№1, 2024, volume 20

The article is dedicated to the Doctor of Medical Sciences, Associate Professor of the Department of Human Anatomy Koshkina Ksenia Alekseevna (1899-1945). The work describes the main stages of her scientific biography, as well as the history of the creation under her leadership and the direct participation of unique anatomical preparations "the corpse of an adult man with reconstituted vessels and nerves of the whole body" and "the corpse of an adult man with reconstituted muscles of the whole body". For 85 years, these drugs have been the central exhibits of the fundamental educational and anatomical museum of the Department of Human Anatomy of Saratov State Medical University named after V. I. Razumovsky.

Objective: to establish the dependence of thrombocyte (Tc) aggregation efficiency on crosstalk-signaling pathways associated with stimulation of TR-receptor and purine P2-receptors, with different cyclooxygenase (COX) activity against the background of non-steroidal anti-inflammatory drugs (NSAIDs) administration in patients with nephrolithiasis (NLT). Material and methods. The study was prospective and included 60 patients with NLT who received non-steroid anti-inflammatory drugs (NSAIDs) for analgesia as part of lithokinetic therapy (LKT). The cohort of patients was divided into two groups, with effective (group 1, n=30) and ineffective (group 2, n=30) COX inhibition. The activity of TP receptors, purine P2 receptors (P2X1 and P2Y receptors) of platelets was assessed on a ChronoLog analyzer (USA). Agonists (ATP, ADP and Arachidonic acid) were used at EC50 and EC10 concentrations. Results. In the 1st group, after 72 hours of LCT, the activity of the TR receptor, P2 receptors of Tc decreased to the level of hyporeacti-vity. The regulation of the compensatory reaction of Tc in response to hematuria was provided through the synergism of the P2 receptors, and the TP receptor and the P2X1 receptor. In 2nd group hyperreactivity of the TP receptor and P2 receptors persisted. Optimal modulation of the compensatory reaction of Tc was provided by the synergism of the TP receptor and P2Y receptors. Conclusion. The efficiency of Tc aggregation during NSAIDs administration is determined by intracellular signalling associated with TR receptor and P2 receptors.

Objective: To improve the motivation of drug users to undergo social rehabilitation, to analyze the main sex and age characteristics, as well as data on the drug history of persons undergoing social rehabilitation in the Samara regional charitable public organization "Rehabilitation of drug addicts (Remar)". Material and methods. Anonymously, 173 rehabilitants were surveyed according to a developed questionnaire of 15 questions related to gender, age and drug history of rehabilitants. Results. Social rehabilitation services are more often used by men (75.7%), the average age of rehabilitants in the study was 37,3±0,9 years; 51.4% of rehabilitants use opiates, 36.4% — psychostimulants, 24.8% — alcohol. 35.8% of rehabilitants previously applied for treatment to state medical organizations, while 19.2% of respondents were not satisfied with the quality of the service provided, 25.8% were available. Conclusion. Patients of the Samara regional charitable public organization "Rehabilitation of drug addicts (Remar)" are more often men living mainly in cities who consume psychoactive substances for a long time, mainly opiates, psychostimulants and alcohol. The sex and age characteristics of rehabilitants identified during the study, as well as the data of their narcological history, will allow adjusting the ongoing motivational work on the involvement of users of psychoactive substances in the process of social rehabilitation.

Objective: to determine the dominant motives for choosing a profession "clinical psychology". Material and methods. The methodology of R. V. Ovcharova was applied to determine the motives for choosing the profession of a clinical psychologist. The opinion of students in the specialty "Clinical Psychology" was also studied with the help of a specially designed author's questionnaire (19 questions), which allowed to determine significant motivation factors in choosing a profession students (n=126). Regression analysis was used to determine the relationship between gender, the presence of relatives — medical workers and motivation factors. Results. For a group of students, the total score for internal individually significant motives is 2500 points, for internal socially significant motives — 2172 points. The motive of "the opportunity to realize their personal qualities" is statistically more significant for men (b=1.12±0.52; p=0.03), the motive of "low tuition" —for women (b=-1.10±0.55; p=0.04). 68.3% of respondents have medical workers in their environment. For people who do not have relatives — medical workers, such motives as "vocation" (b=-0.81±0.35; p=0.02), "low tuition" (b=-1.18±0.50; p=0.02), "parents' desire" (b=-0.89±0.37; p=0.02) are more significant when choosing a profession. Conclusions. The dominant motives for choosing the profession of "clinical psychology" for students are internal motives. The motives for choosing a profession depend on such personal identifiers as gender and the presence of relatives — medical workers.

