2024, volume 20

The article presents the contribution of Professor Boris I. Slovtsov to the development of Russian science during his work at the Military Medical Academy, the St. Petersburg Women's Medical Institute and the Imperial Nikolaev University (Saratov). His scientific research in the field of biochemistry, nutrition, fasting, physiology of labor, as well as in the study of the effect of chemical warfare agents on the body of animals is shown. The work highlights the issues of improving the educational process in the training of medical personnel in medical universities of the country and social activities. Professor B. I. Slovtsov made a significant contribution to the organization and formation of the Department of Pharmacology with Formulation, Toxicology and the Study of Mineral Waters at the Medical Faculty of the Imperial Nikolaev University (Saratov) in 1910-1912.

Objective: to identify the frequency of occurrence and size characteristics of various forms of the head of the lower jaw, depending on the sex and shape of the skull in people of the first period of adulthood. Material and methods. Subject: 77 women (21-35 years old) and 78 men (22-35 years old). The shape and dimensions of the man-dibular head were determined on cone-beam computed tomograms. Results. The most common was the oval shape of the mandibular head (73% in women, 51 % in men). In women, the bean-shaped form was least common (9%), in men — cone-shaped (10%). Bilateral differences in the size characteristics of the mandibular head were revealed: on the right, the frontal diameter is 5.0% larger, and the sagittal diameter and height of the head are 3.7 and 5.0% smaller (p=0.010-0.017). The height of the oval head on the right and left is 15.5 and 10.8% greaterthan that of the head of the lower jaw, which has a bean-shaped shape (p<0.001). With an increase in cranial index, the height of the mandibular head on the right decreases (r=-0.36); the height of the head on the right increases with increasing cranial vault length {r=0.33) and with decreasing cranial vault width (r=-0.27). Conclusion. The oval head of the lower jaw in women/men with brachycrania was found in 18.2/23.1%, with dolichocrania in 22.1/11.5%, with mesocrania in 32.5/16.7% of cases. The bean-shaped head in women/men of brachycranes was detected in 1.3/2.6%, mesocranes in 7.7/24.4%, dolichocranes in 0/11.5% of cases. The cone-shaped head in women/men of brachycranes was noted in 2.6/6.4%, mesocranes in 7.8/3.8%, dolichocranes in 7.8/0% of cases.

Objective: to evaluate basic metabolism and its relationship with changes in body composition in patients with liver cirrhosis. Material and methods. A retrospective study was conducted, which included an analysis of data from 110 patients with a confirmed diagnosis of liver cirrhosis from 02.2020 to 12.2022. Assessment of body composition and basic metabolic data was carried out using ABC-01 MEDASS (STC MEDASS, Russia). Results. The basic metabolism in men with cirrhosis was 1631.0 (1577.5-1760.0) kcal/day, in women — 1337.0 (1256.0-1421.5); p=0.005. At the same time, among women, the indicator was reduced by an average of 18.1 % relative to the reference values of the main exchange for their age group. According to the results of multivariate regression analysis, gender (p<0.001), active cell mass (p<0.001), proportion of skeletal muscles (p<0.001), mineral mass (p=0.0034) and phase angle (p<0.001) were significantly associated with basic metabolism in patients with liver cirrhosis. The correlation coefficient between basic metabolism and extracellular fluid was r=0.807; p<0.001; between active cell mass index r=0.877; p<0.001, respectively. Conclusion. The level of basic metabolism against the background of cirrhosis of the liver is determined by changes that affect the components of the body composition against the background of the disease. Active cell mass, skeletal muscle fraction, mineral mass, phase angle and sex are important parameters to consider when predicting changes in basal metabolism and its correction in patients with cirrhosis.

