2023, volume 19

Objective: to prove the possibility of reducing the severity of the course of organ dysfunctions and inflammatory response with the compound L-17 in the model of acute post-manipulation pancreatitis (APMP). Material and methods. The APMP model was made on 40 rats. Animals were divided into control (without treatment) and experimental (with the introduction of the compound L-17) groups of 20 rats. The daily dose of the compound is 40 mg/kg. Results. APMP developed in all animals. In the control group, persistent organ dysfunction and inflammatory response corresponded to a severe course of acute pancreatitis with a mortality rate of 70%. In the experimental group, there was a decrease in the severity of organ dysfunction and inflammatory response, with a decrease in mortality up to 30%. Conclusion. The use of the compound L-17 reduces the severity of organ dysfunction and inflammatory response during APMP in the experiment.

Objective: based on world literature data, to determine the main reasons for patient dissatisfaction with the results of primary knee arthroplasty, and also to propose ways to solve them to increase the level of patient satis¬faction with the results of surgical treatment. Review writing methodology. A search for scientific papers on the subject understudy was carried out in the PubMed and eLibrary databases from 1997 to 2022 using the keywords: "knee-joint", "knee arthroplasty", "gonarthrosis", "epidemiology", "satisfaction", "evaluation methods", "awareness", "forecasting techniques", "results". Full text papers on epidemiology, patient dissatisfaction, and methods for assessing the results of primary knee arthroplasty were analyzed. Conclusion. The main reason for patient dissatisfaction with the results of primary knee arthroplasty is their unfulfilled expectations due to lack of information about the upcoming operation.

Objective: to improve the outcomes of medical rehabilitation of mature second-degree patients with spi¬nal cord injury complicated by emotional-volitional disorders in the long-term period of injury, by applying intrathecal electrostimulation. Material and methods. The results of intrathecal electrostimulation in the treatment of chronic bone pain syndrome complicated by the development of anxiety-depressive disorders in patients with mono- and bisegmental fractures of the A1 and A2 types of lumbar vertebrae (according to Magerl) were studied. Two groups of patients (n=36) comparable in gender, age, and degree of functional impairment in the age range from 45 to 65 years were the objects of the study. Intrathecal electrostimulation was used as monotherapy in the patients of the main group (n=17). Patients included in the comparison group (n=19) received treatment corresponding to stages II-III of medical rehabilitation. Pain intensity was assessed by measuring the electrical potential of the skin and using the VAS scale. The degree of anxiety-depressive disorder was determined by a specialized questionnaire, Simptom Check List-90-Revised. Quality of life was assessed using the Oswestry Disability Index. Results. Positive treatment outcomes in the form of reduced anxiety were achieved in 100% (n=17) of patients in the main group and 53% (n=9) in the comparison group (p=0.05). Pain syndrome was eliminated in more patients in the main group (n=17) compared to (n=11) in the com-parison group. There was a difference in a number of numerical measures of quality of life and patient satisfaction with the treatment received: the value (vector) of the level of rehabilitation potential and the value of the outcome level at p=0.01. Conclusion. An effective, pathogenetically grounded technique for rehabilitation of patients with spinal column injuries was proposed, and the tactics of applying intratissue stimulation to mature and elderly patients with disorders of the emotional-volitional sphere at the outpatient stage of rehabilitation treatment was developed.

Objective: to study the effectiveness of surgical treatment of patients with retinal detachment complicated by macular hole of the PVR B-C, depending on the method of subretinal fluid drainage. Material and methods. We studied the data of 18 patients (18 eyes) with a disease duration of 60±9 days. The size of the macular hole averaged 331 ±38 urn. Group 1 patients (9 patients, 9 eyes) underwent fluid drainage through a central hole, group 2 patients (9 patients, 9 eyes) underwent surgical treatment with drainage through a primary peripheral break. Visual acuity, mi-croperimetry, and optical coherence tomography were used to assess the outcome. Results. In the group 1, the macu¬lar hole remained unclosed in 33% of cases (3 patients), in the group 2-11% of cases (1 patient). In group 1, BCVA increased to 0.09±0.03; in group 2, to 0.11±0.03. According to ОСТ data in the Full Retinal Thick patients of the group 1 a month after the operation, it was 318±42 urn, in the group 2-245±30 urn. Conclusion. Based on the analysis of the results of the study, it can be concluded about the higher efficiency of surgical treatment using the peripheral method of drainage of subretinal fluid.

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.