalovirus (CMV). The main group included 60 newborns, which were divided into 2 subgroups. Subgroup 1 included 30 newborns from mothers who had an acute phase of chronic CMVI, leading to the development of chronic compensated placental insufficiency, subgroup 2 consisted of 30 newborns from mothers with exacerbation of CMVI, initiating the formation of chronic subcompensated placental insufficiency.

   Results. In the control group, DNA of CMV, IgM antibodies to CMV and IgG antibodies to CMV were not detected. In the main group, in newborns of subgroup 1, compared with the control, DNA of CMV, both in the cord blood and in the nasopharyngeal aspirate, was isolated in 3.3 % of cases, and was not detected in scrapings of the buccal epithelium. The titers of IgG antibodies to CMV were determined in the ratio of 1: 100 in 36.7 %, 1: 200 in 43.3 %, 1: 400 in 13.3% and 1: 800 in 6.7 % of cases. At the same time, in mother-newborn pairs, higher titers of IgG antibodies to CMV in pregnant women, compared with those in their offspring, were detected in 18 cases, and equal titers of IgG antibodies to CMV were detected in 12 dyads. In the control group, the concentration of TNFα was equal to (Me) 16.2 (12.9-32.7) pg/ml, IL-6 – 1.93 (1.65-2.21) pg/mL, endothelin-1 – 0.52 (0.45–1.21) fmol/mL. In subgroup 1 of the main group, in comparison with the control one, there was an increase in the concentration of TNFα by 2.6 times (p=0.000001), IL-6 – by 2.1 times (p = 0.000001) and endothelin-1 – by 2.1 time (p = 0.000002). In newborns of subgroup 2, compared with subgroup 1, CMV antigens were identified in the blood in 6.7 % (p > 0.05), and in nasopharyngeal aspirate – in 10% (p>0.05) in the absence of identification of the CMV genome in the buccal epithelium. In 6.7%, IgM antibodies to CMV were detected. IgG antibodies to CMV 1:800 were detected more often (in 33.3%, p<0.05), as well as equal titers of IgG antibodies to CMV in 20 mother-offspring pairs (p<0.05). There was an increase in the concentration of TNFα by 1.47 times (p=0.0076), IL-6 - by 1.33 (p = 0.0016) and endothelin-1 - by 1.5 times (p = 0.0161), respectively.

   Conclusion. In the offspring of mothers who had an exacerbation of CMVI in the second trimester of pregnancy and with the presence of chronic subcompensated placental insufficiency, compared with newborns from women with the acute phase of chronic CMVI at similar gestation periods and formed chronic compensated placental insufficiency, higher levels of pro-inflammatory cytokines and endothelin-1 are recorded, indicating activation of the fetal immune system as a result of viral aggression and penetration of IgG to CMV of maternal origin. 

   Introduction. Placental insufficiency is one of the most frequently developing complications in pregnant women with acute respiratory failure, which is a consequence of community-acquired pneumonia (CAP), including viral etiology. The impact of COVID-19 infection on the course of pregnancy, the condition of the fetus and newborns has not been studied enough.

   Aim. To study the state of uteroplacental-fetal circulation, placenta and fetus in women with bacterial and COVID-19-associated CAP in the second and third trimesters of pregnancy.

   Materials and methods. The history of childbirth and the results of examinations of 120 women in the second and third trimesters of pregnancy were analyzed, including 37 women with moderate CAP of bacterial etiology, 48 women with COVID-19 infection. The comparison group consisted of 35 women with uncomplicated pregnancy. The state of the placenta and fetus was assessed according to the data of ultrasound and utero-placental-fetal blood flow – Doppler study. Pulsation indices (PI) and cerebro-placental ratio (CPR) were analyzed.

   Results. According to our data, the risk of developing chronic placental insufficiency in pregnant women with COVID-19-associated CAP of moderate severity was higher than in groups of women with CAP of bacterial etiology and in the comparison group. In groups with CAP, significant differences were found in the indices of CPR, PI of the uterine arteries, umbilical cord arteries and middle cerebral artery, corresponding to I (A, B) or II degree of disturbance of the uteroplacental and/or placental-fetal blood flow. Chronic intrauterine fetal hypoxia and fetal growth retardation were more frequently detected in the group with COVID-19-associated CAP. Newborns born to mothers with COVID-19 infection have an increased risk of neonatal damage to the central nervous system (CNS).

