2025, volume 21

Objective: to assess the influence of the characteristics of marital and parent-child relationships on the formation of self-attitude in adolescents with chronic gastroduodenitis. 37 adolescents were examined, average age 15,5±1,2 years. The studies were conducted in a mother-child pair, a total of 37 pairs. Material and methods. «Questionnaire of Parental Attitudes to the Child» by AYa Varga, VV Stolin, «Family Life through the Eyes of the Mother» by ES Sheffer and RK Bella adapted by TV Neshcheret, «Parent-Child Relationships of Adolescents» by PV Troyanovskaya, the «SHSO» method — the family environment scale by EG Eidemiller, «Methodology for the Study of Self-Attitude» by SR Pantileev, the projective method «Unfinished Sentences» by D Saks — S Levy. The conversation method was used in the analysis of individual cases. Statistical method: linear regression analysis was performed to identify the contribution of predictors to the overall variance of the self-attitude indicator. Results. The contribution of predictors to the change in the self-attitude index of adolescents with chronic gastroduodenitis was determined, the significance level of their contribution to the variance of the dependent variable was p<0.05: authoritarian hypersocial-ization (R2=35%, (3=-0,037), hostility towards a spouse (R2=25%, (3=-0,313; R2=54%, (3=-0,397; R2=33%, (3=-0,278; R2=28%, (3—0,287; R2=31%, (3=0,369), intellectual-cultural orientation (R2=17%, (3=0,738); irritability, maternal temper (R2=13%, (3—0,141), autonomy promotion (R2=30%, (3=0,312), acceptance (R2=25%, (3=0,201), activity orientation (R2=20%, (3=0,868), emotional distance (R2=25%, (3=0,221), decision making (R2=37%, (3—0,259), demanding (R2=23%, (3=0,394), independent (R2=24%, (3—0,894). Conclusion. The presence of marital conflicts, the lack of mom's interest in the child impede the teenager's positive attitude towards herself and contribute to the formation of intrapersonal problems.

Objective: determine structural patterns of disease burden of atopic dermatitis (AD) and comorbid conditions in adult patients. Methodology for writing a review. A literature search was conducted using Medline, PubMed, and eLibrary databases. Search terms included: "atopic dermatitis", "burden of disease", "comorbid conditions". The number of sources considered is 53. For the final analysis on the issue under consideration, 32 sources from 2006 to 2023 were included, reflecting the influence of structural patterns on the quality of life of adult patients with AD. Conclusion. The disease burden of AD in an adult cohort of patients is reflected in the structural components of quality of life. Self-perception, psychosocial, academic and professional spheres are most affected by AD and are structural patterns of the true disease burden. Reduced physical activity and missed educational opportunities in childhood, affecting adulthood, reflect the hidden disease burden. Clinical features of the dermatosis: hereditary, chronic, recurrent nature of the disease, dysfunction of the skin barrier, increased risk of comorbid conditions reflect the individual disease burden. The degree of impact of AD on the quality of life of not only patients but also their family members demonstrates the cumulative burden of the disease. The economic component of the cost of the disease, as well as indirect costs associated with a decrease in the working capacity and productivity of patients, reflect the high index of the negative impact of AD.

Objective: identification of the relationship between the receipt of preferential drug provision and the development of recurrent vascular events and hospitalizations according to the data of the survey of patients who had suffered myocardial infarction. Material and methods. The study included 304 respondents (68% men, age 62 [47; 72] years, 63.4% — rural residents). At the time of the survey, 74.3% of the respondents were eligible for preferential drug provision. A sociological study using an original questionnaire was implemented through individual oral interviews. Re-sults. The overwhelming majority of respondents were aware of the possibility of undergoing rehabilitation measures (70%) and receiving preferential medications (90%) after suffering a myocardial infarction. Regularly, 188 (61.8%) patients take medications. Of these, 147 (78.2%) receive preferential drug provision. Dispensing of discounted medications to patients after vascular events showed a trend toward decreased seeking of medical care by this cohort of patients, with an odds ratio of 0.026 (95% confidence interval 0.012-0.056). Conclusion. In the Saratov region, there is a significant reduction in emergency medical calls and hospitalizations among patients receiving preferential drug provision within the framework of the Federal Project "Fight against Cardiovascular Diseases."

