2026, volume 22

The article presents the scientific and practical contribution of Professor Fyodor Ya. Kitaev to the development of bacteriology, epidemiology, and cardiology, as well as to the production of vaccines and serums for the prevention of infectious diseases during his work at the bacteriological institutes in Kazan and Perm, and at Saratov University (since 1931, at the Medical Institute). The results of his scientific research have been implemented in the practical healthcare of our country. The review reflects the main issues of research and medical and diagnostic activities during his work at the Departments of Infectious Diseases and Hospital Therapy at Saratov University and the Medical Institute.

The article is dedicated to the 70th anniversary of the birth of the Saratov surgical school representative, a talented scientist and teacher, professor of the Department of General Surgery, doctor of Medical Sciences, Professor Yuri V. Chalyk.

Objective: to evaluate morphogenic changes in surrounding tissues at the recipient site during lipofilling modeling and the use of hyaluronic acid-based fillers. Material and methods. The study was performed on 50 sexually mature Wistar rats. The group 1 (intact animals) included 5 animals. The group 2 (single injection of 0.9% sodium chloride solution in the withers area) included 15 animals. In the group 3 (n=15), minced fat was injected intradermally in the withers area, and in the group 4 (n=15), a hyaluronic filler was injected. After 30, 90, and 180 days, 5 animals in the groups 2 to 4 were euthanized and the changes in the recipient tissues were evaluated. The sections were stained using the Mallory method and hematoxylin and eosin. Results. On the 30th (p<0.001) and 180th (p=0.018) days in group 3, the thickness of the cellular epidermis was significantly lower than in group 4. The thickness of the dermis was significantly higher on the 30th day in group 3 (milled fat) and on the 180th day in group 4 (hyaluronic filler; p<0.001). The area of the sebaceous glands in group 4 on the 90th and 180th days increased compared to the 30th (p=0,02). Fat graft thickness significantly decreased on the 90th postoperative day compared to day 30 (p=0.041). In group 4, gel integration with surrounding tissue was noted after 90 days, while after 180 days, the thickness of the implanted hyaluronic acid-based gel in this same group varied, as the gel was often unevenly distributed. Cavities frequently formed after gel implantation, which were not due to gel degradation. Conclusion. Thus, the use of lipofilling leads to a more uniform distribution of adipose tissue and a decrease in the area of sebaceous glands, compared to hyaluronic acid filler, which contributes to an increase in the thickness of the cellular epidermis and dermis.

Objective: to provide a topographical-anatomical rationale for the safety and efficacy of a new surgical technique for treating patients with impression fractures and deformities of the posterolateral aspect of the proximal tibial epiphysis. Material and methods. The study was conducted on 11 non-fixed preparations of the lower extremities, obtained from 6 corpses that died at the age of 52 to 64 years. The experimental study was conducted in two series. In the first series, the proposed surgical technique was simulated on 3 cadaveric specimens, followed by dissection to assess the risk of damage to anatomical structures. In the second series, the procedure was performed on 8 specimens, after which horizontal sections were made and processed using epoxy plastination according to the established method, followed by morphometric analysis. Results. In the first experimental series, the technique of the proposed treatment method was refined, confirming the absence of risk to major neurovascular structures. In the second series, the shortest distances from the fixation screw to the neurovascular structures were determined. The popliteal vein was located at a distance of 20.1–24.8 mm, the popliteal artery at 16.2–23.2 mm, the tibial nerve at 17.8–24.5 mm, and the common peroneal nerve at 13.2–24.1 mm. Conclusion. An effective technique for the proposed method was experimentally developed. The anatomical safety of the intervention was confirmed: the tibial nerve and popliteal vessels are situated outside the risk zone. The identified risk of injury to the common peroneal nerve during mobilization of the fibular head is minimized by the correct execution of the technique.

Objective: to identify features of typical morphology of gastroesophageal junction structures. Material and methods. Anthropometric and videoendoscopic data of 75 patients without esophageal and gastric pathology were analyzed. Subjects were divided into 3 groups according to their body type by V.N. Shevkunenko and 3 groups according to their abdominal shape by V.M. Zhukov. Shape of cardia opening, its diameter, and size of mucous membrane fold at junction of left esophageal wall and stomach’s fundus (Gubarev's fold) were assessed by videoendoscopy. Results. In meso- and dolichomorphic types, slit-shaped cardia opening was most often observed in closed state (59.5 and 57.1%), and oval in open state (81.1 and 78.6%). In brachymorphic type, round shape was predominant (78.9% in closed, 94.7% in open state). Diameter of opening was larger in subjects with brachymorphic type (median – Me=7.0 vs Me=2.0 and 3.0 in the closed state; Me=18.0 vs Me=11.0 and 12.0 in the open state) and in individuals with an upward-expanding abdomen (Me=6.0 vs Me=2.5 and 3.0; Me=17.0 vs Me=11.5 and 11.0). Gubarev's fold had the smallest dimensions in brachymorphic type (Me=22.0 and 10.0) and in subjects with an upward expanding abdomen (Me=24.0 and 13.0). Conclusion: Structural features of gastroesophageal junction have pronounced typical differences. Subjects with brachymorphic body type and an upward expanding abdomen have the largest diameters of cardia opening and the smallest dimensions of Gubarev's fold.