Objective: to determine the typological features of the intertragal notch (ITN) shape of the auricles (AU) in young men. Material and methods. After somatotyping and cephalotyping of 140 young men both right and left AU were photographed. 25 marks were applied on the images of AU along the margin of the ITN by digitizer tpsDig2 2.31. We performed a procedure for superposition of label configurations using the method of generalized Procrustean analysis using MorphoJ 1.06d soft. Procrustean coordinates were determined, characterizing the variability of the ITN shape of the right and left AU. A one-way AN OVA was carried out on the obtained data with the determination of Goodall's F-criterion, which was used to determine the strength of the influence of the cephalotype and somatotype of the young men on ITN shape both left and right AU. The significance level of the F-criterion is set at 0.05. To visualize the change in the shape of the ITN of AU of the corresponding side, the method of transformation grid was used. Results. As a result of ANOVA, a statistically significant influence of the somatotype of young men on ITN shape only in the left AU was established (F =1.98; p<0.0001). The significance level of the F-criterion in determining the strength of the influence of the cephalotype on ITN shape of both AU exceeded the critical value. As a result of discriminant analysis of ITN shape in groups of young men belonging to different morphotypes, models were obtained that allow for the correct classification of ITN. The classification accuracy of such models in some cases exceeds 90%. Conclusions. Variability in the form of ITN is more associated with the somatotype than with the cephalotype of young men. The shape of ITN differs in young men with different morphotypes.

Objective: to analyze the dynamics of the activities of medical organizations repurposed to provide medical care to patients with COVID-19. Material and methods. In two repurposed multidisciplinary medical organizations in Saratov, a multi-criteria assessment (according to 31 indicators) of the dynamics of their activities was carried out (retrospectively by doctors — 26 and 22 people who participated in providing medical care to patients with COVID-19). Three stages were evaluated: 1) the beginning of admission of patients in April — May 2020; 2) December of 2020; 3) December of 2021. Results. The activities of both repurposed medical organizations throughout the study received an average integral rating of "good". At the same time, its positive statistically significant dynamics between the first and second stages (from 3.9±0.1 to 4.5±0.1 points) was revealed, accompanied by a significant increase in the number of excellent grades given by respondents and indications of a high level of gradation of informative criteria. Informative criteria have been identified, the low and medium levels of which need to be corrected. Conclusion. The expediency of repurposing multidisciplinary medical organizations to provide medical care to patients with COVID-19 has been confirmed.

Objective: to assess the availability of medical care for retinal diseases in the subjects of the Russian Federation according to the data of a survey of physicians and patients with age-related macular degeneration (AMD) and diabetic macular edema (DME). Material and methods. The medical and sociological study included 20 interviews with specialized doctors from 13 subjects of the Russian Federation and questionnaire survey of 264 patients with AMD and 260 patients with DME living in 10 regions of the country. Results. According to the data of the patient survey, AMD and DME were diagnosed during prophylactic measures in 41.3% and 50.0% of respondents (p=0.009). All prescribed intravitreal injections of angiogenesis inhibitors were given free of charge to 64.4-71.4% of respondents. The wait for hospitalization was less than one month for 40.3 and 50.9% of respondents with AMD and DME (p=0.041), respectively. Some of the interviewed patients (18.0%) interrupted the intravitreal injections of angiogenesis inhibitors course due to personal circumstances. According to the data of interviews of medical specialists, the main problems in providing care to patients with AMD and DME include territorial disparities, excessive volume and repetitiveness of preoperative examination and insufficient patient adherence to treatment. Conclusion. Medical care for retinal diseases in the studied regions is characterized in general by a high level of accessibility, which is confirmed by their predominant detection during preventive measures, timely performance of the necessary examination and treatment.

