2024, volume 20

Objective: to identify the features of expression of immunohistochemical markers CD3, CD68, CD163 and CK-19 in thymus cells of neonatal children with enlarged thymus who died from infectious diseases. Material and methods. Autopsy material of children of early and late neonatal period (n=33) who died in the hospitals of Saratov city served as the material of the study. The causes of death of children were pneumonia (n=17), sepsis (n=16). Morphologic material was divided into 2 groups: Group 1 (comparison) — children whose thymus gland mass corresponded to the age norm (n=19); Group 2 (study group) — children whose thymus mass exceeded the age norm (n=14). The expression of the following markers was evaluated in the study: CD3, CD68, CD163 and CK-19. Results. As a result of the study, it was found that with increasing thymus mass in its cortical substance the proportion of CD3+ cells increase 2.7 times (p=0.009), the proportion of CD68+ cells increase almost threefold (p=0.009) CD163+ cells decreases by 10% (p=0.005), and CK-19 positive cells do not form a network. Conclusion. Increased thymus mass in children of early neonatal period with infectious diseases is accompanied by disturbances in the processes of migration and differentiation of lymphocytes.

Objective: to identify bilateral and sexual variability, as well as the average morphometric characteristics of the cerebral arteries in children during the first childhood are normal. Material and methods. The material for the study was samples of brain arteries obtained during autopsy of 35 children 3-7 years old. Transverse millimeter sections of the anterior (АСА), wedge-shaped parts of the middle (MCA), pre-communication segments of the posterior cerebral (PCA), intracranial parts of the vertebral arteries (VA) and cerebral internal carotid arteries (ICA) under a microscope determined the external diameter, wall thickness, internal diameter. Results. The above parameters of the arteries in the right and left hemispheres of the brain ranged from 0.2 to 7.9% (p>0.05); in boys and girls — from 0.5 to 15.4% (p>0.05). The average values of the outer diameter, wall thickness and inner diameter were: ICA—2.65±0.04, 0.16±0.005 and 2.33±0.04 mm; АСА— 1.90±0.02, 0.14±0.004 and 1.61±0.03 mm; MCA—2.25±0.03, 0.15±0.005 and 1.95±0.03 mm; PCA— 1.81±0.03, 0.14±0.004 and 1.54±0.03 mm; VA —2.23±0.03, 0.16±0.005 and 1.91±0.04 mm. Conclusion. In the first period of childhood, bilateral and sexual differences in the value of the studied parameters of ICA and main cerebral arteries were not found. In this regard, arterial mean values are presented excluding sex and arterial circle side. In the first period of childhood, the lumen of АСА is 86.0%, MCA—80.4%, PCA—79.0%, VA—79.9% of the size of similar arteries in an adult.

Objective: to assess the readiness of patients for online communication with a medical professional and the demand for medical care in a remote format. Material and methods. 507 patients were interviewed using a questionnaire developed by the author. The questionnaire allows you to obtain data on the respondent's experience in using online communications with a doctor, the respondent's readiness for "digital" visits, the impact of Internet resources on the patient's trust in the recommendations of the attending physician. Results. 30.6±2.1 % of patients use online communications when interacting with their doctor, 40.5%±2.2% would like to have this opportunity. There was a difference in readiness for digital communications between groups of respondents interested in pediatric specialists (parents of children attending children's clinics) and groups of Central District Hospital patients and patients of urban hospitals (p<0.001). The influence of age on patients' readiness for online communication has been confirmed. The most in demand in the remote format were referral services (for tests, hospitalization), especially in the parent group. The study of patients' behavior in relation to the search for a "second opinion" on the Internet showed that most of the respondents are currently not inclined to double-check their doctor's appointments, and the absolute majority of respondents (82.8±1.7%) trust their treating real doctor, and not Internet advice. Conclusion. The results of the study indicate the readiness of the population to introduce digital communications and transfer part of medical care to the digital field, the most in demand were services for registration of referrals to hospitalization, to narrow specialists, tests, prescriptions for medicines that the patient receives on a regular basis.

