Мета. Проаналізовано рідкісний клінічний випадок успішного лікування 44-річного пацієнта з вторинною артеріальною гіпертензією, спричиненою феохромоцитомою лівої надниркової залози, що ускладнилася розшаровуючою аневризмою аорти (РАА). Позитивний результат лікувальної стратегії представлено в статті.
Результати. Діагноз хронічної РАА за De Bakey type I встановлено при мультиспіральній КТ-ангіографії грудної та черевної аорти з внутрішньовенним контрастним підсиленням. Проведено операцію ендопротезування низхідного відділу аорти, після якої — лапароскопічну тотальну лівобічну адреналектомію. Пацієнт перебуває під спостереженням кардіолога із застосуванням фармакологічної терапії.
Висновок. Вчасна діагностика важкої поєднаної патології, наступна хірургічна корекція й медикаментозне лікування спрямовані на запобігання ускладненням і продовження життя пацієнта.

Aim: To assess, under experimental conditions of cellular dehydration of varying severity, the nature of structural changes in the nephron and the dynamics of reparative processes during the recovery period.
Materials and Methods: The study was conducted on 110 young male Wistar rats, divided into two groups. The first group (30 rats) remained intact, while the second group (80 rats) was adapted to dehydration. Adaptation was achieved through alternating a low-mineral diet with 1.5% hypertonic sodium chloride solution (for two days) and a standard vivarium diet (for one day) over 42 days. Cellular dehydration in the second group was induced by administering 1.5% hypertonic sodium chloride solution along with dried oats and crackers. The degree of dehydration was determined based on the water deficit. In the next stage of the experiment, animals were returned to a normal diet, and readaptation changes were assessed at 1, 3, 6, and 12 weeks after the cessation of the dehydrating factor. The morphological state of the kidney structures was examined using microscopic, electron-microscopic, morphometric, and statistical methods.
Results: As a result of exposure dehydrating factor, the renal parenchyma shows functional tension in the glomeruli and tubular epithelial cells due to the increased load on the kidney. Changes of podocyte pedicels affect the size of filtration slits that regulate glomerular filter permeability. The first indicators of disorders in the glomerular-tubular system are the basal membranes in the composition of capillaries and epithelium. Even in mild dehydration, as the dehydrating factor increases, the basal membrane thickens, loses its three-layer structural organization, becomes homogeneous and osmiophilic. Gradually, podocytes and endothelial cells of capillaries are damaged, undergoing dystrophy. The process of readaptation after rehydration of the previously dehydrated organism involves a complex of morphological changes following cellular dehydration, aimed at restoring lost or weakened functions of cells and tissues, their adaptive-compensatory changes, which ensure adaptation to certain conditions. Structural transformations of cells during readaptation may manifest in the enhanced stabilization of cell membranes and the resistance of tissues to intensive influences. Previous adaptation under dehydration leads to the mitigation of the dehydrating factor’s impact, manifested in a lower severity of structural-metabolic disturbances and increased energy exchange.
Conclusions: The structural components of the nephron immediately respond to disturbances in the body’s water-electrolyte balance by changing their structural organization. These changes are significant in severe cellular dehydration, and their restoration requires a long period of time.

Aim: To investigate the effect of succinic acid on the humoral component of the immune system in rats.
Materials and Methods: The study was conducted on two groups of mature non-linear white rats (males) of similar weight (200-270 g, aged 6-8 months),with 5 animals in each group. The control group was fed a standard diet with free access to water throughout the experiment. Rats in the experimental group were subcutaneously injected with a 0,1% solution of succinic acid in a liposomal emulsion at a dose of 20 cm³ for five days. The state of the humoral component of the immune system was assessed by measuring serum immunoglobulins A, M, and G using solid-phase enzyme-linked immunosorbent assay. Circulating immune complexes were determined in a 40% solution of polyethylene glycol.
Results: Under the influence of succinic acid in liposomal emulsion the content of class A immunoglobulins increased by 44,0% (p<0.01) compared to rats in the control group. The activation of class A immunoglobulin synthesis points to the provision of local immunity of the mucous membranes in the rat’s body. The content of class M immunoglobulins increased by 61,0% (p<0.001) compared to the control group rats. This high activity of class M immunoglobulins indicates their rapid activation in the body of rats in response to primary contact with succinic acid in liposomal emulsion. The content of class G immunoglobulins increased by 36,0% (p<0.05) compared to the control group rats. No clinical deviations from physiological norms were observed in the rats after the use of succinic acid in liposomal emulsion. After the use of succinic acid in liposomal emulsion in the experimental group of rats, the concentration of CICs increased by 15,0% (p<0.05) compared to the control group rats. In our case, the increase in CIC levels is not correlated with clinical manifestations but is a consequence of increased levels of class M and G immunoglobulins.
Conclusions: The succinic acid in liposomal emulsion activates the production of class A, M, G immunoglobulins, circulating immune complexes, it prevents
the development of secondary immunodeficiency and has a positive impact on the humoral branch of the immune system in rats.