Objective: to evaluate the effects of protein-energy malnutrition (РЕМ) on the course and outcome of ischemic stroke (IS) in patients with neurogenic dysphagia (ND). Material and methods. The study was performed in 110 patients (64 men and 46 women aged 44-89 years) using the National Institutes of Health Stroke Scale, Nutrition Risk Screening (NRS) 2002, Mann Assessment of Swallowing Ability (MASA). The level of total blood protein was measured at admission and on the day 10 of IS. The weight of patients was determined at admission and on the day 10 of the disease. The results of IS were analyzed according to the Glasgow Outcome Scale (GOS) and the frequency of complications: pneumonia, pulmonary embolism, phlebothrombosis, multiple organ failure, bedsores. Results. All patients with ND and IS at admission on the NRS 2002 scale had at least 3 points, signs of mild РЕМ were observed in 5.45%. On day 10, signs of РЕМ were observed in 40.9% of patients, of which mild in 20% of patients, moderate in 13.6% of patients and severe in 7.3% of patients. Differences between the level of total protein in the blood of patients with ND in IS at admission and on the day 10 from the onset of the disease were significant in all groups according to the severity of dysphagia on the MASA (p<0,001). In patients with clinical manifestations of РЕМ, the incidence of pneumonia, multiple organ failure and bedsores was statistically significantly higher than in patients without clinical manifestations of РЕМ. As a consequence of the complications that developed, a negative outcome on the GOS (1 point — death) was more common in patients with signs of РЕМ, and a positive outcome (4 points) in patients without signs of РЕМ (p=0.049). Conclusions. ND in the acute period of IS is one of the factors of the development of РЕМ, which aggravates the severity of the condition of patients, entails a number of complications and more often leads to a fatal outcome.

Objective: can dermatoscopy serve as the "gold standard" for the diagnosis of nail plate psoriasis, eliminating the need for histopathological examination for the final diagnosis of nail psoriasis. Methodology for writing a review. A literature search was conducted using Medline, PubMed, and eLibrary databases for all years to date. Search terms included words and phrases such as "psoriasis", "nail psoriasis dermatoscopy", and "nail plate dermatoscopy". The number of sources considered is 35. A total of 16 studies from 2010 to 2022 were critically assessed. Conclusion. Nail psoriasis is characterized by many specific dermatoscopic features. In this regard, dermatoscopy, which allows diagnosing psoriatic onychodystrophies, is an effective method for studying the specific lesion of the nail plates to clarify the diagnosis of nail psoriasis.

Objective: to evaluate the frequency and identify risk factors for the development of stent restenosis in patients with acute coronary syndrome (ACS) after percutaneous transluminal coronary angioplasty Material and methods. Retrospective analysis of 665 case histories of patients with acute coronary syndrome who were hospitalized from January to November 2023 was performed at the 1st stage of the study. At the second stage we analyzed the risk factors of in-stent restenosis development based on clinical and laboratory data in the compared groups of patients: group 1 (n=62) and group 2 (n=55). Results. Stent restenosis was detected in 62 patients out of 665 (9.3%). The risk of in-stent restenosis was significantly influenced by concomitant type 2 diabetes mellitus (OR 1.6 (1.2-2.3); p=0.007), IBS duration of more than 10 months (OR 2.24 (1.7-3.0); p=0.001) and stenting with a holometallic stent (OR 1.8 (0.9-3.4); p=0.049). Conclusion. The incidence of stent restenosis after stenting for ACS is 9.3%. Concomitant diabetes mellitus and duration of the underlying disease of 10 months are risk factors for early restenosis.

Objective: to evaluate the impact of a remote dynamic monitoring system on the lipid profile after myocardial infarction in urban and rural areas of the Perm Territory. Material and methods. The study, conducted between 2020 and 2022, included 253 patients diagnosed with myocardial infarction. The study compared two groups of patients: those who refused to participate (n=105) and those who took part in the "Remote health monitoring of patients with cardiovascular disease" (RM program) (n=148). Patients were monitored at least once a month via telephone calls using an approved list of questions. Results. The group of patients participating in the RM system showed a significant improvement in lipid profile compared to the groups without RM. A comparison between urban and rural patients showed statistically significant differences in the levels of cholesterol (p=0.002 for residents of the Perm region) and low-density lipoproteins (LDL) (p=0.049 for residents of Perm; p=0.025 for residents of the Perm region), indicating potential differences in the effect of RM in different areas. Patients in the RM group from the Perm region were 15.56 times more likely to achieve target LDL levels compared to a similar group without RM. Conclusion. The RM system had a positive effect on the reduction of LDL and cholesterol in groups of residents, both in urban and rural areas.