卷 35, 编号 11 (2024)

This literature review examines data on the informativeness of each research method proposed in the diagnosis of HPV-associated neoplasia, recommended cervical screening programs are described, and the need to search for new, more accessible relevant research methods is justified.

Objective. To perform macroscopic and histological analysis of the vascular wall after implantation of a self-expanding nitinol stent in the in vivo experiment.

Material and methods. 2 Danish Landrace pigs were selected for experimental implantation of a new self-expanding nitinol stent with an oversizing of 5–20%. Vital signs were assessed in both pigs throughout the observation period. In the postoperative period, both animals received dual antiplatelet therapy for 3 months. After 3 months, the animals underwent control angiography and ultrasound examination of the iliofemoral segment, followed by withdrawal from the experiment by euthanasia. The next step was a morphological analysis of the stented areas of the vessels.

Results. The observation period of the animals was 3 months. Throughout the entire observation period, vital signs in both animals remained within normal values. Control angiography and ultrasound examination after 3 months demonstrated patency and the absence of significant restenoses in both pigs. Morphological analysis showed no signs of damage to the vessel walls.

Conclusion. This study showed a favorable response of the animal's body to the implantation of the presented self-expanding nitinol stent with minimal neointimal hyperplasia from the inner wall of the common iliac artery in the postoperative period.

This article discusses the main causes of acute appendicitis. We analyzed domestic and foreign literature sources, as well as data from randomized controlled trials on the etiology of acute appendicitis. Acute appendicitis is one of the most widespread urgent surgical pathologies, and complications of this nosology remain at a fairly high level regardless of the development of modern medicine. Despite years of studying acute appendicitis, the problem of its etiology is still debatable. There are different patterns between acute appendicitis and gender differences, as well as age and comorbidities, but it is currently impossible to give an unambiguous answer to the question of the etiology of acute appendicitis.

The article analyzes foreign and domestic sources to identify similarities and differences in approaches to the classification, diagnosis and treatment of pulmonary embolism (PE) within various treatment profiles.

The literature search was carried out using the eLibrary, CyberLeninka, and PubMed databases. Using the keyword “pulmonary embolism” over the past 10 years, 783 published clinical studies, 741 meta-analyses, >3000 review articles, >1000 systematic reviews, 90 monographs and textbooks were found.

It is noted that PE does not have a specific clinical picture, it can be a complication of many diseases or occur under the “mask” of another pathology, which makes its diagnosis difficult. Despite the fact that there are reliable methods for verifying pulmonary embolism, their use is not always possible, which requires extensive knowledge and developed clinical thinking from doctors of various specialties. Rehabilitation is carried out as part of outpatient follow-up treatment and, as a rule, takes about 6 months, while patients are prescribed oral anticoagulant therapy under the supervision of a physician. In individual cases, the rehabilitation period is extended indefinitely. Currently, there is an increase in pulmonary embolism among people who have had a new coronavirus infection (COVID-19).

Osteoporosis (OP) is a disease characterized by a decrease in bone mineral density (BMD) and a high risk of fractures. In perimenopausal women with a disturbed hormonal background, the risk of developing this pathology increases significantly. Special diagnostic methods and therapy that take into account the etiopathogenesis of the disease can reduce the disability rates associated with OP among patients of this group. The article provides data on the results of examination and treatment of 57 perimenopausal women with OP and reveals the potential of diagnostics that allows evaluating the effectiveness of therapy. The drug "Osteomed Forte" has shown effectiveness in reducing and closing cavities in the trabecular bone sections in patients with verified OP and androgen deficiency, and improving hormonal status in perimenopause allowed to suspend the development of OP and even achieve its partial regression.

Objective. To study the smoking status of medical university students.

Material and methods. The study involved 483 pediatric students and 503 medical students. Study participants filled out a questionnaire containing 19 questions about smoking with the ability to select an answer from the proposed options. The analysis of the obtained data was carried out using the IBM SPSS Statistics 26.0 program.