Objective: to determine the bilateral variability of the morphometric parameters of the crowns of the lower dental arch of young men depending on the type of dental arch. Material and methods. The study was conducted on plaster models of the lower dentitions obtained from 140 17- to 21-year-old young men. The dental arches were classified as microdont (n=9), normodont (n=23) and macrodont (n=108). The height and mesiodistal size of the teeth on the lingual surface of their crowns, as well as the bucco-lingual size of the crowns were measured. The influence of the dental arch type on the odontometric parameters was performed using the Kruskal – Wallis one-factor analysis. The strength of the influence of the studied factor was determined by calculating ε2. The Holm method was used to adjust p-values for multiple comparisons. Results. The mesio-distal size of the crowns of all teeth of the lower dentition largely depends on the type of the dental arch. The influence of the studied factor on the specified parameter of the crown of tooth 35 was determined as strong (ε2=0.390), and on teeth 34, 36 and 42 – as relatively strong (ε2=0.220, ε2=0.244 and ε2=0.163, respectively). Conclusion. Bilateral variability in the morphometric parameters of dental crowns not pronounced. However, the dental arch type factor has a statistically significant effect on odontometry parameters.

Objective: identify the most evidence-based health-saving strategies in primary medical prevention of chronic non-communicable diseases. Review methodology. The search was conducted in the PubMed, Cochrane Library, and Scopus databases (2010–2025). The selection was conducted in accordance with PRISMA (Preferred reporting items for systematic reviews and meta-analyses)-2020 and PRISMA-NMA (Network Meta-Analyses); the quality of the reviews was assessed using AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews), and the risk of bias in randomized clinical trials was assessed using the Cochrane Risk of Bias scale. The final synthesis included 31 publications (2010–2025), including systematic reviews, meta-analyses (including network meta-analyses), large randomized clinical trials, and cohort studies. Conclusion. The most proven strategies for primary medical prevention of chronic non-communicable diseases are antihypertensive and lipid-lowering therapies, as well as comprehensive dietary programs. The use of acetylsalicylic acid in the general population is not justified due to the unfavorable benefit/risk balance. Organizational measures increase the coverage of primary medical prevention, but require integration with patient adherence support.

Objective: to determine the episode of occurrence and diagnosis of post-stroke ignore syndrome associated with movement disorders. Material and methods. The study included 100 patients in the acute period of stroke with hemiparesis (49 men and 51 women, mean age 68.0±11.8 years). All patients underwent a neurological examination with assessment using standard post-stroke scales and tests (Catherine Bergego Scale and Sunnybrook Neglect Assessment Procedure) to assess the presence and severity of neglect syndrome. Results. Neglect syndrome was detected in 84 patients, including 36 men and 48 women. In 53.6% of cases, the syndrome was observed in patients with acute cerebrovascular accidents in the left middle cerebral artery basin, and in 46.4% of cases, in the right middle cerebral artery basin. The median score on the Catherine Bergego Scale was 4.0 (1.0; 8.75), which corresponded to mild neglect syndrome. The average score on the Sunnybrook Neglect Assessment Procedure was 39.32±19.6, which also corresponds to a mild degree of neglect syndrome. Both scales have a statistically significant direct relationship with each other (rxy=0.33 with a 95% confidence interval of 0.143–0.493; p=0.001). Conclusion. Neglect syndrome occurs with a high frequency (84 out of 100 patients), more often in the left middle cerebral artery basin. Both scales equally diagnose the frequency of the syndrome and its severity. Neglect syndrome is combined with post-stroke motor disorders, aggravating their severity.

Objective: dynamic assessment of T-receptor excision ring (TREC) and kappa-deletion recombination excision ring (KREC) values in immunocompromised newborns, as well as identification of significant anamnestic factors that may affect the values of the markers under study. Material and methods. A dynamic assessment of TREC and KREC levels was performed in 203 children born at 22–41 weeks of gestation. The primary assessment of TREC and KREC levels was performed using dry blood spots on Guthrie card test forms, while the secondary assessment was performed using venous blood. 79 children whose values were outside the reference ranges were re-evaluated for the markers 2 and 4 weeks after the initial sample collection. Results. In immunocompromised newborns, the values of the markers under study gradually normalize with each week of postnatal development. TREC values are statistically significantly influenced by maternal anamnesis factors such as congenital kidney malformations (p=0.008), spontaneous miscarriages (p=0.004), chronic vaginitis (p=0.015), nicotine addiction (p<0.001), and alcohol abuse (p=0.029), while KREC values are influenced by chronic pyelonephritis (p=0.028) and bacterial vaginosis (p=0.02). Conclusion. As the volume of immunocompetent cells increases, the number of TREC and KREC also increases, and as a result, children with borderline values of the markers in question are classified as conditionally healthy.

The article presents the features of the course of the disease in a child with Wolf – Hirschhorn syndrome (with characteristic clinical manifestations and molecular genetic confirmation), born by emergency cesarean section at a gestational age of 30 weeks; from pregnancy occurring against the background of a burdened obstetric and gynecological history and recurrent herpes infection in the mother; severe neonatal period with broncho-pulmonary and congenital genetic pathology of the nervous system, with manifestations of early neonatal sepsis, followed by addition of hospital infection, septicemia and death from multiple organ complications in infancy.