Objective: to assess the dynamics of the formation of a culture of health and the perception of their own health by schoolchildren on the example of students at the stage of pre-professional medical education. Material and methods. The study was conducted on the basis of the Pre-University of Sechenov University. A questionnaire was used to assess the physical, mental, social and spiritual components of health culture. A questionnaire was used to assess the key components of the culture of health: physical, mental, social and spiritual. In 2018, 260 teenagers (171 girls and 89 boys, average age — 16.6±0.74 years) were interviewed, in 2024-702 (519 girls and 183 boys, average age 16.3±0.91 years). The data were analyzed using the Pearson x2 test with Yeats correction, and Spearman's rank correlation coefficient was calculated to study the relationship between qualitative features. Results. During the period understudy, the share of students with high values of the level of health culture increased by an average of 12.9±5.5% (p<0.01); attaching importance to lifestyle, ecology, rejection of bad habits, receiving information about health from reliable sources by more than 10%(p<0.01), a relationship was found between adolescents' perception of their own health and the professional status of their mothers (2024 —p=0.733; 2018 — p=0.730, t=0.11). Conclusions. An increase in the proportion of adolescents with a high level of health culture has been shown, there is no significant difference in health self-esteem and there is a strong and direct link between the perception of adolescents of their own health and the professional status of their mothers.

Objective: to identify the main trigger mechanisms of carcinogenic factors of biological nature and develop, on their basis, preventive measures to prevent the development of cancer in the population. Methodology for writing a review. A review 50 scientific papers posted in the databases Web of Science, Scopus, PubMed, CyberLeninka, eLibrary.ru were analyzed. The electronic search was carried out using a combination of keywords: "carcinogenic factors of biological nature", "viruses", "bacteria", "trematodes", "preventive work", "sanitary service", "oncological morality". The depth of searches in electronic databases and citation lists amounted to more than a 10-year period from 2013 to the middle of 2024. Conclusion. An analysis of the scientific literature showed that the trigger mechanisms in the pathogenesis of the formation of EIT caused by carcinogenic factors of biological nature lie in the ability of infectious pathogens to cause inflammatory reactions, turning into chronic infections that provoke the development of cancer among the infected population. Preventive measures, in the absence of specific vaccination, can be presented in the form of a set of preventive measures aimed at ensuring the sanitary, hygienic and anti-epidemiological well-being of the population.

Objective: to assess the impact of mobile phone use on the mental state of adolescents. Material and methods. On voluntary terms, a survey was conducted of 917 students (427 boys and 490 girls) in grades 9-11, aged 15-17 years, attending all 14 secondary schools in the city Alchevsk. The students answered questions about the nature of their use of mobile phones. Self-assessment and assessment of mental states according to Eysenck (anxiety, frustration, aggressiveness and rigidity) were also performed. Results. There were more students with a high level of aggression according in the group of people who made 6 or more calls per day — 12.0±2.4%, compared with adolescents who made less than 3 such calls — 5.4±1.8% (p=0.013) and 3-5 calls —6.2±1.3% (p=0.029). Similar differences in the group of adolescent girls were 18.4±3.8%, compared with 5.6±1.7% (p=0.003) and 7.2±1.8% (p=0.009). There were more schoolchildren with a high level of aggression according in the group of teenagers who talked on the phone for an average of more than 10 min a day— 11.7±2.0%, compared with their peers who talked for 3-10 min — 5.4±1.1% (p=0.007), and also less than 3 min — 5.1±1.4% (p=0.008). Conclusion. With an increase in the number of outgoing calls, incoming calls, as well as the duration of conversations on mobile phones, the level of aggression among schoolchildren increases. To the greatest extent, this pattern is typical for teenage girls, which can be explained by the longer duration of mobile phone use by girls.

Objective: to evaluate the value of tuberculosis preventive treatment (PTT) in children with tuberculosis infection. Material and methods. As part of a continuous study, a cohort of 200 children from 1 to 17 years old taken for clinical observation in group VI A (positive test result with the recombinant tuberculosis allergen [ATR]) was analyzed. All children underwent additional examination methods to exclude the local form of tuberculosis: physical examination, laboratory clinical and biochemical tests of blood and urine, multislice computed tomography of the chest organs and, according to clinical recommendations, PTT was proposed, which the parents of 65 children refused. Study groups: 1 — those with no family contact with a patient with tuberculosis (ТВ) (n=70): 2 — those with contact with a patient with ТВ (n=65), in group 3 included children whose parents refused PTT, despite the presence of indications (n=65), incl. 14 children were from Tl lesions. Children group 1 and 2 received PTT. Control over the PTT was carried out on the "Yandex.Teleconference". Results. As a result of comparison of the three groups, reliable data were obtained on the effectiveness of PTT according to the criteria of preventing the disease and reducing the results of the ATR test. A significantly high percentage of sick children in group 3 was established, compared with children from group 1 (p=0.008; x2=18.6). When assessing the dynamics of the results of immunodiagnostic tests in children of the group 1 who received PTT, a decrease in the test with ATR was significantly more often observed compared to children without PTT(p=0.001; x2=17.2). It is worth noting that children had satisfactory tolerability of the drugs; no adverse events were observed in patients with daily video recording. Conclusion. A conclusion was made about the need for preventive work with parents of children who refused preventive treatment to increase their level of adherence, the need to evaluate the effectiveness of PTT courses using primary and additional criteria, including the importance of controlled PTT.

