2022, volume 18

Abstract. Objective: to present information about the craniological collections of the fundamental museum of one of the oldest anatomical departments of our country — the Department of Normal Anatomy of the Military Medical Academy. This richest collection of skulls has more than 6000 copies and is divided into 6 collections: 1) unique skull preparations; 2) craniological collection of Professor V. L. Gruber (1340 copies); 3) craniological collection of Professor A. I. Tarenetsky (1004 copies); 4) comparative anatomical collection of skulls of various animals (125 copies); 5) collection of skulls of fetuses, newborns and children of different ages (138 copies); 6) craniological collection of Professor B.A. Dolgo-Saburov (4251 copies). The article provides a complete and detailed description of each of the six collections, examines the history of their creation, analyzes their composition and scientific significance. It is safe to say that this craniological collections are national treasure (there are no equal exhibits in Russia either in number, content or value): a fundamental educational and material base for teaching medical craniology and anthropology, as well as a fundamental base for performing applied scientific research. These collections make it possible to compare the cranioscopic and craniometric parameters of various national and ethnic groups of the Russian population in the XIX and XX centuries, including age, sex and typical features.

Abstract. Objective: to analyze the level of readiness and expectations of future medical specialists regarding their future professional activities. Material and methods. A questionnaire survey of 383 senior medical students was conducted, which focused on studying the readiness of respondents to practical work in the chosen specialty, as well as key motivational factors that contribute to the "consolidation" of young doctors in practical healthcare and detailing the parameters of their professional formation as part of independent practical activities. Results. The majority of respondents highly rate their level of professional training and plan to work in the chosen specialty (85.2%). The triad of factors of attractiveness of the medical profession, according to students of the medical university: interest in medicine and the chosen specialty (61.0%), high wages (41.4%), the desire to help people (36.8%). At the same time, 59.5% of students assess the level of competitiveness in the labor market at 4-5 points (on a 5-point scale). Conclusion. With a high level of training in the specialty, most graduates of a medical university have quite objective ideas about the requirements for medical professionals by employers, strive to gain experience in labor activity in the chosen specialty and realize the need to replenish their professional baggage with additional competencies not only in the chosen specialty, but also in related (including non-medical) areas of expertise considered to be additional competitive advantages in the industry labor market.

Abstract. Objective: to identify the prevalence of symptoms characteristic of pelvic floor dysfunction among women working at an enterprise in a large industrial region, and to assess the impact of medical and social factors on the frequency of their occurrence. Material and methods. Respondents (317 women aged 20 to 69) were asked to assess the presence of the most common symptoms of pelvic floor dysfunction on a scale of four levels: never; several times a month; several times a week; almost daily or every time an event occurs. Results. Involuntary leakage of urine was noted by 37.4±2.7%, weak pressure or intermittent flow during urination — 20.0±2.2%, unpleasant sensations during sexual intercourse — 19.9±2.2%, a feeling of dryness and discomfort in the vagina — 13.6±1.9% of the survey participants. The presence of a statistically significant relationship between the frequency of urinary incontinence symptoms and age, an increase in body mass index, low physical activity, the presence of independent childbirth; between the frequency of intermittent jet during urination, a feeling of discomfort in the vagina and the age of women; between the frequency of discomfort in the vagina and the presence of physical exertion at work. Conclusions. The results of the study indicate that women working at an industrial enterprise, among the symptoms characteristic of pelvic floor dysfunction, most often there is involuntary leakage of urine, noted by more than a third of the survey participants. Taking into account the statistically proven influence of such medical and social factors as age and high body mass index on the frequency of symptoms of pelvic floor dysfunction, it is these groups of patients who are prioritized for active detection of pelvic floor dysfunction by obstetricians and gynecologists during preventive examinations.

Abstract. Objective: to profile foreign experience of palliative care of patients with chronic diseases in the terminal situation of the disease. Literature review was conducted on materials of foreign scientometric, abstract and full-text databases: SCOPUS, Web of Science, Medline, PubMed, ProQuest Dissertations & Theses, Cambridge University Press, Oxford University Press, журналам издательств Sage, Taylor&Francis, Wiley, Springer Nature and others. Publication period is 1996-2022, request formulation: "integrated medical and social care", "palliative care in chronic diseases", "palliative care in terminal illness", search queries by authors' last names. 47 publications were analyzed. The given in the review publications define necessity of prolonged interdisciplinary medico-social approach to palliative care in the terminal stage of disease, including integration of medical care with other services for empowerment and optimization of quality of life of the patient.