   Conclusion. COVID-19-associated CAP, compared with CAP of bacterial etiology, increases the risk of chronic placental insufficiency, intrauterine fetal hypoxia and fetal growth retardation, and the development of neonatal CNS damage.

   Aim. To give an anatomical description of the placental cotyledon bloodstream in women who had an exacerbation of cytomegalovirus infection (CMVI) in the second trimester of gestation.

   Materials and methods. A study was conducted on 117 placentas, of which 101 were from women with full-term pregnancy and 16 from women with premature birth. In all cases, CMVI led to the development of chronic compensated (CCPI), subcompensated (CSPI) and decompensated placental insufficiency (CDPI). 5 groups were identified: the first group consisted of 30 placentas from women with full-term pregnancy seronegative for cytomegalovirus (CMV); the second – 27 placentas from patients who had an acute phase of chronic CMVI, initiating the development of CCPI; the third – 23 placentas from women with exacerbation of CMVI, leading to the formation of CSPI; the fourth – 21 placentas from patients with an exacerbation of CMVI, which caused the development of CDPI and prolongation of pregnancy to the term of delivery; the fifth – 16 placentas from women with an acute phase of chronic CMVI, initiating the formation of CDPI and miscarriage. The assessment of the bloodstream of cotyledons of the placenta was carried out by injection of contrast (red lead-paint on drying
oil) through the vein of the umbilical cord. To obtain X-ray phlebograms, the apparatus RUM-20M “Sapphire” was used.

   Results. It was shown that the total number of cotyledons did not differ in the studied groups. In the first group, anatomical forms with a well-contrasted bloodstream were 21.4±2.17, with weakly contrasted vessels – 9.3±0.47, and with no contrast in the veins, arteries and capillaries of the villi – 2.9±0.22. In the placentas of the second group, in comparison with the first one, no differences were found in the number of cotyledons, in which blood vessels were clearly visualized and not detected. However, the number of anatomical forms with poorly contrasted vessels increased by 1.51 times (p<0.05). The placentas of the third group in comparison with the second one were characterized by a decrease by 1.97 times (p < 0.001) in the proportion of cotyledons with a clear contouring of the vascular network and an increase in anatomical forms with a poorly contrasted bloodstream by 2.34 times (p<0.001). In the fourth group, in comparison with the third group, the number of cotyledons with clear visualization of vessels decreased by 2.05 times (p<0.001), and the number of anatomical forms increased by 1.44 times (p<0.01), in which X-ray phlebography did not determine the vasculature. In the fifth group compared to the fourth one, cotyledons with a well-contrasted bloodstream were found 2.83 times less frequently (p < 0.01).

   Conclusion. With an exacerbation of CMVI in the second trimester of gestation, leading to the formation of CDPI, in comparison with CCPI and CSPI in the placenta, a reduction of blood flow in cotyledons is more often detected as a result of direct endotheliotropic and mediated effects of CMV. This is the anatomical basis of placental ischemia and one of the pathogenetic mechanisms for the development of miscarriage.

   Over the past decades, the eastern regions of Russia are characterized by a constant in-crease in the number of patients with oncological pathology, in the structure of which malignant neoplasms of the respiratory system occupy the first place in the cause of death.

   Aim. A scientific assessment of the main indicators of morbidity and mortality of the population from the cancer of oral organs in the Far East of Russia (2008-2020).

   Materials and methods. The morbidity and mortality rates, reporting forms of statistical records of cancer patients and regulatory documents of superior organizations, information on observations of the dynamics of changes in the numerical values of the pathology under study were used in the course of the work.

