2025, volume 21

Objective: to evaluate the relationship between blood clotting factor activity and the closure of full-thickness macular holes after surgical intervention using autologous conditioned plasma (ACP). Material and methods. A single-center retrospective cohort study was conducted involving 62 patients (62 eyes) with primary full-thickness macular holes. Patients underwent treatment: microinvasive subtotal vitrectomy with removal of epiretinal and internal limiting membranes, application of ACP, and airtamponade. Patients were divided into two groups: the main group (31 patients with coagulogram abnormalities) and the control group (31 patients with normal coagulogram parameters). Results. Surgical outcomes showed recurrence in 85.7% of cases in the main group versus 14.3% in controls (p=0.005). Among recurrence cases, 83.3% had prolonged prothrombin time (p=0.042) and 75.0% had reduced fibrinogen levels (p=0.049). Conclusion. Abnormalities in the coagulogram may be a risk factor for failure to close the macular rupture with ACP mass. Relapse was detected 6 times more often with an increase in prothrombin time, as well as with a decrease in fibrinogen below 2.0 g/L in the blood of patients.

Objective: to develop an effective prognostic model for the development of metabolic syndrome (MS) in women during early postmenopause. Material and methods. The case — control study included 82 early postmenopausal women. Group 1 consisted of 35 women with MS, group 2-47 women without MS. The research methods included the collection of medical history in a specially designed form, analysis of medical information from outpatient records, anthropometry and laboratory studies, assessment of the severity of menopausal syndrome by a modified menopausal index (MMI). Results. In patients with MS, compared with the control group, index HOMA-IR (Homeostasis Model Assessment of Insulin Resistance), the visceral adiposity index and MMI were significantly higher (p<0.001, p<0.001 and p=0.003, respectively), while the levels of follicle-stimulating hormone (p=0.008) and prolactin (p=0.011) were lower. Using the method of multiple logistic regression, a screening model has been developed to assess the likelihood of MS in women, including 5 parameters: somatic comorbidity, visceral adiposity index, MMI, levels of follicle-stimulating hormone and prolactin. The ROC curve was used to build the model. The area under the ROC curve (AUC) of the model was 0.909; 95% confidence interval 0.835-0.984 (sensitivity — 87.1 %, specificity — 78.6%). Conclusion. A prognostic model of the development of metabolic syndrome in women during early postmenopause has been developed, which helps identify patients with increased cardiometabolic risk, which will allow timely initiation of personalized preventive and treatment measures.

A clinical case of a rare orbital lesion with mucormycosis, which developed against the background of odontogenic osteomyelitis in a patient with diabetes mellitus, is presented. A comprehensive approach, including antifungal therapy, surgical interventions and correction of carbohydrate metabolism, made it possible to localize the infection and stabilize the patient's condition; however, vision in the right eye could not be restored.

Objective: to evaluate the olfactory function and olfactory fissure (OF) parameters in patients with varying severity of chronic polypous rhinosinusitis (CRSwNP) symptoms. Material and methods. A total of 50 patients with CRSwNP (mean age 44,5 [36,2; 55,0] years) were examined: group 1 (n=12)— patients with mild CRSwNP symptoms (total SNOT-22 score 8-20 points), group 2 (n=38)— with moderate and severe CRSwNP symptoms (total score over 21). A questionnaire was administered using Sino-Nasal Outcome Test, Sniffin' Sticks Screening Test-12, Questionnaire of Olfactory Disorders — Negative Statements and computed tomography of the paranasal sinuses was performed. Results. According to Sniffin' Sticks Screening Test-12, olfactory function was impaired in 91.7% of patients in group 1 (33.4% — hyposmia, 58.3% — anosmia), and in 94.7% of patients in group 2 (71.1% — hyposmia, 23.6% — anosmia). According to Questionnaire of Olfactory Disorders — Negative Statements, the total score in group 1 was 19.0 [5.0; 19.0], and in group 2-7.5 [6.0; 13.0]; (p=0.053). The volume of the OF in patients in groups 1 and 2 was 21.0 [20.0; 24.0] and 7.5 [6.0; 13.0] mm3, respectively, but the nature of the differences revealed was statistically insignificant (p=0,053). The density of the OF in group 1 was-100 [-192.5; —9] HU units, in group 2------149.5 [-302.3; 68.3] HU units (p=0.958). Conclusion. Olfactory function was impaired equally often regardless of the severity of CRSwNP symptoms. The volume of the OF in patients with moderate and severe CRSwNP symptoms was 3 times smaller than in CRSwNP with mild symptoms. The density of the OF was comparable with different severity of CRSwNP symptoms.

The article presents the scientific and practical contribution of Professor L. I. Los to the development of hygienic science and sanitary affairs for the 50-year period of his work at the Kazan and Saratov Medical Institutes (1923-1974), as well as highlights the main scientific research conducted by the staff of the Department of General Hygiene, the Saratov Research Institute of Rural Hygiene and the Communal Department of the Saratov Regional Sanitary and Epidemiological Station under his leadership, the results of which were implemented in practical health care. The work reflects the issues of organizing the educational process at the Department of General Hygiene for students and the training of scientific and pedagogical personnel for medical universities of the country. His active social activity in scientific and medical societies and participation in АН-Union and All-Russian congresses, and conferences of hygienists are shown.

