№1, 2022, volume 18

Objective: to study the influence of various kinds of kinesiotherapy on the formation of motor skills in children with ASD, as well as the influence of motor activity on social interaction, communication abilities, stereotypical behavior based on the analysis of published scientific data. A search was made for studies in the scientific databases MEDLINE® (Ovid), AMED, Embase, CINAHL и АРА PsyclNFO® in the period from 1995 to 2021. Key words and phrases were used for the search: "autism spectrum disorders", "autism", "physical activity", "physical exercise". 26 studies were included. The data demonstrated the positive impact of various types of motor rehabilitation not only on motor, but also social, emotional, cognitive and behavioral characteristics of children with ASD. However, more thorough studies are needed, which should include a comprehensive description of the population understudy, a larger sample size, and a thorough assessment of the effectiveness of the rehabilitation impact. Methods of physical rehabilitation should be considered as methods that have a multifactorial effect on the manifestations of ASD.

The article presents a rare case of a combination of two paraneoplastic syndromes at the stage of preclinical detection of neoplasm. This example is a vivid illustration of the complexity of the diagnosis of paraneoplastic syndromes at an early stage, associated with the appearance of neurological symptoms prior the detection of the primary tumor.

Forestier's disease is a rare degenerative-dystrophic disease of the spine and surrounding prevertebral tissues, manifested by secondary dysphagia against the background of significant ossification of the anterior longitudinal ligament in the cervical spine. Objective: to analyze the clinical course of Forestier's disease, diagnostic errors and the results of surgical treatment in order to improve patient outcomes. Material and methods. From 2010 to 2020, 5 patients with a verified diagnosis of Forestier's disease were treated, who underwent surgical intervention in the scope of ventral osteophytectomy Previously, patients were examined to exclude other causes of dysphagia. Results. All patients (100%) had swallowing disorders, movement restriction, and cervical pain syndrome. The average duration of swallowing disorders was 2.8±0.7 years. In the postoperative period, swallowing disorder was resolved in all patients, postoperative complications and recurrence of dysphagia were not observed. Conclusion. In a number of clinical cases, the diagnosis is delayed due to difficulties in diagnosing dysphagia and clinical interpretation of symptoms. In clinical and instrumental diagnostics, radiography of the cervical spine and a contrast study of the esophagus with barium play a leading role. Surgical correction by ventral osteophytectomy is an effective, low-traumatic and reliable method of radical treatment.

In this paper, we present three clinical cases of patients whom we observed with genetically proven familial cases of hereditary spastic paraplegia caused by mutations in SPG4 gene. We give detailed clinical descriptions, pedigrees and discuss these patients comparing them with data published in Russian and international journals. The considered clinical cases attract attention with manifestations that are not often encountered in practice (cognitive deficiency, limbs malformations), and demonstrate additional possibilities for symptomatic relief using botulinum toxin therapy to alleviate muscle spasticity in the legs. All patients registered a positive effect.

The article presents the biography of the famous scientist — pediatrician, doctor of medical sciences, professor Alexander Semyonovich Eiberman. His labor and scientific activity as a professor, head of the department of hospital pediatrics and neonatology at the V. I. Razumovsky Saratov State Medical University was investigated. The work is dedicated to the 80th anniversary of the birth of A.S. Eiberman. Reveals the main milestones of his activities, the content of his main scientific works.

Objective: to conduct a comparative analysis of mitochondrial respiration in brain homogenates of rats with step-wise incomplete cerebral ischemia (SICI) with varying duration between ligations of both common carotid arteries (CCA). Material and methods. The experiments were performed on 24 male mongrel white rats weighing 260±20 g. All rats were distributed among three subgroups. Cerebral ischemia was simulated under intravenous thiopental anesthesia (40-50 mg/kg). The control group (n=6) comprised sham-operated rats of similar gender and weight. To study mitochondrial respiration, the brain was extracted in the cold environment (0-4 °C), dried with filter paper, weighed and homogenized sensu the modified technique in an isolation medium containing 0.32 M sucrose, 10 mM Tris-HCI, 1 mM EDTA, pH of 7.4 (in a ratio of 1:10), using Potter— Elvehjem homogenizer with Teflon pestle. Results. SICI with an interval of 1 and 3 days between ligation of both CCA led to neuronal damage in the parietal cortex and hippocampus of rats, which manifested itself in a reduction of the neuron size, deformation of the perikaryons, an increase in the number of shrunken neurons and shadow cells. The most pronounced changes were observed in the subgroup with one-day interval between ligations. These changes were similar to the changes in incomplete cerebral ischemia (ICI) (p=0.07), except for the absence of cells with pericellular edema in the hippocampus and a smaller number of those in the parietal cortex. ICI with seven-day interval between CCA ligations, on the contrary, was manifested by less pronounced histo-logical changes, especially in the hippocampus. Conclusion. Comparative analysis of mitochondrial respiration in brain homogenates revealed that the severity of brain damage in SSIC depended on the interval between blood flow arrest in both CCA. At the same time, the highest level of energy metabolism disorder was observed during CCA ligation with an interval of one day, which implied insufficient implementation of compensatory mechanisms.

