2025, volume 21

This clinical case focuses on the complexity of surgical treatment of patient with central non-small cell carcinoma of the left lung. The minimum standard amount of surgical treatment for our patient is a left pneumonectomy with systematic mediastinal lymph dissection due to the spread of the tumor to the distal part of the left main bronchus. Taking into account the young age (47 years old) of patient, in order to improve the quality of life, we performed organ-preserving surgery: lower lobectomy on the left lung with systematic mediastinal lymph dissection, circular resection of the left main bronchus, the left upper lobular bronchus, bronchoplasty with the formation of a circular anastomosis between the left upper lobular and left main bronchus. To prevent the occurrence of bronchopleural fistula, we used a free, unvascularized pleural fat flap from the pericardial part. The postoperative period was uneventful. 30 months after the operation, the patient is observed without tumor recurrence and generalization. Thus, bronchoplastic surgeries make it possible to save the patient more lung parenchyma and improve the quality of life compared to pneumon- and bilobectomies, while remaining a radical method of treating lung cancer, without worsening disease-free survival.

Objective: to conduct a systematic analysis of long-term outcomes of surgical treatment in patients with uncomplicated thoracic and lumbar spine trauma. Review methodology. The studies to analyze were retrieved from PubMed, Scopus, and Web of Science using a combination of MeSH terms and keywords: "spinal fracture", "surgical treatment", "support spondylosis", "visual analog scale", "health-related quality of life", "Oswestry Disability Index". The search was limited to the full text original studies. The search retrieved 1,245 articles, leaving 6 articles published between 2018 and 2024 after checking the eligibility criteria for inclusion. We calculated the changes in visual analog scale (AVAS) and Oswestry Disability Index (AODI) scores, Cobb loss of primary correction (COBB0), and complication rates (percent). Conclusion. AVAS ranged from 1.88 to 7.8 scores, AODI ranged from 33.05 to 51.85 percent, ACOBB0 ranged from 0.9 to 4.7 degrees, and complication rates ranged from 5 to 70 percent. Thus, the anterior support spondylosis leads to clinically significant reduction of pain syndrome and restoration of functional activity in patients who suffered uncomplicated fractures of thoracic and lumbar vertebrae; however, it should be noted that the data are limited by small samples and heterogeneity of study protocols, which may require further randomized multicenter studies.

Objective: to perform systematic search and both quantitative and qualitative synthesis of published evidence on the associations between salivary secretory immunoglobulin A (IgA) and caries in children and adolescents. Review methodology. A systematic review with meta-analysis based on papers published in journals indexed in PubMed and eLibrary indexing systems. The search for papers was not limited in time and language of publications, methods of determining IgA. The results reflected in dissertations, reports, clinical cases and recommendations were not included. Random effects meta-analysis was performed with Cohen's d as a measure of the effect. Higgins - Thompson P was used as a measure of heterogeneity. All results are presented with 95% confidence interval. In total, 140 original articles were identified using our search criteria. After screening and using exclusion criteria, the final sample for qualitative synthesis consisted of 15 publications. Of them, 11 publications have reported greater values of secretory IgA levels in oral fluid in children and adolescents without caries was noted, in 8 of them a statistically significant difference was revealed. Weighted average effect was 0.76 (95% confidence interval -0,22-1,74) with high degree of heterogeneity (/2=96,5%). Conclusion. Although the majority of original articles provide the evidence on the association between salivary secretory IgA and dental caries, the results of meta-analysis do not reach the level of statistical significance suggesting that the evidence is inconclusive and warranting further research on the associations between salivary secretory IgA and dental caries.

Objective: to analyze the impact of surgical intervention in resistant diabetic macular edema (DME) on the morphological and functional parameters of the retina according to ОСТ and microperimetry data. Material and methods. 75 patients diagnosed with resistant DME: group 1 (25 patients, 25 eyes) underwent intravitreal administration of anti-VEGF drugs; group 2 (26 patients, 26 eyes) underwent vitrectomy with membrane peeling; group 3 (24 patients, 24 eyes) underwent vitrectomy with membrane peeling and subretinal administration of balanced salt solution (BSS). Results. After 1 week, the thickness of the fovea in the group 3 decreased by 1.3 times (p=0.043 compared to the 1st group), by 1.2 times (p=0.044, compared to the group 2), after 1 month by 1.5 times (p=0.041) and by 1.2 times (p=0.044). After 6 months by 1.2 times (p=0.042) in the group 2 and by 1.4 times (p=0.042) in the group 3, compared to the group 1. After 12 months by 1.3 times less in the group 3 (p=0.043 compared to the 1st group). When analyzing the best-corrected visual acuity after 6 months, the functional results of patients in groups 2 and 3 improved by 1.8 times (p=0.038) and 1.9 times (p=0.039) compared to those in group 1. Light sensitivity 1 week after surgery in groups 2 was 1.4 times (p=0.042) and in groups 3was 1.5 times (p=0.041) higher than those in group 1. Conclusion. In the treatment of DME, vitreoretinal surgery plays an important role in changing retinal parameters, contributing to a decrease in thickness in the early stages, an increase in light sensitivity and an increase in best-corrected visual acuity.