Objective: to study the effectiveness of multidrug- and pre-extensively drug-resistant tuberculosis (ТВ) chemotherapy regimens with the inclusion of linezolid (Lzd) and bedaquiline (Bq) in operated patients for pulmonary ТВ. Material and methods. A non-randomized continuous single-center retrospective study of the data of 154 patients operated of NMRC PhPL for drug-resistant pulmonary tuberculosis in the period from 2018 to 2023 was performed. A comparative analysis of the effectiveness of chemotherapy regimens was carried out depending on the inclusion of new anti-tuberculosis drugs in it. Results. The proportion of adverse reactions in both observation groups when prescribing anti-tuberculosis drugs, excluding the use of Lzd and Bq, was comparable. Undesirable side effects were observed in 24.1% (n=21/87) in group 1 and in 25.4% (n=17/67) in group 2. The inclusion of Lzd and Bq in the postoperative chemotherapy regimen allowed a statistically significant reduction in the duration of the course to 38.5±2.1 weeks compared with the control group, where this period was 44.6±2.2 weeks. Thus, the timing of a favorable outcome was reduced by 6.1 weeks (p<0.05). Adverse reactions occurred in 24.1 % of patients treated with Lzd and Bq. Conclusion. The inclusion of Lzd and Bq in the multidrug- and pre-extensively drug-resistant ТВ chemotherapy regimen makes it possible to reduce the total duration of the course until a favorable outcome occurs.

Nevus of the sebaceous glands of Jadassohn is a congenital hamartoma, which is of interest to dermatologists with the possibility of benign and malignant degeneration during the patient's life. The article describes rare manifestations of nevus: a case of a cranial nevus with a late onset in adulthood, an extracranial nevus with a large area of distribution, a clinical and dermoscopic description of an advanced malignant cranial nevus. A detailed description of the stages of the course of the nevus, its dermoscopic and pathomorphological characteristics, and approaches to therapy are also given.

The features of the clinical picture and diagnosis of congenital Epidermolysis bullosa in a newborn girl born in a closely related marriage (parents are cousins) are described. Among the features of the clinic, it should be noted the rapid increase in damage to the skin and mucous membranes during the first 10 days of life and the weak ability of damaged tissues to epithelize and heal. Genetic analysis of the blood and skin of a sick child made it possible to clarify the type of congenital hereditary disease, to detail the mutation of the corresponding genes and to clarify the prognosis of the disease.

Objective: to evaluate echocardiographic changes in patients with acute coronary syndrome (ACS) combined with post-COVID syndrome. Material and methods. The study included 118 patients, including 61 men and 57 women with ACS and a post-COVID syndrome. All patients underwent echocardiography on the first day, in addition to coronary angiography and general clinical examination methods. The comparison group consisted of 121 patients with ACS without post-COVID syndrome. Results. In the ACS and post-COVID syndrome group, statistically significant increases in blood pressure (relative risk — RR 2.327, 95% confidence interval — Cl 1.582-2.699), tachycardia (RR 2.067, 95% Cl 1.415-3.730), dyspnea (RR 2.022, 95% Cl 1.495-2.736), weakness (RR 4.077, 95% Cl 2.946-5.643), and insomnia (RR 1.893, 95% Cl 1.519-2.358); p<0,001, were recorded. In the group of patients with ACS and post-COVID syndrome, there was a statistically significant increase in the mean pulmonary artery pressure, dilation of the pulmonary artery diameter, and regurgitation on the mitral valve (p<0,001). The risk of developing left ventricular apex thrombosis (RR 1.785, 95% Cl 1.304-2.444), left ventricular aneurysms (RR 1.736, 95% Cl 1.23-2.443), hypokinesis and akinesis (RR 1.673, 95% Cl 1.275-2.196); p<0,05, was observed more often. Conclusion. Patients who have had ACS combined with post-COVID syndrome show more severe echocardiographic changes compared to patients without post-COVID syndrome.