   Results. We present the main indices of morbidity and mortality of patients with oral cancer in the eastern regions of the Russian Federation where 596 new cases of malignant neoplasms were registered in 2020, which is 53.7 % more than thirteen years ago (in 2008 – 320 people). There was a similar increase of 76.7 % for Russia. During the studied period of time the number of patients with I-II stages of disease has increased (in 2020 – 39.5 %; in 2008 – 27.6 %) with simultaneous increase of the number of patients with advanced forms of the disease (in 2020 – 33.7 %; in 2008 – 25.9 %). In recent years the morbidity and mortality rates have been steadily increasing. The percentage of actively diagnosed patients has declined (in 2020 – 23.5 %; in 2019 – 24.3 %), while at the end of the year contingent accumulation index has become higher (4.5 %). Morphological confirmation of the diagnosis (over 95.4 %) did not exceed the national average (98.3 %). The ratio of patients who had been on the registry for 5 and more years was lower than the average Russian values, but the mortality rate during the first year after the diagnosis has improved (in 2020 – 28.0 %; in 2008 – 42.0 %).

   Conclusion. Thus, against the background of increasing total number of patients with malignant neoplasms in the territories of the eastern regions of the Russian Federation there is a steady increase in morbidity and mortality in oral cancer.

   Aim. Demonstration of cases of melanoma of rare localization – with damage to the respiratory system.
   Materials and methods. A brief review of the literature on non-skin melanomas is presented; special attention is paid to melanomas of airways and lungs, primary localization and metastatic lesions. Clinical observations of this pathology are given.

   Results. The paper presents two rare cases from the personal practice of the authors: the diagnosis of primary melanoma of the paranasal sinuses with germination of the base of the skull and metastatic lung damage, in which it was difficult to determine the primary localization of the tumor. In both cases, differential diagnosis was carried out with other formations in the respective areas. The final diagnosis was made by histological and immunohistochemical studies.

   Conclusion. The diagnosis of melanoma with damage to the respiratory organs requires differential diagnosis with other formations of this localization. A histological and immunohistochemical study helps to establish the final diagnosis.

   Introduction. The European Respiratory Society, the American Thoracic Society, and the Russian Respiratory Society are currently working on updating the technical standards and interpretive strategies for routine lung function tests. There is a search for recommendations for the best choice of reference values, the optimal limits of normal and severity grading of detected impairments. An important step in this work is the standartization of pulmonary function tests interpretation, including spirometry.

   Aim. Review of existing concepts for the spirometry interpretation, according to new approaches to their quantitative and qualitative assessment. Materials and methods. The scientific publications on the PubMed and eLIBRARY.RU platforms were analyzed. The materials posted on the official websites of the European Respiratory Society, the Russian Respiratory Society, the American Thoracic Society and the Global Lung Function Initiative
were also used.

   Results. A brief overview of the main reference values for spirometry is presented: the European Coal and Steel Community (1993), Global Lung Function Initiative (2012, 2021), R.F.Klement et al. (1986, 1991). The issues of defining the lower limit of the normal, diagnosing ventilatory impairments and assessing the severity of lung function reduction using the z-score and a percentage of the predicted value when analyzing the results of spirometry are considered.

   Conclusion. The type of ventilatory impairment and severity should be presented in the spirometry interpretation just like the vital capacity assessment. The obstructive ventilatory impairment is generally diagnosed by spirometry, if the signs of restrictive or mixed patterns are present, it is recommended to determine the total lung capacity by body plethysmography
method. Assessment of the limits of normal and the severity levels for any spirometry indices should be carried out using the z-score values.

   Introduction. The thoracic lymphatic duct in the upper half of the body collects lymph from the left lung, the left half of the heart, the walls of the left half of the chest, from the left upper limb and the left half of the neck and head. Therefore, the left-sided localization of the revealed pathological changes, with the involvement of the mediastinum and neck in the process at the same time, can be a sign of damage to the thoracic lymphatic duct (at the location), and therefore the key to a successful diagnosis of the disease.

   Aim. Demonstration of modern possibilities of clinical and radiological diagnosis of cystic malformation of the thoracic lymphatic duct (CMTLD).