The problem of studying the mechanisms of steatohepatosis development and its correction remains relevant, despite the significant number of scientific studies on the pathogenesis of metabolic-associated fatty liver disease. This is con-firmed by the increase in morbidity, which may be associated with a wide range of factors that cause liver steatosis and the lack of effective therapeutic and preventive agents. The study aims to establish the lipid and phospholipid composition of the inner mitochondrial membrane of rat hepatocytes under conditions of diet- and glutamate-induced steatohepatosis and to evaluate the corrective effect of nanocrystalline cerium dioxide on the formation of steatohepatosis induced by neonatal administration of monosodium glutamate. The direction of the experiments included the study of the mechanisms of de-velopment of diet- and glutamate-induced visceral obesity in 4-month-old rats and the determination of the lipid and phos-pholipid composition of the inner membrane of hepatocyte mitochondria in rats under conditions of high-calorie diet and after neonatal administration of monosodium glutamate against the background of periodic administration of nanocrystal-line cerium dioxide. It was established that rats that were on a high-calorie diet with a high content of fats, carbohydrates, and a reduced content of proteins for 4 months, and rats that were administered monosodium glutamate in the neonatal period, developed visceral obesity without the manifestation of hyperphagia, characterized by dyslipidemia and the devel-opment of steatohepatosis. A feature of the development of diet- and glutamate-induced steatohepatosis is mitochondrial dysfunction, which is characterized by changes in the lipid and phospholipid composition of the inner membrane of hepatocyte mitochondria. Not only structural changes occur in the membrane, but also dysfunctional changes in the mito-chondria as a whole, manifesting themselves in the fact that ROS are generated in the respiratory chain instead of ATP, and this causes the development of oxidative stress in both the mitochondria and the entire hepatocyte. Periodic admin-istration of nanocrystalline cerium dioxide to rats with glutamate-induced steatohepatosis significantly restored the lipid and phospholipid composition of the inner membrane of hepatocyte mitochondria, reduced manifestations of oxidative stress, and reduced the content of oxidized forms of phosphatidylcholine and phosphatidylethanolamine in the inner mem-brane of hepatocyte mitochondria against the background of normalization of cardiolipin content, which indicates the antioxidant effect of this drug and the possibility of its use for the prevention of steatohepatosis.

UDC 616–07–08–036.8].001.36(063)

The 10th McMaster International Review Course in Internal Medicine (MIRCIM 2025), held in Kraków, Poland, confirmed its status as a high-impact scientific forum promoting evidence-based medical practice. With over 100 speakers from more than 40 countries, MIRCIM fostered multidisciplinary discussions on pressing topics in cardiology, rheumatology, pulmonology, and digital health.
The cardiology section focused on current evidence regarding angina and ischemia with non-obstructive coronary arteries, tailored oxygen therapy strategies in non-hypoxemic patients, the role of complete revascularization post-ST-elevation myocardial infarction, the impact of iron deficiency in heart failure, and perioperative cardiovascular risk management in non-cardiac surgical patients.
The rheumatology track emphasized stratified, biomarker-guided treatment strategies for rheumatoid arthritis, systemic lupus erythematosus, (аnti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, calcium pyrophosphate deposition disease, fibromyalgia, and adult-onset J. F. Still’s disease. These strategies involve integration of phenotypic, immunologic, and serologic data, as well as imaging findings and reduction of long-term
corticosteroid exposure.
Pulmonology sessions addressed the fundamental lung physiology, updated Global Initiative for Asthma (GINA 2025) guidelines, especially in children under six years old, early detection of lung cancer using low-dose computed tomography, and strategies for perioperative pulmonary complication prevention.
The gastroenterology section focused on several key topics of contemporary clinical relevance. The management of diverticular disease was discussed with particular emphasis on current therapeutic approaches. The treatment of irritable bowel syndrome (IBS) was addressed in detail, with a symptom-based and comorbidity-oriented management
strategy highlighted. The section also explored the prevention of gastrointestinal cancers, analyzing various cancer prevention strategies and emphasizing the implementation of evidence-based methods into clinical practice.
Additionally, the current management of metabolic-associated steatotic liver disease (MASLD) was reviewed in accordance with the latest 2024 European Association for the Study of the Liver (EASL) - European Associationm for the Study of Diabetes) (EASD) - European Association for the Study of Obesity (EASO) guidelines, with a focus on therapeutic interventions targeting metabolic dysfunction-associated steatotic liver disease.
The session on artificial intelligence in medicine explored the current applications and limitations of generative language models such as Generative Pre-trained Transformer (GPT) in medical decision-making, telemedicine, education, and public health awareness. Benefits such as enhanced access to knowledge and reduced clinical burnout were noted, along with necessary precautions in clinical implementation.
MIRCIM 2025 once again affirmed its position as a key platform for advancing interdisciplinary medical knowledge, fostering international cooperation, and enhancing evidence-based healthcare delivery in both global and local contexts.