Objective: to evaluate the effectiveness of the corporate program for the prevention of dental health among employees of an industrial enterprise. Material and methods. The program included 2 stages: informational (round tables, brochure) and dental (dental consultation). The participants are employees of one workshop of an industrial enterprise. 150 (50% men, average age 38.5±0.8 years) took part in the information stage, 20 employees (45% men, average age 41.1±2.8 years) took part in the dental stage. The effectiveness of the program was assessed by awareness, the CFE index, and the Green — Vermillion hygiene index. Results. The awareness of employees about the causes of hypersensitivity of teeth and the rules for cleaning them increased by 1.3 times, the need to use specialized toothpastes by 2.1 times, the use of mouthwashes and a change in nutrition by 14.3 times. Awareness of doctors providing care for increased tooth abrasion has increased: dental therapists 1.3 times, orthopedic dentists 3 times, general practitioners 3.7 times and periodontists 10.4 times. The differences are significant (p=0.001-0.041). The CFE index has not changed. The Green — Vermillion index decreased from 1.9±0.2 (from a score of "unsatisfactory") to 0.5 (p<0.001), which corresponds to a good level of oral hygiene. Conclusion. The introduction of a corporate program to strengthen dental health at an industrial enterprise has led to increased awareness among employees about the causes and methods of preventing increased tooth abrasion, and improving the level of oral hygiene.

Objective: evaluation of factors affecting hospitalization of children of the first month of life in a multi-disciplinary children's hospital in a metropolitan area. Material and methods. Using the continuous method, data from 267 children in the first month of life in St. Petersburg was copied from the Ariadna medical information system. Re-sults. In 2020-2022 the majority of children were treated through compulsory medical insurance (89.5-93.2%). During the year of the COVID-19 pandemic, 66.7% of patients were admitted as emergencies. More than half of the children were admitted through internal routing. In 2022, the highest hospitalization rate was in patients with certain conditions arising in the perinatal period (452.6%o) and congenital malformations (242.1%o), and the longest average duration of treatment was observed in patients with factors influencing health status population and visits to health care institutions (24.5±7.5 days), respiratory diseases (22.5±21.5 days). Most children were discharged with improvement. Conclusion. The hospitalized morbidity of children in the neonatal period is influenced by a significant number of factors, among the main ones being the location of the medical organization, the presence of a perinatal center in its structure and the COVID-19 pandemic.

Objective: to assess the influence of medical and social risk factors for cardiovascular diseases on outcomes of patients living in rural and remote areas of the Russian Federation. Review writing methodology. A systematic review was carried out according to the PRISMA (The Preferred Reporting Items for Systematic reviews and Meta-Analyses) methodology using eLibrary, Google Scholar, and CyberLeninka databases. Search depth — from 2002 to 2022. The review included 19 original studies. It has been established that the prevalence of cardiovascular diseases risk factors in the rural population is not always higher than in the urban population, and the outcomes are worse. Conclusion. It has been shown that among the rural population, social determinants of health come to the fore, determining the ability of patients to follow recommendations for managing risk factors and receive timely and high-quality medical care.

Objective: an integral assessment of the working conditions of doctors of central district hospitals, followed by a quantitative differentiated selection of the totality of the most adverse factors for the health of doctors. Material and methods. A study of the harmful factors of production activities of 80 medical workers (24 surgeons, 16 anesthesiologists, 18 neuropathologists and 22 emergency doctors) of the central district hospital was carried out during 2021-2022 in accordance with the requirements of R 2.2.2006-05, based on the results of a special assessment of working conditions (SOUT). A mathematical model proposed by V. Ivanov (2016) was used to calculate the values of the integral assessment of the working conditions of doctors, expressed in conditional units (UE). Results. The indicators of integral assessment of working conditions calculated as a result of the studies were: for emergency doctors — 5.18 units, surgeons — 3.47 units (were consistent with the dangerous), for anesthesiologists — 2.27 units (met unacceptably harmful conditions), for neuropathologists — 0.13 units (were characterized as harmful). Conclusion. The method of integral assessment of harmful working conditions of medical workers makes it possible to quantitatively carry out a differentiated selection of the totality of the most dangerous industrial factors for the health of doctors.

Objective: to determine the effectiveness of magnetopuncture techniques in the corrective treatment of asthenic syndrome with autonomic manifestations in operators. Material and methods. 66 employees of the operator service aged 24-47 years with asthenia were examined. A survey, a neurological examination, a subjective assessment of fatigue using Fatigue Assessment Scale (FAS) were conducted before and after treatment. Acupuncture treatment included 10 sessions of magnetopuncture. Results. After the course of magnetopuncture, there was an improvement in the condition of the patients, a significant decrease in the subjective assessment of fatigue on the FAS scale from 31.2 (28.6; 34.6) to 17.6 (15.4; 18.8) points (p=0.001). According to the data of the heart rate variability spectrum after corrective treatment, there was a significant increase in the high-frequency component (HF) in absolute values (p<0.001), as well as significant differences in the components of LF (p=0.011) and HF (p=0.027) in normalized units, and the ratio of the low-frequency component to the high-frequency one (LF/HF) (p=0.006). Conclusions. The proposed scheme of magnetopuncture is an effective non-drug technique for the correction of autonomic disorders in asthenic syndrome among operators, and can be used for complex rehabilitation.

In the article is presented clinical case of a patient with late parenchymal neurosyphilis in the form of progressive paralysis. The basis of the clinical manifestations of the disease in the patient was progressive cognitive impairment. The described case demonstrates clinical similarities with chronic cerebral circulatory disorders, multiple sclerosis, neurodegenerative and mental diseases, shows the need to remain vigilant of neurologists and therapists regarding rare but curable diseases of the nervous system due to their polymorphic clinical picture and erased course.