Objective: to evaluate the correlation between psychoacoustic hearing thresholds and ASSR (Auditory Steady-State Response) thresholds in patients with sensorineural hearing loss (SNHL) and in otologically healthy subjects. Material and methods. Auditory function was studied in 130 people grouped into 3 groups: group 1 consisted of patients with chronic SNHL (n=50), group 2 - patients with acute SNHL (n=50), group 3 - otologically healthy subjects (n=30). Thresholds were compared when registering tonal threshold audiometry and when registering auditory stationary evoked potentials. Results. The average difference between psychoacoustic hearing thresholds and ASSR thresholds at 4 speech frequencies in patients with SNHL in the right ear was 15 dB normal hearing threshold (NHT; p=0.005), in the left ear- 14.4 dB NHT (p=0.005), with a minimum difference of 12.3±5.9 dB NHT at 4000 Hz in patients with chronic SNHL in the right ear (p<0.001), with a maximum difference of 18.4±8.2 dB NHT at a frequency of 2000 Hz in patients with acute SNHL in the left ear (p=0.005). In otologically healthy subjects, the average difference between psychoacoustic hearing thresholds and ASR thresholds at 4 speech frequencies in the right ear was 10 dB NHT, in the left ear- 11.2 dB NHT. The minimum threshold difference was detected at a frequency of 4000 Hz in the right ear (6.5±1.6dB NHT; p<0.001), the maximum at a frequency of 500 Hz in the right ear (14.8±5.8 dB NHT). In patients with SNHL, the correlation coefficient ranged from 0.81 to 0.94 (p<0.001) when registering the tonal threshold audiometry and ASSR test. In otologically healthy subjects, the correlation closeness on the Chaddock scale ranged from 0.76 to 0.96 (p<0.001). Conclusion. The obtained values demonstrate a significant strong correlation between psychoacoustic hearing thresholds and ASSR thresholds.

Objective: to carry out calibration of a non-contact laser Doppler flowmeter (LDF) with justification for its subsequent use in model experiments and clinical trials. Material and methods. An experimental setup is described for reproducing a given blood flow velocity by simulating a capillary; methods are presented for calibrating the flowmeter in tissue perfusion units using a calibration emulsion fluid to determine the instrument readings' dependence on the concentration of moving particles. A method is provided for measuring the level of "biological zero" tissue perfusion of gastrointestinal tract mucosa. Results. Key parameters for processing signals from the non-contact LDF were established along with their relationship to characteristics of the calibration solution's flow and particle movement speed within it. The average value of the "biological zero" index was determined for gastric mucosal wall at 0.07±0.014 tpu. Conclusion. As a result of the carried out work on calibration of the experimental LDF apparatus which measures microcirculatory blood flow using a contactless method, suitability for measurements of the microcirculatory bed of human tissues was confirmed, basic dependences of the parameters of processing the LDF signal on the volume of the flowing calibration emulsion, its speed and the number of moving microparticles in it were obtained.

The article presents the history of the student scientific club of radiology in Saratov, established in 1912 by Professor N. E. Shtern on the Saratov University base. The issues of creating a club, the main stages of its formation, directions of activity, scientific work, and the need to optimize student learning are highlighted.

The article presents a brief history of the development of the blood transfusion service in the Saratov region, from its inception and during the Great Patriotic War. Archival documents on the production activities of the staff of the blood transfusion station in the cities of Saratov, Engels, Balakovo and Volsk are presented.

The preventive activities of the Department of General Hygiene of the Saratov Medical Institute during the Great Patriotic war is present here. During this period, the head of the Department of General Hygiene was professor Lev Los. In addition to educational activities, employees of the department took part in sanitary and epidemiological measures, conducted active scientific work, taught sanitary knowledge to the civilian population, participated in agricultural work, and the activities of self-defense teams (fire, emergency response, sanitary, chemical, and law enforcement). The activities carried out by the faculty of the department during the difficult years of the Great Patriotic war played an invaluable role in the development of strategic preventive sanitary-hygienic and anti-epidemic measures to effectively combat infectious and non-infectious diseases of the population.

Objective: to determine morphofunctional changes in the kidneys under the influence of new derivatives of α-cyanothioacetamide with anti-inflammatory activity in a chronic experiment. Materials and methods. 80 male rats were divided into 8 individuals in 10 groups, for 10 days they received intragastric aqueous suspensions: group 1 — control (distilled water); group 2 — indomethacin at a dose of 7 mg / kg, group 3 — paracetamol at a dose of 50 mg / kg, group 4 — acetylsalicylic acid at a dose of 50 mg / kg, 5 — nimesulide at a dose of 5 mg / kg, from 6 to 10 — dihydro pyridine derivatives at a dose of 5 mg / kg. On day 11, slaughter was performed, the levels of Na+, K+, and creatinine in the blood were determined, and histological sections of the kidneys were examined. Results. The use of indomethacin, acetylsalicylic acid, and paracetamol led to impaired renal excretory function, contributing to sodium and creatinine retention in the blood. There were no statistically significant significant differences with the indicators of the intact group in the experimental groups after administration of α-cyanothioacetamide derivatives with laboratory codes d02–123, d02–139 and d02–172. These samples also did not reveal the ability to provoke the occurrence of gross structural changes in the renal parenchyma. There was no damage to the renal corpuscles with minor tubular changes. In the group receiving the compound with the d02–123 cipher, a possible potassium-sparing diuretic effect was noted. Con clusion. α-Cyanothioacetamide derivatives with codes d02–123, d02–139 and d02–172 do not contribute to impaired renal excretory function and their structural changes.