Vrach

The improvement of clinical and laboratory research methods contributes to the timely diagnosis and improvement of the effectiveness of disease therapy, which ensures the preservation of public health, reducing the time of temporary disability and rehabilitation of patients. The evidence base for determining the predictive role of biomarkers of renal dysfunction is small and is available only for a very limited number of substances – some serum proteins, the synthesis of which increases with acute kidney injury, low molecular weight urine proteins, intracellular enzymes of tubular epithelial cells and some other substances. This article provides an overview of modern laboratory methods of early diagnosis of kidney dysfunction in combined mechanical injury.

Photopolymer printing technologies are getting increasingly popular especially in the medical field. They allow the creation of precise 3D models of organs, tissues, bones and other anatomical structures with a high degree of detail and accuracy. This ability has become particularly important in medical practice, where the accuracy and quality of the models are fundamental to assessing the patient’s condition, planning treatment and preparing surgery. This article considers technologies of stereolithographic printing in medicine and their practical application, advantages and disadvantages, in addition, the potential of the application of this technology to treat people who suffered serious injuries during a special military operation.

The medical history of N.A. Nekrasov still causes fierce disputes among medical historians, clinicians of various specialties (therapists, surgeons, proctologists, urologists), literary critics and literature lovers. Studying the issues of the journal «Vrach» of a century and a half of antiquity, we came across the reaction of this extremely popular publication in Russia to the death of N.A. Nekrasov with merciless criticism of the surgeon who operated on the poet.

Objective. Retrospectively study the treatment of the poet N.A. Nekrasov and determine what mistakes were made by doctors.

Materials and methods. For 45 years, the funds of N.A. Nekrasov have been studied in the archives of St. Petersburg, Moscow, Yaroslavl, Karabikha; his correspondence with the selection of materials concerning his illness.

Results. N.A. Nekrasov from December 1874 to December 27, 1877 had rectal cancer with the spread of the tumor to the sacrum and bladder. The disease was complicated by colonic obstruction, in connection with which, by the decision of the family, Professor Theodor Billroth arrived from Vienna, who on April 12, 1877 performed a colostomy operation. The analysis revealed 13 medical mistakes committed in the treatment of Nekrasov, which did not allow timely diagnosis and prolong the life of the poet for a long time, who died of sepsis and uremia, which complicated the course of cancer. The negative evaluation in the late nineteenth-century publications of the Journal «Vrach» that T. Bilroth received is discussed.

Conclusion. Serious medical mistakes were made in the treatment of N.A. Nekrasov, which brought the fatal outcome closer, which caused fair criticism by the journal «Vrach» of the surgeon, who operated on the poet.

The article studies the possibility of using the Memo-Vit drug in order to prevent and correct the course of dementia. Actual statistical data and the content of forecasts for the spread of the disease are given, a description is given of the currently available means of prevention and therapy. The most common causes of the occurrence and development of pathology (including atrophic and vascular forms) are singled out. The components of the domestic nootropic Memo-Vit (red-stemmed buckwheat grass, May rose hips, HDBA organic complex) are considered, their chemical composition and influence on the biochemical mechanisms of dementia development are analyzed. The prospects for the use of the drug in the fight against the disease are evaluated.

The presented clinical case demonstrates the possibilities of a multidisciplinary approach to medical rehabilitation of a patient who underwent staged surgical treatment for widespread destructive pulmonary tuberculosis. Particular attention is paid to the possibilities of interdisciplinary interaction for the restoration of cardiorespiratory function of the body, correction of disorders of the musculoskeletal system, psycho-social adaptation and improvement of the quality of life of a patient who has undergone several extensive surgical interventions on the lungs.

The article presents the results of 24-hour Holter electrocardiogram monitoring in 33 patients with arterial hypertension and abdominal obesity. When analyzing the nature and structure of cardiac arrhythmias, it was found that supraventricular extrasystoles, including allorhythmic ones, are quite often registered in hypertension and obesity. Similar trends can be observed with regard to the frequency of ventricular arrhythmias. The drug Kardioton is a natural cardioprotector of the cardiovascular system; strengthens the heart muscle by improving its oxygen supply, stops inflammatory processes in the myocardium; has antiarrhythmic, cardiotonic, hypotensive effect. It is recommended for disorders of the cardiovascular system, with increased physical activity. After using the drug Kardioton, there is a positive trend towards a decrease in the number of extrasystoles, normalization of heart rhythm and improvement of general well-being and quality of life of patients.

Post-COVID syndrome develops after a COVID-19 infection, and is also observed in cases of mild or asymptomatic course of the disease. The most common symptoms of bridge syndrome are asthenia and decreased performance, with further development of cognitive deficit. Taking into account the leading role of immune disorders in the pathogenesis of COVID-19, the use of immunotropic drugs that have both direct activity in relation to immune interactions and those that work indirectly through the reduction of post-stress reactions that can maintain immune dysfunction seems promising. In this regard, Selank is of interest, a peptide created on the basis of the immune regulator tafcin, which has proven itself well in the treatment of a wide range of neurotic and neurosis–like disorders.

Objective. To study the efficacy of the drug Selank in patients with complaints of asthenia, decreased performance and emotional disorders that developed after COVID-19 infection.

Material and methods. The study included 64 patients divided into 2 groups: Group 1 (n=32) – patients received neuroprotective complex (cholitilin, mexidol, milgamma) and the drug Selank; Group 2 (n=32) – patients received neuroprotective complex (cholitilin, mexidol, milgamma) without the drug Selank.

Results. The drug Selank (nasal drops, 1.5 mg) when used at a dose of 2-3 drops 4 times a day for 30 days showed a good effect in patients with asthenia and impaired mental performance. In parallel, relief of anxiety and depressive symptoms was observed. Based on the data obtained, it can be argued that Selank demonstrates a good effect when used in patients with asthenia, which developed as a result of a previous COVID-19 viral infection, with concomitant depressive and anxiety symptoms.

This study was designed to determine what factors contribute to infection areas of surgical intervention. In spite of the scientific advances in the field of asepsis and antiseptics, the development of surgical infections is still a common adverse phenomenon.

There are two groups of factors that influence the development of a surgical infections: exogenous factors and endogenous factors. Exogenous factors are primarily technological and procedural interventions, as well as violations of hygienic norms and rules. Some researchers include the influence of the nature of the materials used in surgical instruments and various types of sutures.

Endogenous factors depend directly on the patient himself. These factors include violation of the patient's immune status, co-morbidities, including endocrine disorders, chronic diseases.

Although some of the triggering factors cannot be corrected or prevented, the remaining factors can be significantly influenced in the preoperative period. Competent choice of drug therapy, timely control of pathogen susceptibility to used antibacterial agents, shortening the time of stay in a medical facility, balanced diet and strict restriction of patients' alcohol, nicotine or drug consumption can reduce the number of postoperative complications of infectious genesis.