2021, volume 17

The social environment is the source and context of the formation of social health risks of the population, the relevance of the impact of which on the health of the child population is pointed out by many researchers. Modern Russian studies discuss a wide range of risks and territorial differentiation in the state of children's health. The interdisciplinary analysis of social risks of children's health allows us to consider perinatal pathology from the perspective of multicausal pathology. In order to typologize the social risks of children's health based on the study of literature, the authors analyzed 34 publications from domestic and foreign scientometric, abstract and full-text databases (e-Library, SCOPUS, Web of Science, Medline, PubMed, Scientific Electronic Library, and others) for the period 2009-2021. The authors of the publications cited in the article fix socio-economic inequality, poverty, and limited access to medical care, which are more typical for Russian regions, in the context of the leading social health risks of the child population in Russia.

The aim: assessment of the state of cognitive functions, mental and physical status, and their interconnection during the entire period of training among female students of medical specialties. Material and Methods. The sample size was 626 respondents. The response rate was 93.5%. In the study of cognitive abilities, the Montreal rating scale (lOCa test) was used. Health-related quality of life was assessed using the MOS SF-36 Health-Related Quality of Life Brief Self-Assessment Questionnaire. The significance of differences in the groups was identified using analysis of variance (ANOVA). The level of correlation of variables was assessed using the Spearman's correlation coefficient. Results. The average assessment of the state of cognitive functions (lOCa test) was 25.8 points, which is within the reference values. By the senior years of study, the functions of attention, concentration and working memory (4.8 versus 4.1 points, p<0.05) and executive functions (3.8 versus 3.0 points, p<0, 05). The average value of the variable describing cognitive functions among female students studying in the 6th year is significantly higher than among freshmen. The total self-assessment of Health-Related Question of Life MOS SF-36 was also within the limits of the normative values (68 points) and significantly higher than the average in the population. Correlation of the total indicator of the level of ac- tivity of cognitive functions of female students with the main indicators of self-assessment of the quality of life related to health was Я?=0.45-0.63, which corresponds to the average level of interconnection. The relationship between the activity of cognitive functions and objective markers of health status turned out to be weak. Conclusion. The dynamics of cognitive functions among female students of medical universities in the learning process is interconnected with self-assessment of physical and mental status. The level of co-cognitive functions in them corresponds to the reference values, self-esteem of the quality of life related to health is high. Self-esteem of physical status among primary-year students is significantly higher than that of mental status.

Aneurysmal dilatation of the visceral arteries is quite a rare disease in vascular surgery (only 0.1-2% of cases per 100000 population). Nevertheless, for patients with this pathology, timely diagnostics is very important, since there is a high risk of sudden bleeding into the retroperitoneal space associated with a rupture of aneurysm. This paper presents a clinical case of successful endovascular treatment of a giant splenic artery aneurysm by its embolization with coils. Our experience shows that endovascular treatment is a valid alternative to open surgery for patients with splenic artery aneurysm. It is believed that transcatheter embolization of visceral artery aneurysms is the method of choice for this pathology.

The article presents a report on a case of successful application of allogeneic spongious graft made from the resected femoral head that was prepared following the Marburg Bone Bank System requirements. It was used for the restoration of the vast bone defect in osteosynthesis of multi-fragment intra-articular distal humerus fracture (AO/ASIF type 3) with metal plates and screws.

Aim: development of an experimental model for studying the course of the wound process and the effectiveness of applying wound dressings both in clean conditions and on a purulent wound in one animal. Material and Methods. Pig wound modeling is used as an in vivo model. In the operating room, under general anesthesia in the lateral position, the laboratory animal is marked with the future burn surface. A hot steel contact pad applies a thermal injury to the skin of a given size and the required depth of thermal injury (IIIB and IV grades according to Vishnevsky’s classification). Then necrectomy was performed with primary and delayed plasty using the studied wound dressings. After this, non-viable tissues are removed with primary and delayed autodermoplasty and plastic wound dressings. The research subject — in vivo study included 4 Landrace pigs (animal weight from 18 to 24 Kg). Results. With burns IIIB Art. under the decellularized scaffolds, scar tissue was formed by the 12th day, under the recellularized ones by the 8th day, epithelialization of the wound occurred. With burns IV Art. granulation tissue without aseptic inflammation on the 8th day was formed. Conclusion. The developed method for modeling a wound in an experiment allows one animal to analyze the engraftment of wound coverings, both in early and in staged surgical treatment of burns.

The article presents the data on pathomorphological and pathogenetic features of the acute brain infarction in the middle cerebral artery (MCA) circulation. We have analyzed more than 38 research papers published in 2010-2020 and distributed in PubMed, eLibrary.ru, Medscape, Cochrane Library, and Medical NDX databases. Due to the wide prevalence, huge socio-economic significance, as well as high mortality rates of patients with brain infarction in the MCA basin, the coverage of issues and further study of the pathomorphological and pathogenetic aspects of this disease is extremely important for the timely diagnosis of acute complications and the use of modern methods of complex treatment.