Objective: to conduct a comparative pathomorphological analysis of wounds of various origins requiring full-thickness skin autoplasty. Material and methods. Histomorphological comparison of the wound bottom before plastic surgery with full-layer skin autografts was performed in those groups of patients: 1 — for excision of scar tissue in elective surgery; 2 — traumatic detachment of the skin perform plastic surgery by Krasovitov; 3 —when excising granulation tissue to the fibrous layer. The object of research is biopsies of patients from three study groups. Results. The histologi-cal picture of wounds after scar removal is characterized by well-developed dense fibrous-cellular connective tissue, has signs of chronic inflammation. Unlike a cicatricial wound, acute lesions were characterized by granulation and mature dense fibrous connective tissue, with pronounced inflammatory changes, each of which had its own characteristics. Conclusion. The results of a comparative analysis revealed the features of the morphological picture of wounds depending on the type of injury. In the group of acute injuries, traumatic and burn wounds, the most pronounced tissue injuries were revealed. Given the data obtained, it should be assumed that full-thickness autodermoplasty will have the best result in the group of patients after planned excision of scar tissue.

Objective: to determine the main factors determining the occurrence of professional deformities of the lower extremities in ballet dancers based on the analysis of literature data. The analysis of 33 scientific publications presented in the databases and web resources of MEDLINE, PubMed, Google Scholar, Cyberleninka, the electronic library eLibrary and published in the period from 2011 to 2020 was carried out. The most frequent professional deformities of the lower extremities in ballet dancers are valgus deformity of the foot, talus partitus, hypertrophy of the posterolateral process of the talus bone (formation of the Steida process), flattening of the butt joints and excessive acetabular retroversion. Based on the analysis of studies, the order of occurrence of professional changes in the lower extremities of ballet dancers (foot — ankle joint — hip joint — knee joint) was determined. The systematization of the factors that cause the professional deformity of the lower extremities, and the association into groups based on their genesis (exo- and endogenous) is carried out. The nature of the influence of a number of exo- and endogenous factors on the features of the development of pathological morpho-functional changes of the lower extremities in ballet dancers is determined

Objective: to analyze the satisfaction of doctors (in the social role of patients) suffering from chronic diseases with medical care in rural health care. Material and methods. 188 doctors with chronic diseases from medical organizations of the Saratov region took part in the survey. The questionnaire developed by Academician of the Russian Academy of Sciences A. V. Reshetnikov (Moscow) was used. Results. The respondents attributed the lack of necessary specialists (67.1%), queues (9.6%), inability to get an appointment at a convenient time (8.5%), inattentive attitude of employees (8.5% of responses) to negative phenomena in the activities of medical organizations in which they received medical care. The respondents attributed insufficient technical equipment of medical organizations (67%), high cost of medicines (60.0%), long queues for doctor's appointments (27.1%) to the problems that arise in patients in a situation of chronic disease. Conclusion. Despite the limited availability of medical care, when assessing satisfaction with medical care in rural medical organizations in the region, the majority of respondents positively assessed the quality and availability of medical care in different conditions of provision and indicated high and medium estimates of the social responsiveness of rural healthcare. An explanation of the results obtained is possible in the perspective of what was described by Academician of the Russian Academy of Sciences A. V. Reshetnikov of the phenomenon of "paradoxical" medicine that arose in Russian healthcare at the end of the 20th century.

Objective: to analyze changes in the opinions of young people about measures to prevent and treat sexually transmitted infections (STIs) against the backdrop of the coronavirus pandemic compared to the pre-pandemic period. Material and methods. The research program is based on a comparison of data from a sociological survey of 400 respondents aged 16-21 in 2021 and an analysis of 838 questionnaires from participants in a similar study in 2017 of the same age. Research method — sociological (questionnaire). The author's questionnaire was used, consisting of 46 questions, combined into five blocks: self-assessment of the relevance of the STI problem, the likelihood of infection risk, readiness to undergo preventive screening examinations, preferred directions for seeking help if STI symptoms occur, consent to examination and treatment together with a sexual partner. By gender, the distribution was as follows: in2017 — women — 51%(n=427) men — 49%(n=411); in2021 — 52%(n=208)and 48%(n=192). In processing and presenting the data, extensive indicators were used, compared with the assessment of the significance of differences according to Student's t-test. Results. In 2021 an increase in the interest of young people in undergoing screening examinations (79.5% versus 63% in 2017, p=0.006) and seeking medical help (93.5% versus 89.5%, p=0.007) was noted. However, the number of cases of concealing the state of health from a partner increased significantly (from 8.3 to 32.2%, p=0.003). Conclusion. The study revealed a change in the opinions of respondents regarding STIs during the pandemic, which consists in an increase in understanding of the need for regular examinations, seeking medical help when symptoms of the disease appear, but at the same time, a decrease in the sense of responsibility for the health of their partner.