Vol 30, No 12 (2019)

The paper deals with the selected issues of ethics and deontology in medicine, in surgery at all stages of the surgeon’s activities in particular. A brief historical outline of the development of the concepts under discussion is given using the examples of famous research scientists. Various interaction models are considered; the concepts of medical secrecy and a medical error are disclosed; the term of iatrogenism is explored; the need for scientific activity of surgical departments is proven. The dominant aspects of the behavior of physicians in giving information to their patients when the latter are detected to have life-threatening diseases are identified. The model of interaction between the surgeon and the patient is elucidated in detail and a way out of extremely difficult situations is proposed. Important aspects of preoperative preparation and direct application of anesthesia during surgery are considered. The concepts of «anesthesiologist» and «resuscitator» are logically separated and the importance of the functions of each of these two different specialists is shown. The complex ethical and moral aspects of treating the patients posing a danger to the surgeon himself/herself, in particular HIV-infected patients, are considered; the inevitability of providing assistance to such patients is defined. Emphasis is laid on the importance of the problem of medical ethics since this concept has been introduced, by taking into account the rapid development of medicine, that of surgery in particular.

The available data on the relationship of gender and age to long-term prognosis are contradictory in patients after ST-segment elevation myocardial infarction (STEMI). A study of 606 middle-aged and elderly patients who had undergone stenting after myocardial infarction could propose a new scale for assessing longterm survival rates after STEMI.

Hypoglycemia is one of the most common adverse events in patients with type 2 diabetes mellitus (DM) and occurs more often than hyperglycemia-associated complications, especially among the elderly and patients with long-term DM. Every four emergency drug-related hospitalizations are associated with hypoglycemia; this rate is even higher in elderly patients. Severe hypoglycemia is strongly associated with injuries and the occurrence of ventricular arrhythmias, dementia, death, and worsens quality of life in patients. Treatment for hypoglycemia remains expensive. Severe hypoglycemia that is common in inpatients poses a significant threat to their health and requires systemic interventions for improving treatment outcomes.

The paper highlights issues on the features of cerebral hypoperfusion in hypertensive patients. It considers the rational use of neuroprotective drugs to correct and increase the resistance of nerve tissue to ischemia.

The paper discusses the evolution of eradication therapy. It emphasizes the efficacy and safety of Helinorm used alone and in combination with standard eradication therapy.

Ehlers-Danlos syndrome is a rare ontogenetic anomaly in the body's development, which is one of the challenges to modern medicine. Hyperelastic skin (Chernogubov-Ehlers-Danlos syndrome, imperfect desmogenesis) is a hereditary connective tissue disease caused by insufficient collagen synthesis of various etiologies. Its prevalence is between 1:5,000 and 1:560,000. The paper describes a clinical case in a patient with Ehlers-Danlos syndrome, which includes: his medical history, clinical presentations, and treatment regimen. This clinical case is of interest as a rare syndrome with typical objective signs, such as skin hyperextensibility, prolonged wound healing with scarring, and joint hypermobility.

The paper analyzes the effect of low-frequency magnetic waves in the early recovery period of ischemic stroke.

The prevalence of stress in the family has been established in young men and women of an open population of a medium-urbanized Siberian city. It seems necessary and timely to determine the gender characteristics of the prevalence of stress in the family of young men and women in order to design effective regional programs for the multifactorial prevention of cardiovascular diseases.

The clinical and morphological features of amyloidosis of the liver and gallbladder were investigated when examining the biopsy specimens with histologically confirmed amyloidosis. The material was fixed in formalin and embedded in paraffin. Sections were stained with hematoxylin and eosin, as well as with Congo red. Amyloid deposits were immunohistochemically classified using a broad panel of antibodies to different types of amyloidosis.

Aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed.

The prevalence of non-alcoholic fatty liver disease (NAFLD) worldwide is 25%; this rate is much higher in the russian Federation. NAFLD is closely associated with obesity, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular diseases. Patients with NAFLD have a significantly increased risk for cirrhosis, terminal liver failure requiring liver transplantation, as well as hepatocellular carcinoma and mortality (overall, cardiovascular and liver-related). The prevention and treatment of NAFLD are aimed at correcting modifiable risk factors, primarily at losing weight (by 7-10% of the baseline value) through moderate physical activity per day and a low-calorie diet.