The article presents the main facts of the professional biography of Oleg Alexandrovich Tsarev, Doctor of Medical Sciences, Professor of the Department of Hospital Surgery, Faculty of Medicine, V. I. Razumovsky Saratov State Medical University, reflecting his achievements as a surgeon and scientist.

Objective: to analyze the antibacterial effect of bioformed silver nanoparticles on the museum and clinical strain of Pseudomonas aeruginosa in vitro. Material and methods. Silver nanoparticles were obtained using metabolites of the non-pathogenic bacterium Azospirillum brasilense SR80. The size, shape, homogeneity and degree of aggregation of the obtained nanoparticles were characterized by electron microscopy, UV-visible spectroscopy and dynamic light scattering. The antibacterial effect of various concentrations of silver nanoparticles was assessed by the level of metabolic activity of cells using the resazurin test. Results. Biosynthesized silver nanoparticles exhibited antibacterial activity against the reference strain P. aeruginosa ATCC 27853 and the clinical strain P. aeruginosa. A decrease in the metabolic activity of bacterial cells was shown, depending on the concentration of nanoparticles. Maximum antibacterial activity (100% cell death) for the reference strain P. aeruginosa was achieved when the cells were treated with silver nanoparticles at a concentration of 12,5 ug/ml, for the clinical strain, complete suppression of cell growth was noted when adding nanoparticles at a final concentration of 25 ug/ml. Conclusion. Silver nanoparticles obtained by the "green" synthesis method using the cell-free extract of Л. brasilense SR80 exhibit pronounced concentration-dependent antimicrobial activity against the clinical and standard strains of P. aeruginosa in vitro.

Objective: to analyze anatomical and hemodynamic transformations in the umbilical cord vascular bed during labor using computer modeling of physiological processes and the associated change in the external pressure gradient. Material and methods. The first stage of this work included three-dimensional modeling in Ansys Fluent 2021 of a single straight umbilical artery under external pressure of 120 mmHg. The second stage consisted of 3D modeling of the umbilical vessel organ complex surrounded by fetal mucous connective tissue under similar external pressure. Results. In an isolated straight umbilical artery, when exposed to external pressure, the blood flow velocity increases by 85.5%, intravascular pressure by 38.5%. In three-dimensional modeling of the entire umbilical cord under similar pressure, the blood flow velocity in the umbilical arteries increased by 20%, intravascular pressure increased by 8%. In this case, the blood flow velocity in the umbilical vein increased by 24%, intravascular pressure by 10%. The cross-sectional area of fetal mucous connective tissue, umbilical arteries and vein did not change, despite the external deformation of the umbilical cord, vascular wall and change in the lumen of the vessels. Conclusion. Anatomical and hemodynamic parameters in the umbilical vessels in the intranatal period undergo transformations of varying degrees of severity. These changes consist of an increase in intravascular blood flow velocity and pressure, deformation of the umbilical cord and vascular wall, narrowing of the lumen of the vessels, while maintaining the cross-sectional area of the umbilical cord and its vessels against the background of external pressure.

Objective: to assess the level of absenteism, presenteeism, general decline in productivity and daily activity in persons suffering from substance use disoders. Material and methods. The object of the study is patients undergoing treatment for addiction to a psychoactive substance in the inpatient department of a narcological dispensary. At the first stage, patients were determined to have an employment relationship within the last year. Then, at the second stage, the working patients answered the questions of the Work Productivity and Activity Impairment Questionnaire, which assesses the impact of the disease on indicators of labor activity. Results. The level of absenteism in patients was 7.1 hour per week, or 13.8%. The average value of presenteeism in the group of those who actually worked during the study period was 60.2% working hours, which in absolute value corresponds to an average of 31.0 hour per week per patient. The overall decrease in productivity (OSP) was 63.5%. Daily activity (PA) was reduced by 56.7% in all patients included in the study. Conclusion. Substance dependence syndrome has a significant impact on the ability to perform the work functions of patients, reducing them. A significant decrease in daily activity was also revealed.

Objective: to verify the characteristics of the social portrait of pregnant women with complicated pregnancies associated with prenatal risk. Material and methods. The study included 385 pregnant women. The average age is 29.0±0.5 years. Questionnaire and differentiation of respondents according to the degree of prenatal risk were carried out using the scale of prenatal risk factors V. E. Radzinsky et al., According to which respondents are divided into low, medium and high prenatal risk groups. Spearman's correlation coefficient was used for correlation analysis of the characteristics of the social portrait of respondents and the degree of prenatal risk of complicated pregnancy. Results. The characteristics of the social portrait of pregnant women associated with prenatal risk include: age and education of respondents, age and education of the husband of respondents, family composition, number of children, number of minor children, number of previous pregnancies, smoking and alcohol consumption. The most correlated with the degree of prenatal risk: the number of previous pregnancies +0.45 (p<0.001), the age of the husband +0.39 (p<0.001), the age of the woman +0.34 (p<0.001). Conclusion. The study verified the characteristics of the social portrait of pregnant women associated with the prenatal risk of complicated pregnancy. The relationship between the social characteristics of respondents and the degree of prenatal risk of complicated pregnancy was established.