Abstract. Objective: to determine the role of continuous glucose monitoring in achieving compensation in children with type 1 diabetes mellitus with different levels of glycemic control. Material and methods. The evaluation of clinical and metabolic parameters in 80 adolescents with diabetes mellitus with varying degrees of carbohydrate metabolism compensation was carried out. Based on the Flash monitoring data, insulin dosages were corrected, after which the monitoring results were compared before and after the adjustment of insulin therapy. Results. As a result of the correction of insulin therapy in children with HbAc 9% or more, according to monitoring data, the time spent by glycemia in the target range increased. There was no significant increase in the number of hypoglycemia. In patients with HbAc less than 9%, after changing therapy, the number of children with glycemia in the target range significantly increased, and the number of hypoglycemia decreased. The variability of daily glycemia significantly improved (p=0,039). Conclusion. The use of the Flash Glucose Monitoring System in patients with type 1 diabetes mellitus made it possible to detail glycemic disorders during the day and to conduct an objective control of the correction of insulin therapy according to its indicators.

Abstract. Objective: prognostic significance determination of skin autofluorescence (SAF) as a factor of mortality and cardiovascular complications. Material and methods. We undertook the prospective study included 122 patients with peripheral arterial disease (PAD): stenotic atherosclerosis of the brachio-cephalic trunk was revealed in 95 (77.9%), chronic arterial insufficiency of the lower extremities (CAI) in 47 (38.5%). SAF parameter was determined using an original device developed by the authors. Clinical, anthro-pometric, biochemical as well as instrumental parameters of heart and vessels were studied by ultrasound investigation methods. The prospective part was carried out at periods of up to 1043 days (mean 736 days). Results. SAF parameter was positively and significantly correlated with the scores on the scale of clinical prognostic signs, with CAI, the fact of operations on the leg arteries. There were 7 fatal cases and at least one hospitalization for cardiovascular reasons in 42 patients during the observation period. The most frequent were hospitalizations for conservative treatment of PAD, the need for aortocoronary bypass grafting and coronary artery stenting. The method of logistic regression determined that the fact of hospitalization or mortality was associated with SAF and blood plasma glucose, the presence of chronic heart failure above functional class 1. Model parameters: sensitivity 71 %, specificity 68%. Conclusion. SAF parameter can be used as an integral independent predictor in patients with multifocal atherosclerosis.

Abstract. Diaphragm disfunction is a rarely diagnosed condition. Its clinical manifestations depend on severity and the underlying disease nature. The development of some ventilation, cardiovascular and gastrointestinal syndromes are pathognomonic for its disorder due to functional features of the muscle. The presented clinical observation demonstrates the difficulties of diagnosis of diaphragm paresis of comorbidity and focuses on the importance and possibility of individual selection of treatment activities.

Abstract. Objective: to analyze the literature data on the effectiveness of modern methods of surgical treatment of pudendal neuropathy to select the most optimal of them. To write the review we studied databases: PubMed, MEDLINE, Cohrane Library, eLibrary using keywords: "pudendal neuralgia", "surgical treatment", "open decompression of the pudendal nerve", "pulse radiofrequency denervation". Depth of search: from 1966 to 2022. The number of analyzed sources was 75. Thirty nine were selected for the review.. Despite the availability of a variety of surgical interventions, so far we have not been able to achieve the most positive results of treatment of this pathology. Open decompression of the genitourinary nerve, while having satisfactory treatment results, simultaneously increases the probability of postoperative complications. Sacral stimulation and pudendal nerve stimulation have fewer complications, but are characterized by ambiguous results. The use of pulsed radiofrequency denervation of the pudendal nerve leads to a significant regression of the pain syndrome in the postoperative period and, due to the least invasiveness, practically has no postoperative complications. However, the samples of patients treated by this method presented in the literature are too few for an unambiguous judgment. Therefore, the question of choosing the most effective method of surgical aid in pudendal nerve neuropathy remains open.

Abstract. The authors present a case report of the use of an allogeneic graft in the simultaneous surgery of multiple juxta-articular fractures in upper extremity. The reports on such cases are rare in medical literature though the probability of post-surgery complications is high.

Abstract. Objective: analyze the available methods of amblyopia conservative treatment. A review of Russian and English-language scientific and medical literature was carried out using the databases of medical and biological publications PubMed, Scopus, Google Academy, Russian scientific electronic libraries eLibrary and CyberLeninka, as well as the disserCat electronic library of dissertations and abstracts. 74 sources of literature on amblyopia were analyzed for the period from 2006 to 2021, 48 were identified as the most informative publications that meet the purpose of this work. For the conservative treatment of amblyopia, traditional methods are used, such as correction with glasses or contact lenses (optical correction), a temporary decrease of vision in the better seeing eye (occlusion and penalization), neuroprotective or antioxidant (drug) treatment, apparatus treatment, special programs for the computer. Many authors point to the maximum effectiveness of the complex impact on the visual analyzer of patients with amblyopia, which requires the development of new methods of exposure and revision of the frequency of application of stimulating treatment courses. The review details the existing approaches to the conservative treatment of amblyopia.