№2, 2023, volume 19

The article follows all milestones of professor Elena V. Karyakina's scientific career. Her research of the connective tissue biochemistry and designing of medical technologies aimed at improving the efficacy of treatment and surgical management in patients with rheumatoid arthritis and osteoarthrosis of larger joints made a significant contribution to the development of Russian experimental and practical rheumatology.

Objective: To establish the effect of the administration of tartrazine for 60 days, as well as Mexidol® under these conditions, on the structural features of the parafollicular cells of the rat's thyroid gland at the electron microscopic level. Material and methods. Thirty white male rats weighing 200-210 g were divided into five groups six rats each. The Group I is the control; the Groups II and III — rats received tartrazine at a concentration of 750 and 1500 mg/kg for 60 days; the Groups IV and V — under similar conditions Mexidol® was administered at the rate of 50 mg/kg. Qualitative changes in parafollicular cells were studied using electron microscopy, and quantitative changes — by morphometry Results. The fine-grained or fibrous contents were detected in the cisterns of the rough endoplasmic reticulum, and areas of the destroyed matrix in some mitochondria after exposure to tartrazine. The ratio of area eu-chromatin/heterochromatin decreased in the Groups II and III by 5.7% and 56.9%, respectively, and the diameter of secretory granules — by 12.3% and 19%, respectively, compared with the Group I. The ratio of area euchromatin/het-erochromatin increased by 79.6% in Group V, and diameter of secretory granules — by 8.2% and 6.5% in the Groups IV and V respectively, compared with the data of the Groups II and III. Conclusions. The introduction of tartrazine in different doses for 60 days causes dose-dependent qualitative and quantitative changes in the ultrastructure of parafollicular cells, and the introduction of Mexidol® against this background causes a decrease in their severity.

Objective: identification of variability in the size and shape of the sacrum of men and women of the Middle and Lower Volga regions. Material and methods. Macerated sacrums 21 men aged 18-75 and 21 women aged 22-85. Osteometry was performed according to the method of V. P. Alekseev. Results. In the sacrum of men, the sagittal diameter (by 3 mm, p<0.001) and width of the body of the first vertebra (by 4 mm, p=0.003), height (by 8 mm, p=0.006) and width (by 5 mm, p<0.001) predominate) ear-shaped surfaces, the lower width of the sacrum (by 7 mm, p=0.007). In the sacrums of women, the upper width of the pelvic surface (by 7 mm, p=0.008) and the sagittal diameter of the sacral canal (by 1 mm, p=0.007) predominate. The index of narrowing of the sacrum as a whole (63.8% in men, 58.5% in women) and the index of narrowing in the lower part (75.5% in men, 69% in women) demonstrate a high level of statistical significance of differences (by 5.3%, p=0.001, and 6.5%, p=0.008, respectively). Conclusion. The revealed variability in the size and shape of the sacrum of men and women of the Middle and Lower Volga regions lies in the large size of the body of the first vertebra and ear-shaped surface of the male sacrum, which is less narrowed in the lower part than the female one, while in women the sacrum has a greater degree of narrowing from top to bottom.

Objective: to analysis of indicators of preventive medical examinations and dispenserization of the adult population of Kursk, districts and the Kursk region as a whole, development of medical and organizational measures to achieve planned indicators. Material and methods. Analysis of data from form 131 and copying of information from the summary reports of medical institutions by cluster analysis and grouping of indicators depending on the achievement of the plan, extensive indicators were calculated, the results are presented in bar charts. Results. All districts and cities of the Kursk region are divided into three clusters. The first cluster (at least one of the features must reach 100% fulfillment) included 6 districts. The second cluster (districts with the implementation of the plan from 50%) included 21 districts and three cities of the Kursk region. The third cluster (districts with the implementation of the plan up to 50%) included 1 district. Conclusion. The analysis made it possible to identify areas with a low level of completeness of coverage of the adult population with preventive medical examinations and dispenserization. In these areas, it is necessary to resume the work of volunteer detachments with the population to educate them in order to achieve the planned indicators.

Objective: to study the attitude of doctors and patients of the central district hospital to the use of digital medicine technologies. Material and methods. The study was conducted by a questionnaire survey. 43 doctors and 213 patients of the central district hospital were asked to assess the possibilities of digital tools in solving health problems, the degree of use of Internet platforms in the process of doctor-patient interaction, the level of influence of the Internet on patients' adherence to doctor's recommendations. Results. Only 14.0% of doctors and 5.2% of patients believe that digital technologies can help solve the problem of staff shortage. Currently, 65.1 % of doctors and 23.9% of patients use digital technologies in communication in the doctor-patient system. 55.8% of doctors stated the desire of patients to get information about treatment in Internet sources, but 97.7% of patients trust doctors more than recommendations on the Internet. Among the possible ways of using digital technologies in medicine, patients see the design of referrals (61.0%), prescriptions (50.2%), temporary disability sheets, certificates (29.6%). Conclusions. Most representatives of both the medical community and patients do not see digital technologies as a way to radically solve the problems of personnel shortage in rural areas: only 32.6% of doctors and 19.7% of patients consider it possible to increase the availability of medical care through telemedicine, only 23% of patients considered remote consultations to be in demand. First of all, the prospects of digitalization of healthcare, according to patients, are associated with the optimization of the issuance of documents in the provision of medical care.

