ORIGINAL RESEARCH
The purpose of the study was to evaluate the effect of pre-carbohydrate loading and perioperative administration of dalargin on immunity indicators in patients who underwent surgery for malignant neoplasms of the oropharyngeal region. The multicomponent general anesthesia was conducted in the control group (n=29). It is established that the use of enkephalin, dalargin, as a component of anesthetic support in the perioperative period in the surgical treatment of malignant neoplasms of the oropharyngeal region is associated with a lower concentration of pro-inflammatory interleukins, an increase in IgG concentration compared with endotracheal multicomponent anesthesia and may contribute to the activation of an antitumor immune response.
In order to study the prognostic importance of risk factors of chronic non-communicable diseases in the development of colorectal cancer (CRC) in older people, a study was conducted in a population cohort 45-69 years. It was found that the 15-year risk of developing CRC was higher in men compared to women. CRC risk was positively associated with age in both men and women. A positive family history of malignant neoplasms of any location increased the risk of developing colorectal cancer in men, and the presence of type 2 diabetes mellitus in women.
A comparative analysis of capillary and venous blood parameters in practically healthy people before and after general cooling was carried out. It has been established that in capillary blood a higher level of leukocytes is provided mainly by mature forms of monocytes, neutrophils, eosinophils and basophils. There were no significant differences in the level of lymphocytes. The response to cooling, depending on the hematological test, is an increase in the circulating pool of leukocytes in capillary blood due to increased cell migration and activation of lymphocyte recycling, and in venous blood an increase in the output of neutrophils from the depot. Red blood cells in capillary blood have a large degree of variation in size. After cooling, erythrocyte indices of capillary and venous blood have the same tendency to increase, with a higher rate of increase in the capillary sample, which may reflect their importance in the regulation of the homeostasis of small vessels during cooling. In capillary blood the level of platelets is lower, but their population is more heterogeneous and the content of large cells is higher. With general cooling, platelet parameters, regardless of the hematological test, did not change significantly. Thus, changes in the composition of venous blood reflect the classic response to stress with an increase in the level of segmented neutrophils. Changes in capillary blood parameters are aimed at maintaining the homeostasis of small vessels, increasing the pool of functionally active and recirculating cells that provide an effective response to antigenic influence.
The purpose of the study: to study features of the sorption activity of the epithelium of the oral mucosa, depending on the body mass index. Results: in subjects with a BMI > 25, the sorption activity of the epithelium of the oral mucosa is lower, the level of IL-1β in the supernatant of the oral fluid is twice as high, and the number of leukocytes in the peripheral blood is higher, but within normal limits, than in persons with normal weight.
The vitamin D supply of healthy newborns and young children living in the Khabarovsk Territory was analyzed. Using a random sampling method, the study included children of two age groups: newborns with their mothers and children aged 1-3 years old, undergoing examination in medical organizations of the Ministry of Health of the Khabarovsk Territory, Khabarovsk. The data obtained as a result of the study demonstrate the high prevalence of low vitamin D status among the child population of Khabarovsk, while there is an increase in the deficiency state as they grow older and, as a consequence, the most vulnerable group is adolescents.
DIAGNOSTIC AND TREATMENT METHODS
A systematic review of the literature was conducted based on the results of the use of interventional methods for the treatment of chronic pain syndrome in oncological practice. The results of the systematic review revealed that there is a need to develop specialized criteria for the selection of an interventional method and to create an algorithm for the treatment of drug-resistant chronic pain syndrome in oncological patients.
The purpose of the study was clinical evaluation of the effectiveness of the treatment tactics developed by us using a Dextran-40 colloidal solution in patients with duodenal MEF disorders with ADP in the first phase of the disease. The use of the technique using the colloidal solution of Dextran-40 showed greater effectiveness in terms of the rate of reduction in intraduodenal pressure compared to the standard method of prolonged nasogastrojejunal decompression of the upper gastrointestinal tract used for this purpose. Among other things, this made it possible to improve the immediate results of treatment.
HEALTHY LIFESTYLE. PREVENTION
In order to identify the main changes in 24-hour blood pressure monitoring (ABPM) indicators and their relationship with the psycho-emotional state in children with Internet addiction (IA), children aged 11-18 years were examined. As a result, children with unadapted Internet use have a tendency to increased variability in blood pressure with increased rates of hypotension during the day and hypertension at night, which is a risk factor for the development of arterial hypertension (AH). At the same time, children with deviations in ABPM indicators were more likely than in the control group to have problems with behavior, hyperactivity and problems communicating with peers, as well as higher rates of personal anxiety with low levels of situational anxiety.
