2024, volume 20

Objective: to determine the role of the TNFSF11 gene polymorphisms rs9594738 and rs9594759 in the development of knee osteoarthritis in postmenopausal women. Material and methods. The case-control study included 483 postmenopausal women. Of these 157 were diagnosed with primary knee osteoarthritis. The remaining 326 women without signs of joint disease were included in the control group. Molecular genetic studies included determination of TNFSF11 rs9594738 and TNFSF11 rs9594759 gene polymorphisms using the real-time polymerase chain reaction. Results. Analysis of genetic markers distribution in two groups of women showed a decrease in the frequency of rs9594738 polymorphism TT genotype among the patients with osteoarthritis (odds ratio 0.59; 95% confidence interval 0.36-0.97; p=0.049). The distribution of this polymorphism alleles, as well as alleles and genotypes of TNFSF11 rs9594759 gene polymorphism in the group of women with osteoarthritis did not differ significantly from the results of the control group (p>0.05). Conclusion. An association of TNFSF11 rs9594738 gene polymorphism with knee osteoarthritis in postmenopausal women has been established. Further research of TNFSF11 gene polymorphic variants role in the knee osteoarthritis etiopathogenesis are needed to develop individual approaches to the prevention and treatment of the above disease.

Objective: to conduct a comparative analysis of the effectiveness of surgical treatment for patients with metastatic lesions of the thoracic spine from anterior and posterior approaches according to the literature. Methodology for writing a review. The search was carried out in the PubMed and Scopus databases. Search words and phrases: "thoracic spine", "metastatic lesion", "spinal cord", "management of thoracic spine metastasis". Search depth for the last 15 years. 13 publications were included in the final analysis. Conclusion. Both approaches are effective, but data such as blood loss, duration of surgery, neurological changes and pain intensity are significantly better in patients who underwent anterior approach. At the same time, in this group the development of respiratory failure is more common, and the 30-day mortality rate is higher compared to group of posterior approach. In the group of posterior interventions there was a significantly higher level of postoperative CSF leakage and wound infection, as well as worsening neurological deteriorations. The frequency of failure of implanted structures and revision interventions for wound hematomas and recurrent tumor growth is almost the same.

Objective: to carry out a comparative analysis of IOL fitting accuracy in patients with eye length less than 22.0 mm using Barrett Universal II, Kane, Hoffer Q and artificial intelligence formulas. Material and methods. The results of 88 phacoemulsification cataract operations with implantation of monofocal lOLs were analyzed. Preoperative biometry and IOL calculations were performed on the IOL Master 700. The accuracy of IOL fitting was also determined using the LensCalc program, which is based on artificial intelligence (DecisionTreeClassifier). Results. The eye length of the patients ranged from 19.8 to 22 mm. The prediction of the target refraction hit was the most accurate when using Barrett Universal II formulas as opposed to Hoffer Q (Z=2.12; p=0.034). The mean value of the target refraction hit error was not different when using the Barrett Universal II formula compared to the Kane formula (p>0.05). Using artificial intelligence it was found that higher accuracy in the results of IOL optical power determination was achieved when using the Barrett Universal II formula. Conclusion. Based on a comparative analysis of the study results and assessment of IOL fitting accuracy using artificial intelligence, it was found that the Barrett Universal II formula (4th generation) is more accurate in determining the optical power of lOLs in "short" eyes than the Hoffer Q formula (3rd generation). The results obtained using the Barrett Universal II formula, in contrast to the Hoffer Q formula, do not differ from the data calculated using the Kane formula (5th generation), which, according to the results of most studies, is the most accurate IOL selection formula at present (p>0.05).

Objective: comparative analysis of the used methods of surgical treatment of pelvic organ prolapse. Methodology for writing a review. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search and analysis of articles published in the scientific databases e-Library, PubMed, Google Scholar for the period from 2015 to 2023 was carried out. After excluding publications that did not correspond to the search, 50 articles were selected for analysis. Conclusion. According to the study, each of the currently used methods of surgical treatment of pelvic organ prolapse has its own advantages and disadvantages, which makes it possible to select the optimal surgical option in each specific case. The determining factors when choosing a surgical intervention are the following factors: the patient's age, the presence of comorbid pathologies, including benign neoplasms, planning or not planning a pregnancy in the future.

Objective: to study the bacteriological landscape of nasal secretions from the middle nasal passage in patients with chronic rhinosinusitis (CRS) aged 60 to 95 years and to identify the most significant genera and types of microorganisms characteristic of the treatment of chronic rhinosinusitis in this age group. Material and methods. Taking into account the inclusion and non-inclusion criteria, 83 patients were selected, of which the following groups were formed by age and presence of CRS: group 1 (comparison group 1) — patients without CRS aged 60-74 years (n=24); group 2 — (comparison group 2) patients without CRS aged 75-95 years (n=20); group 3 — patients with CRS aged 60-74 years (n=22) and group 4 — patients with CRS aged 75-95 years (n=18). All patients received swabs from the middle nasal passage. The obtained samples were sent for bacteriological examination to identify microorganisms. Results. The level of representatives of the genera Staphylococcus spp. with CRS in the elderly and senile 66.6 and 16.6%, respectively, Enterococcus spp. were seeded 66.6 and 16.6%. The presence of Klebsiella pneumoniae (16.6%), Klebsiella oxytoca (5.8%) and Pseudomonas aeruginosa (11.1%) indicates the risk of long-term persistent upper respiratory tract infections. In the group of patients with CRS aged 60-74, representatives of the genus Candidiales (5.5%) were seeded. Conclusion. S. aureus, S. haemolyticus and Enterococcus faecalis were the overwhelming species in elderly patients (60-74 years old). Microflora diversity in patients aged 75-95 years Klebsiella pneumoniae (16.6%), Klebsiella oxytoca (5.8%) and Pseudomonas aeruginosa (11.1 %) it affects the course and possible complications of CRS.

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.