Objective: To assess the impact of peri- and postmenopause and some social-demographic and medical factors on scales of the quality of life (QoL) of women living in Yerevan. Material and methods. Across-sectional study was conducted among 353 women in the >40 age group. WHQ (Women Health Questionnaire) was used for the assessment of quality of life. Results. Negative indicators in peri- and postmenopausal women compared to women with a regular cycle were revealed on the scales "Vasomotor disorders" (0.46±0.05 and 0.51±0.03 vs. 0.17±0.03, p<0.001) and "Anxiety/fears" (0.40±0.04 and 0.38±0.02 vs. 0.27±0.03, p=0.013). The difference only between the groups of postmenopausal women and those with a regular cycle was registered on the scales "Somatic symptoms" (0.53±0.02 vs. 0.49±0.04, p=0.003), "Memory and concentration of attention" (0.47±0.03 vs. 0.39±0.04, p=0.015), Sexual Behavior (0.43±0.03 vs. 0.21±0.03, p<0.001) and "Attractiveness" (0.37±0.03 vs. 0.24±0.04, p=0.015). The presence of chronic diseases had a negative impact on QoL. From socio-demographic characteristics, negative was impact of age, low level of education, lack of employment, unfavorable family and financial status. Conclusions. There was a deterioration in all indicators of the QoL, except "Depressed mood", "Sleep problem", "Menstrual symptoms", in women of peri- and postmenopausal age. Age, low level of education, lack of employment, unfavorable family and financial status, the presence of chronic diseases had a negative impact on the QoL of the study participants.

Objective: to identify the features of oncological examination in dental practice. Material and methods. A survey of patients (n=417) and dentists of various specialties (n=402) was conducted to identify the practice and features of preventive oncological examination of the lips, oral cavity and pharynx. Results. When questioning, 50% of patients noted the incomplete implementation of various constituent elements of a comprehensive oncological examination of the lips, oral cavity and pharynx when visiting a dentist. When questioning dentists, it was revealed that 33% of respondents conduct oncological examinations. Conclusion. According to the results of a sociological study of patients and dentists, a discrepancy between the volume of preventive oncological examination of the lip, oral cavity and pharynx was revealed with the algorithm recommended by the World Health Organization. The Procedure for providing medical care to adults with dental diseases approved by the Ministry of Health of the Russian Federation regulates preventive examinations once every six months, but does not determine the purpose of the examination —the identification of visual forms of malignant neoplasms and precancerous diseases. The card of an outpatient dental patient (Form №043u) requires amendments regarding the inclusion of an algorithm for conducting oncological examination in it.

Objective: to evaluate the frequency, structure and severity of adverse events (AEs) likely associated with computerized electroacupuncture (CEAP) in the complex treatment of diseases of internal organs. Metodology of review. Nine own studies were analyzed, which involved 639 patients suffering from bronchial asthma (BA), chronic obstructive pulmonary disease (COPD) and irritable bowel syndrome (IBS). Patients of the main groups, in addition to standard therapy, received courses of CEAP according to a certain scheme. The frequency, severity, structure and relationship of AEs with CEAP were assessed. Conclusion. The use of CEAP in the treatment of patients with IBS is not associated with an increase in the number of AEs. The frequency of AEs, probably associated with the use of CEAP, did not exceed 2.5 cases per 100 people per one course of CEAP.

Objective: to demonstrate the result of successful treatment of a patient with cystic vestibular schwannoma. Currently, there is no single approach to choosing a surgical treatment method of cystic vestibular schwannoma. When choosing tactics, neurosurgeons are guided, as a rule, by the location of the tumor and the thickness of its walls. Emptying the cyst can also lead to a change in the existing relationship of the tumor with neighboring structures, especially with the facial nerve. The chosen method of treatment of this disease in the form of total removal of cystic vestibular schwannoma under the control of neurophysiological monitoring made it possible to achieve early activation of the patient and avoid postoperative complications, preserve the function the facial and trigeminal nerves involved in the tumor capsule.

Objective: to adapt the Russian version of the 1998 Oxford Knee Score (OKS) to assess the level of pain and function of the knee joint in patients both before and after primary knee arthroplasty. Material and methods. Validation and cross-cultural adaptation of the Russian version of OKS has been completed. A patient survey was conducted, and according to its results, the filling rates of both Russian-language versions of OKS were assessed, based on the criteria developed in the course of the current study. The following parameters were also evaluated in our study: validity, internal fit (Cronbach's a), reproducibility, ceiling/floor effect, filling rate, mean score, mean age of patients. Results. The study involved 200 patients hospitalized for primary knee arthroplasty. 167 of them (83%) were women, mean age 64.4 (SD 8.2) and 33 (17%) men, mean age 64 (SD 9.7). Validity index — 0.73, p<0.001, Cronbach's a — 0.864, reproducibility — 0.93 (0.76-0.98), ceiling effect in questions 1, 2, 3, 4; gender effect in questions 5, 7, 10, 11. Conclusion. The new Russian version of OKS, in comparison with the previous version, showed an improvement in the examined criteria for the comparison of the occupancy rates by 6, 9, 11 and 16%, respectively (p<0.05 for each of the criteria).