The article reflects the assessment of the body's resistance of students living in the Far North to hypoxic conditions. The study group consisted of student athletes, the control group consisted of students engaged in physical education according to the general program of the university. To identify the assessment of the body’s resistance to hypoxia in athletes of Yakutia, the following functional tests were carried out: the Stange test (breath holding on inhalation) and the Genchi test (breath holding on exhalation). The obtained results of the study allowed us to see the prevailing excellent criterion (rating "excellent") in athletes and the average criterion ("good") in the control group, fewer results with an unsatisfactory criterion ("unsatisfactory"). The conducted assessment shows a positive level of non-specific adaptive capabilities of the respiratory system in the studied students. The functional resistance of the respiratory system to hypoxia in young men was significantly higher than in girls.
ORGANIZATION OF HEALTH, MEDICAL SCIENCE AND EDUCATION
The article presents an analysis of statistical data on dementia from official sources of state statistics, medical and scientific organizations, as well as the provision of specialized medical care in the Republic of Sakha (Yakutia) to patients with cognitive impairment.
An algorithm for assessing the professional potential of an otorhinolaryngologist based on the identification of medical risk factors in the provision of medical care to patients with rhinosinusitis has been developed. otorhinolaryngologists from 32 subjects of the Russian Federation were screened and the treatment of patients with polyposis rhinosinusitis was analyzed. The proposed methodological approach was successfully used to assess the knowledge and skills of physicians of other specialties and formed the basis for the methodology of studying the professional potential of physicians, for which the author's invention certificates were also obtained.
The article analyzes the structure and dynamics of abortions for the period 2013-2022 based on statistical data on the territory of the Sakhalin region. Despite a significant decrease in the absolute number of abortions in the region, a fairly high level of abortions per 1,000 women aged 15-49 years remains. There has been an increase in the proportion oлf spontaneous abortions, as well as abortive outcomes associated with other abnormal products of conception. In turn, not a single case of abortion for social reasons was noted during the study period, but the proportion of criminal abortion increased. There has also been an increase in medical (legal) abortions in non-governmental medical organizations, which indicates the need to develop measures aimed at interaction between state and non-state medical institutions providing abortion services. There has been a steady increase in the share of abortions among first-time pregnancies in the structure of all abortions, including in the share of medical (legal) abortions by 31.9% over the period from 2016-2022. This indicates the need to develop preventive measures aimed at increasing the availability of contraception and medical literacy in the field of reproductive health.
HYGIENE, SANITATION, EPIDEMIOLOGY AND MEDICAL ECOLOGY
The article presents manifestations of the epidemic process of meningococcal infection in the Republic of Buryatia: the dynamics of morbidity in different age groups of the population, mortality, serogroup characteristics of meningococcal strains. An assessment of the state of the level of collective immunity is given based on serological monitoring data and an analysis of immunoprophylaxis against infectious diseases. The period 2021-2023 was characterized by worsening of the epidemiological situation (increasing morbidity and mortality; involvement of different age groups of the population; increase in the number of seronegative individuals). Conducting serological and bacteriological monitoring, increasing the volume of immunization against MI and strengthening awareness-raising work among the population about the possibilities of vaccine prevention of MI will help improve epidemiological surveillance of this infection.
Poor-quality drinking water can be a source of morbidity of the population with acute intestinal infections. In order to assess the epidemiological safety of drinking water use, calculations of the correlation and regression relationship between the incidence of intestinal infections in the population and samples of drinking water that do not correspond to sanitary and microbiological indicators over the Russian Federation and the Republic Bashkortostan for the period 2013-2022 were performed. The results showed a statistically significant relationship between inappropriate drinking water samples and indicators of infectious morbidity of the population.
TOPICAL ISSUE
As a result of a comparative analysis, a number of statistically significant features of the medical and social portrait of pregnant women with COVID-19 of varying severity were identified. An increase in the median age, an increase in the frequency of somatic pathology (chronic arterial hypertension, varicose veins of the lower extremities, overweight, obesity, systemic lupus erythematosus) and polypathies are characteristic as the severity of COVID-19 in pregnant women increases. Mild infection is more common in primigravid women, moderate and severe in pregnant women with a history of childbirth and medical abortion, and extremely severe in multiparous women.