   Results. In the literature, the pathology of the thoracic lymphatic duct is designated by two terms: “lymphangioma” and “cystic malformation of the thoracic lymphatic duct”. According to the generally accepted classification of vascular formations ISSVA (adopted at the 20th ISSVA conference in Melbourne in April 2014, last revised in May 2018), the term “lymphangioma” with regard to lymphatic malformations is considered obsolete, its use is recommended for true benign tumors of the lymphatic vessels. CMTLD – benign, extremely rare lymphovascular lesions resulting from embryological disorders (weakness of the duct wall and valve mechanism) in the development of the lymphatic system. The median prevalence is less than 1 % among all mediastinal cystic formations. Effective non-invasive diagnostics at the initial visit of the patient already at the outpatient stage deserves professional evaluation. We present the own clinical and radiological observation of a 26-year-old patient without any special clinical manifestations, in whom volumetric changes in the mediastinum on the left were detected during routine fluorography. The nature (X-ray semiotics) of preoperative imaging using computed tomography has been clarified. The revealed X-ray and pathoanatomical changes were compared.

   Conclusion. CMTLD – congenital lymphatic anomalies, more frequent and symptomatic in children. In older patients, acquired and asymptomatic CMTLD are most often diagnosed. The logistics of modern imaging technologies makes it possible to successfully diagnose such a rare disease as CMTLD already at the stage of the patient’s initial visit to the doctor.

   Introduction. The COVID-19 pandemic is a global public health problem. In COVID-19, systemic inflammation is accompanied by a “cytokine storm”, hypercoagulability, and generalized vasculitis, and new evidence suggests that lipid transportation disorders may exacerbate the course of the disease.

   Aim. Discussion of the role of lipids, fatty acids, and various cascade molecular pathways in the pathogenesis of COVID-19-associated dyslipidemia.

   Results. When conducting a systematic analysis of the scientific literature in the PubMed database, we concluded the following: lipoproteins, oxidized forms of phospholipids and fatty acids can lead to organ damage due to hyperactivation of scavenger of the innate immune response. Thus, restoring lipoprotein function with agents that increase apolipoprotein A-I levels or blocking the relevant scavenger receptors with neutralizing antibodies may be effective in the treatment of COVID-19. The key role of lipoprotein-transported omega-3 fatty acids in the production of specialized proreactive mediators has been demonstrated, and activation of the leukotriene pathway has been shown to be associated with the severity of COVID-19.

   Conclusion. A growing number of scientific studies indicates that lipid and fatty acids have both positive and negative effects in SARS-CoV-2 infection. Additional studies or preclinical models evaluating the eicosanoid profile in patients with COVID-19 will provide new insights into the interaction of the coronavirus with “the host” and the regulation of the inflammatory response.

   Introduction. During the first wave of the pandemic COVID-19, there was limited and poor quality information on the contribution of children to the transmission of SARS-CoV-2. By early August 2020, several confirmed cases of transmission from children had been published, with no clear evidence that the frequency of transmission from children is higher than that of adults. Since the beginning of the pandemic, children have accounted for 18.4 % of the total number of registered cases, and at the beginning of January 2022, 25.5 % of the total number of COVID-19 cases. Most of the new cases of the disease are Omicron strains. Even with the predicted generally less severe illness resulting from Omicron infection in children, doctors fear that more children may be hospitalized in the coming weeks, given the ever-
increasing number of cases of infection with the virus. Data on the risk of SARS-CoV-2 infection among children compared with adults is needed to inform COVID-19 risks and prevention strategies, including COVID-19 childhood vaccination policy.

   Aim. To display literature data containing a review of studies on the transmission of coronavirus infection in children; to analyze the features of the vertical transmission route.

   Materials and methods. An analysis was made of publications containing data from studies of cases and features of the transmission of COVID-19 disease in children, including from mother to child.

   Results. Currently, foreign sources note several options for the transmission of SARS-CoV-2 in children. SARS-CoV-2 infection during pregnancy may affect pregnancy outcome, delivery, and the birth of a potentially infected baby.

   Conclusion. Data on the risk of infection and possible routes of transmission of SARS-CoV-2 in children, including vertical transmission, are needed to improve prevention methods, including immunization of pregnant women and children.