Objective: to compare the levels of biomarkers of systemic inflammation between groups of patients with paroxysmal and persistent forms of atrial fibrillation (AF). Material and methods. The study included 232 patients diagnosed with AF who underwent the primary procedure of pulmonary vein ablation. The average age was 62 (54;67) years. Patients were divided into two groups: with paroxysmal and persistent forms of AF. Results. As a result of the analysis of the levels of inflammatory markers, no statistically significant differences were found between the groups. For systemic inflammatory response index, 0.8 (0.6; 1.1) vs 0.9 (0.7; 1.1); p=0.077; for systemic inflammation index 361 (276; 509) vs 373 (294; 551); p=0.505; for aggregate inflammation systemic index 170 (122; 255) vs 197 (139; 259); p=0.150; for neutrophils lymphocytes ratio 1.6 (1.3; 2.2) vs 1.8(1.3; 2.3); p=0.428; for platelets lymphocytes ratio 122 (86; 132) vs 107 (91; 130); p= 0.576; for monocytes lymphocytes ratio 0.228 (0.177; 0.291) vs 0.241 (0.2200; 0.301); p=0.262. After statistical correction for the initial clinical characteristics, no differences were also obtained. According to the ROC analysis, no statistically significant threshold values of the levels of the studied markers were found for each form of AF. Conclusion. In this study, there was no difference in the level of "new" biomarkers of systemic inflammation between patients with paroxysmal and persistent forms of AF. Currently, data on the existence of an association between the levels of biomarkers of systemic inflammation and various forms of AF are contradictory, further research in this direction is required.

Objective: to analyze the effectiveness of modern methods of prevention and early treatment of scarring in burned patients, taking into account pathogenetic mechanisms. The methodology of writing a review. The review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology using the eLibrary, PubMed, and Medline databases. The search depth is from 2003 to 2024. Number of sources viewed —1372. The review includes 16 original studies. The most effective and widely used methods of early treatment and prevention of scars in burned patients have been established. Conclusion. The analysis of scientific papers revealed that early excision of granulation tissue and fibrously altered dermis, followed by autodermoplasty with full-layer skin grafts, as well as the complex use of drugs whose mechanism of action is aimed at suppressing the metabolic activity of fibroblasts (glucocorticosteroids, calcium channel blockers), worsening blood supply in the scar, removing excess extracellular matrix, reducing moisture loss from the skin surface, improves the characteristics of the emerging scar tissue.

Objective: to analyze the anthropometric features of the prosthetic bed and masticatory muscles in patients with complete secondary adentia for planning orthopedic treatment. Material and methods. 63 people participated in the examination, who, according to the inclusion/exclusion criteria, were divided into two groups: the first (n=30) — control, the second (n=33) — patients with complete secondary adentia. Ultrasound examination was used to study the structural features of the chewing muscles and prosthetic bed, and the results were compared with a group of healthy individuals. Results. In patients with complete secondary adentia, atrophy of the prosthetic bed mucosa is noted, the average blood flow rate was 9.7±0.8%, which is 2.4 times less than in the control group of 23.4±1.9% (p<0,001). A statistical difference was obtained in determining the area of the chewing muscles at rest and tension — 69.8±2.8%, which is 15.7% less than in the group of healthy people — 80.8±1.8% (p=0.03). The thickness of the prosthetic bed varied from 0.3 mm to 0.5 mm, depending on the location, so the thickness of the prosthetic bed in the anterior part was 0.363±0.01 mm, in the lateral — 0.354±0.01 mm. A2.2-fold decrease in this parameter relative to the control group indicated atrophy of the prosthetic bed mucosa (p=0.03). Conclusion. In patients with complete secondary adentia, there is a decrease in the thickness of the masticatory muscles and prosthetic bed due to the development of atrophic processes of muscle tissue against the background of a decrease in the rate of local blood flow against the background of stagnation.