The impact of COVID-19 incidence on long-term cardiovascular endpoints in patients with sick sinus syndrome (SSS) and with an implanted pacemaker has been studied. Patients with COVID-19 and no COVID-19 were examined. The follow-up period was 30 months and the endpoints were cardiovascular death, myocardial infarction, stroke and cardiovascular hospitalization.comparison of the incidence of adverse cardiovascular endpoints in the COVID-19 and control groups showed no differences in all endpoints according to the chi-square test, with the exception of frequency of myocardial infarction in the “COVID-19”. The close relationship between tachybradicardia, microvascular dysfunction and coronary artery disease, and at the same time the impossibility of modulating the heart rhythm in the presence of vvegetative vascular dystonia and an established pacemaker assumed that autonomic dysfunction in postcoid patients caused myocardial ischemia and, as a result, an increase of myocardial infarction. Conclusion. During long-term follow-up, COVID-19 in patients with SSS increased the risk of myocardial infarction.
The frequency of Del 19 and L858R mutations of the EGFR gene was studied among patients of the Yakut Republican Oncology Dispensary with lung adenocarcinoma (n=177). Mutations were found 3.8 times more commonly in female population than in male. Mutations were detected 2.8 times more regularly among patients with stages I and II of the disease in compare with stages III and IV. The mutation frequency was 3.4 times over in the Sakha (Yakut) ethnic group patients as opposed to Russian ethnic group. In addition the mutation frequency was 9.6 times over in the Sakha (Yakut) ethnic group male patients as opposed to Russian ethnic group. It was shown that the overall 36-month survival of patients with a positive status of EGFR mutations increases by 2.5 times (from 29.3% to 74.1%). Moreover in patients with stages I and II of the disease, survival rate increases by 1.4 times, in patients over 65 years old in 2.9 times, in female patients in 2.4 times.
ARCTIC MEDICINE
The correlation of dopamine concentration in peripheral blood with the level of immune protection in Northerners was studied. The registration level of elevated dopamine concentrations in peripheral venous blood was found to be high and 7.14 0.38% in almost healthy residents of northern territories of the Russian Federation, and significantly higher in patients (59.21 1.7%). There was also a high registration level of elevated concentrations of IL-10 and TNF-α in both practically healthy people and people with oncological diseases. An increase in the frequency of phagocyte deficiency, circulating mature, activated lymphocytes, natural killer and phenotypes of transferrins and IL-2 receptors was observed. In oncological pathology, a high frequency of deficiency of neutrophils, phagocyte activity, NK, mature, activated T-cells, phenotypes of lymphocytes with receptors to transferrin and IL-2 was observed. In oncological pathology, there was a high incidence of deficiency of neutrophils, phagocytic activity, NK, mature, activated T cells, lymphocyte phenotypes with transferrin and IL-2 receptors.
We made an analysis of problems of the modern health care in the Arctic zone of the Republic of Sakha (Yakutia), a territory with extremely specific social and environmental conditions, where low population growth has been noted for the past two decades. This article considers issues of logistics of central district hospitals, problem of shortage of qualified personnel. The work of the regional ministry of health to solve some of the most urgent issues, including mobile medical and air ambulance teams is presented. Practical recommendations on improving health care and attracting medical workers to work in remote areas of the republic by providing favourable conditions for employment pensions. Integrating new technologies, improving infrastructure and creating programs to retain and attract health workers are not only important steps to improve the health system in the Arctic zone of the RS(Ya) but should also contribute to reducing the outflow of population.
The aim of the study is to identify regional characteristics and to assess changes in the mean level of cortisol and dehydropepenandrosterone-sulphate in male northerners according to the generation living in the North.
The total sample included male residents (average age 40.0 0.8 years) permanently residing in the territory of Magadan region.
The study has resulted in referring serum cortisol and dehydroepiandrosterone-sulfate concentrations, their ratio, as well as cortisol concentrations in the evening saliva tests to significant markers that reflect readjustments in the endocrine picture with increasing length of residence in the North, thus confirming the generally recognized role of glucocorticoids in hormonal support of the body adaptation to extreme factors including climatic environments.