The aim is to assess the effectiveness of the use of transcranial magnetic therapy in the comprehensive non-drug rehabilitation of newborns with perinatal injury of the central nervous system. Material and Methods. The research includes 214 newborns with postconceptual age more than 30 week and perinatal injury of the central nervous system. Main group (n=79): children underwent standard pharmacotherapy in combination with comprehensive non-drug rehabilitation (which including dry immersion, music therapy and orolingual massage), and transcranial magnetic therapy; Comparison group (n=74): children underwent standard pharmacotherapy in combination with non-drug rehabilitation; Control group (n=61): children received conventional pharmacotherapy. Results. Hyperactivity syndrome was cured in 60% of children in main group, vegetative-visceral disorders — in 80% of children, CNS repressive syndrome signs disappeared in 67% of children, a significant (p<0.05) decrease in the resistance index was noticed, a decrease in elevated peripheral vascular resistance and physiologic reflex extension, especially the oral reflexes group. Odds ratio of the normalization of oral reflexes group by the tenth day for the main and control groups was 5,09 with 95% Cl [1.8-13.8], and for the main and the comparison group — 3.0 with 95% Cl [1.1-8.4]. Normalization of muscle tone and decrease in the resistance index by the tenth day in the main group was observed, respectively, 8 and 4 times more often than in control group. Odds ratio is 8.2 with 95% Cl [1.8-16.3] and 4.05 with 95% Cl [1.06-9.3], respectively. Conclusion. Non-drug rehabilitation methods combined with magnetic therapy produces sedative effect, provides the stimulation of respiratory movements, spontaneous motor activity, the resumption of proper reflex action. Thus it is recommended to be included in perinatal CNS injury newborns therapy.

Submacular hemorrhage is a serious complication of various eye diseases, leading to persistent and often irreversible loss of vision. Age-related macular degeneration (AMD) is one of the main causes of this pathology. The formed hemorrhage has pronounced destructive changes in the photoreceptor and inner nuclear layers of the retina. Patho-morphological disorders are mediated by the complex effect of neurotoxic blood breakdown products, traction effects of fibrin filaments, and blocking of metabolic processes between the retinal pigment epithelium and the overlying layers of the retina. The literature review was carried out using the search engines PubMed, Embase, Cochrane Library, the analysis of literature sources on a given topic, published from 1959 to 2020, was completed. The authors concluded that the study of morphological changes in the retina after acute submacular hemorrhage requires compliance with the principle of multimodal imaging, which makes it possible to establish prognostic criteria for the restoration of visual functions, as well as to facilitate the choice of surgical treatment tactics. This problem is poorly understood and requires additional clinical studies.

Purpose: to assess the efficacy of transpupillary thermotherapy (TTT) in treatment of the progressive choroidal nevus. Material and Methods. Diagnosis and treatment of 29 patients (29 eyes) with progressive choroidal nevus were analyzed. The follow-up was from 4 months to 3 years. In the diagnosis of the neoplasm we paid a special attention to the ultrasound B-scanning, optical coherence tomography (ОСТ), OCT-angiography. According to the ultrasound scanning (B-scanning) data the neoplasm height varied from 0.78 to 3.64 mm (1.60 (1.40; 1.84) before treatment, the length varied from 1.30 to 14.05 mm (6.41 (5.12; 7.54). For treatment we used laser device IRIS MEDICAL IQ 810 "IRIDEX" in the LONGPULSE mode. Results. After treatment the prominence in the nevus zone was not defined in 14 cases (48.3%) according to B-scanning data. In 15 (51.7%) patients the neoplasm height and length decreased: prominence height was 1.40 (1.20; 1.50), varying from 0.7 to 3.1 mm, the length was from 1.3 to 7.5 mm (6.10 (4.69; 7.30). In 28 (96.5%) patients visual acuity has not changed. Conclusion. The treatment of progressive choroidal nevus by TTT showed its efficacy, safety and good tolerance.

Purpose: to establish the effectiveness of valsartan in patients with chronic heart failure with mid-range ejection fraction from the standpoint of influencing the clinic, the parameters of central hemodynamics and the level of natriuretic peptide. Material and Methods. Our study included 45 patients with CHF with mid-range ejection fraction, with NYHA (New York Heart Association) functional class II (FC). All patients underwent a comprehensive clinical and standard echocardiographic examination. Valsartan was administered in titrated dosages up to the maximum tolerated ortarget daily dose in accordance with the recommendations. The observation period was one year. Results. During the observation period, 89% of patients switched from FC II to FC I of CHF (p<0.001), the left ventricular (LV) ejection fraction increased from 46 (44-47) % to 55 (53-60) % (p<0,05), the level of natriuretic peptide decreased from 455 (397-513) pg/ml to 210 (146-343) pg/ml (p<0.05). Conclusion. The use of valsartan in patients with CHF with mid-range ejection fraction improves the clinical condition and parameters of central hemodynamic during a year of observation.