Objective: Assessment of the characteristics of the microelement composition of the hair of children with type 1 diabetes mellitus (T1DM) to develop recommendations for diet correction. Material and methods. The study involved children with T1 DM (n=28) and practically healthy children from the comparison group (n=56) aged 3-5 years living in the Omsk region. The elemental composition of hair was analyzed by atomic emission and mass spectrometry with inductively coupled argon plasma. The research materials were subjected to statistical processing using nonpara-metric criteria. Results. The elemental profile of hair of children with T1 DM has been determined. Significant differences were found in the amounts of microelements in hair: lower values of beryllium (p=0.0001), chromium (p=0.003), lithium (p=0.005), vanadium (p=0.005), selenium (p=0.043), and large amounts of cuprum (p=0.025), phosphorus (p=0.001) in the hair of children with diabetes in comparison with the group of practically healthy ones. In the group of children with T1DM, there was a smaller proportion of people with insufficient magnesium (p=0.003), phosphorus (p=0.001), and cuprum (p=0.001). The severity of mineral metabolism disorders (MMD) was less in the group of children with T1DM: 53.6% of children were classified as having no MMD or having minor MMD. Conclusions. The elemental composition of the hair of children with T1DM was characterized by higher amounts of phosphorus and cuprum, lower content of chromium, selenium, beryllium, lithium and vanadium. The proportion of children with insufficient supply of magnesium, phosphorus, cuprum was higher in the comparison group. The degree of MMD in the group of children with T1 DM was generally less.

Objective: to identify indicators of arterial stiffness that change after COronaVlrus Disease-2019 (COVID-19). Material and methods. Included were 112 people examined before and after the start of the new coronavirus infection (NCI) pandemic: healthy individuals (groups "H" and "H/COVID +") and patients with arterial hypertension (AH) (groups "AH" and "AH/COVID+"). An isolated comparative study was carried out in groups of healthy people and patients with hypertension. Results. Individuals in the "H/COVID+" group had higher levels of non-high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and more low values of high-density lipoprotein cholesterol (p=0.038; p=0.032; p=0.006) when compared with group "H". According to ABPM data, between the "AH" and "AH/Covid+" groups it was revealed difference at night level of reflected wave transit time (RWTT). An increase in cardio-ankle vascular index (L-/CAVI.,) in healthy persons and subjects with AH (p=0.001; p=0.004). In patients "H/COVID+" group higher values of pulse wave velocity in the aorta (PVW), elastic arteries type (R/L - PVW) and biological age (p=0.001; p=0.005; p=0.001) were registered. Conclusion. In healthy individuals who have had COVID-19, lipid profile abnormalities were noted, as well as an increase in L-/CAVI., when compared with the group of those who were not ill. In patients with AH after COVID-19, a negative change in the majority of indicators of arterial stiffness was noted.

Objective: selection of optimal biological wound coverings for the treatment of patients with borderline burns. Material and methods. The results of treatment of 30 patients aged 28-58 years were analyzed. All patients were diagnosed with second degree burn wounds of varying localization and area from 5 to 20% (according to International Classification of Diseases 10th Revision). Of these, 13 (43%) patients in group I (age 48 [39; 54] years) underwent surgical removal of necrosis, and ChitoPran® biological wound dressings were applied to the wounds. The remaining 17 (56%) patients in group II (age 42 [28; 58] years) also underwent early surgical treatment, but the grafts were covered with synthetic Voskopran™ wound coverings. Results. In group I, where the biological wound coating ChitoPran® was used, the epithelialization period was 10 (9.0; 10.0) days. In group II, where the synthetic wound coating Voskopran™ was used, the epithelialization period was 12 (11.0; 13.0) days (p=0.031). The data obtained show that biological wound coatings ChitoPran® demonstrate an advantage in accelerating the timing of wound epithelization compared with synthetic wound coatings Voskopran™. In group I, the duration of hospitalization was 10.5 (10.0; 11.0) days, for group II — 11.5 (10.0; 12.0) days (p=0.048). Conclusion. A comparative assessment of the effectiveness of biological wound coverings in the treatment of patients with borderline burns showed that, in contrast to the synthetic wound covering Voskopran™, the use of the biological wound covering ChitoPran® provides favorable conditions for regeneration, due to which the period of epithelization of wounds was reduced by an average of 1-2 days, and hospitalization time is on average up to 2 days.