SCIENTIFIC REVIEWS
The aim of this study is to summarize studies conducted over the past decades on endothelial damage in cardiac surgery patients who underwent surgical interventions with artificial blood circulation. We searched and analyzed literature on endothelial dysfunction in various medical databases, including PubMed, Cochrane, Elibrary, and Cyberleninka. In addition to medical aspects, our literature review covers historical aspects of the research of endothelial function and dysfunction. We suggest that pathological processes in endothelium during surgery and postoperative period predict adverse treatment outcomes, and therefore should be taken into account by anesthesiologists, resuscitators, cardiac surgeons and transfusiologists. Anaesthetists, cardiologists and transfusionists should take this pathological condition into account during surgical interventions and in the postoperative period due to possible negative impact on treatment outcomes
POINT OF VIEW
The influence of primary peritoneal drainage (PD) on intra-abdominal pressure dynamics and outcome of treatment of preterm neonates (PN) with severe necrotizing enterocolitis (NEC) with very low birth body mass was studied.
The peritoneal drainage reducing intra-abdominal pressure, improves lung and liver function and stabilizes the condition, performs a kind of detoxification by reducing the level of toxic fluid, determines the nature of the weaning, indicating necrosis of the intestinal wall, thus, it definitively diagnoses the perforation. Overall the survival with PD is higher, and it should be assumed that it is preferable in the severe stages of NEC before laparotomy to apply PD, thus avoiding complications associated with direct laparotomy.
In recent decades, a new interdisciplinary field of research in the field of neuroscience neuroethics has been formed. The article is aimed at discussing the possibility of introducing neuroethics into clinical practice, since complicated complex methods are used for examination, treatment, rehabilitation and prevention of neuropathology, which differ from traditional ones. At the stages of treatment, rehabilitation and prevention of neurodegenerative diseases, ethical questions and dilemmas occur that force health care professionals to make decisions by reflecting on the moral problems arising in the process of work.
CLINICAL CASE
The article presents a description of the clinical case of a 62-year-old woman who had been suffering from headaches for 5 months. MRI of the brain revealed pachymeningeal enhancement, especially in frontal-parietal regions, and tentorium cerebellum. Based on the clinical picture and neuroimaging data, the patient was diagnosed with idiopathic hypertrophic pachymeningitis. Corticosteroid therapy resulted in regression of pain and reduction of MRI changes. The article also discusses the difficulties of differential diagnostics of hypertrophic pachymeningitis with other diseases, which can be imitated by clinical picture and changes on MRI images.
Diagnosis of mitochondrial pathology is a difficult practical task. The variability of clinical manifestations of mitochoric diseases is associated with high genetic heterogeneity of mitochondrial pathology. Therefore, the analysis of clinical cases of mitochondrial pathology is an urgent task for early diagnosis. The purpose of this study: to analyze a clinical case of mitochondrial complex deficiency complex I, nuclear type 5 (Ley syndrome).
It is shown that the development of the disease manifested in early preschool age against the background of intercurrent disease. The disease manifested itself by metabolic disorders, degenerative signs from the nervous system, immunological changes and within 9 months led to a fatal outcome. The absence of specific signs at the initial stage significantly complicates the diagnosis of the disease and leads to difficulties in diagnosis.
A clinical case of dilated cardiomyopathy (DCM) is presented in a young male patient who has suffered an acute respiratory viral infection, with the formation of a further clinical picture of rapidly progressing heart failure. The clinical case focuses the attention of the medical community not only on the complexity of timely diagnosis of possible causes of DCMP, but also on the formation of further patient management tactics with a parallel assessment of further likely consequences and, most importantly, on the development of "alertness" among doctors in similar clinical situations.
This article presents a clinical case of a severe course of COVID-19 in a pregnant woman. The infectious process was complicated by bilateral out-of-hospital pneumonia.
Against the background of progressing respiratory failure, acute respiratory distress syndrome woman delivered by emergency cesarean section at 39 weeks' gestation. A live, premature baby girl was born, without asphyxia. The patient's condition remained extremely serious. On the 2nd day of the postoperative period sepsis was diagnosed, the lesion of lung parenchyma amounted to 75-100%.
Multicomponent therapy, including recombinant monoclonal antibodies to the interleukin-6 receptor, led to improvement of the condition.
The clinical observation of a rare disease hypopituitarism in a child of 8 years old is described. Due to the specificity of clinical signs, the early diagnosis is difficult. In this case, the late diagnosis and the late replacement therapy caused the child’s growth retardation.
Three cases of 22q11.2 deletion syndrome based on prenatally detected fetal anomalies are presented. The possibility of targeted prenatal diagnosis based on echographic criteria in the fetus for the formation of a high-risk group for deletion syndrome (DM) of chromosome 22q11.2. is shown.
ISSN 2312-1017 (Online)