Results. There were more smokers among students of the Faculty of Medicine than among students of the Faculty of Pediatrics. At the beginning of training, the number of non-smoking students was 4 times higher than the number of smokers, but by the end of training the number of smokers reached 50%. Among the reasons for starting smoking, curiosity prevailed. 38.9% of students attempted to quit smoking, and in the vast majority of cases without results. Respondents named the anti-stress effect of smoking as the main reason for the failure of the attempt. Despite a short history of smoking, 31% of respondents developed a cough, which they associated with smoking. Among the non-smokers, the main motivating reasons for quitting smoking were harm to health and the high cost of cigarettes. At the same time, 45.2% of non-smoking students have a negative attitude towards smokers.

Conclusion. The data obtained justify the need for more active educational measures and promotion of a healthy lifestyle among medical students.

The article discusses the etiology, risk factors for development, stages, clinical symptoms, clinical and laboratory markers, approaches to the diagnosis and treatment of chronic kidney disease (CKD). The modern classification and diagnostic features of CKD are presented, as well as approaches to treatment at different stages of the disease.

Sarcopenia is a pathological condition found in elderly patients that impairs their quality of life and increases the risks of disability.

Objective. To assess the functional state of the cardiovascular system in elderly patients with sarcopenia.

Materials and methods. The main group included patients with sarcopenia diagnosed according to the criteria of EWGSOP-2 (European Working Group on Sarcopenia in Older People 2) supplemented by the screening questionnaire SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls). The state of the cardiovascular system was assessed based on the results of ECG, echocardiography and duplex examination of vessels at rest.

Results. The features of the functional state of the cardiovascular system in sarcopenia were determined, which manifested themselves in the form of impaired repolarization processes and arrhythmic dysfunction, lower parameters of cerebral perfusion, and the presence of an early sign of latent heart failure.

Conclusions. The treatment of cardiovascular diseases in the elderly population requires special attention due to the polymorbidity of patients and sarcopenia should be taken into account, among other things, as a factor affecting the state of the cardiovascular system.

A clinical example demonstrating the need for a comprehensive approach in the treatment of patients with chronic tuberculosis and extensively drug-resistant pathogen is presented. The patient repeatedly had relapses of a specific process, despite ongoing anti-tuberculosis therapy for several years. During this period, drug resistance to the new anti-tuberculosis drug bedaquiline was formed, which significantly reduces the possibility of selecting adequate anti-tuberculosis therapy. In addition, the patient has a widespread tuberculous process of the trachea and bronchi, accompanied by massive bacterial excretion. Against the background of the complex treatment, by the 6th month of treatment, it was possible to achieve pronounced positive dynamics, however, a massive fibrous cavity remained in the right lung. Given the low functional parameters limiting the use of resection surgery, the patient was able to undergo collapsosurgical treatment in the form of extrapleural pneumonitis

Pulmonary and pleural suppurations, complicating oncological diseases, significantly worsen their prognosis and determine the features of treatment tactics. The clinical forms of pulmonary-pleural suppuration in patients with cancer of extrapulmonary localizations in the post-Covid period are considered. The data of surgical interventions and the results of staged treatment of complicated forms of lung cancer are presented.

The prevention of visual impairment in people with uncontrolled use of computers and electronic gadgets, the study of clinical manifestations of their negative effects on the body and, especially, on the organ of vision, is an urgent problem of modern medicine.

The purpose of the work was to substantiate the need for the prevention and treatment of visual impairment in adolescents with uncontrolled smartphone use. The article describes the negative effects of irrational use of computer gadgets on users' eyesight, clinical manifestations of computer vision syndrome and its component – dry eye syndrome, and describes in detail approaches to the prevention and treatment of visual impairment associated with uncontrolled use of computers and electronic gadgets. The results of our own research revealed the general prevalence of problematic smartphone use in 15.2% of adolescents, its more frequent occurrence in girls (21.2%) than boys (5.0%), and a higher prevalence of vision problems (computer vision syndrome, dry eye syndrome) in smartphone-dependent adolescents compared with independent ones.

The authors conclude that the approach to the prevention and treatment of pathological changes in the body (primarily from the organ of vision) caused by the irrational use of modern gadgets should be comprehensive, including recommendations for optimizing the regime and working conditions with electronic computer devices, as well as the use of various ophthalmological measures in a complex of preventive and therapeutic measures funds.

Objective. To study the peculiarities of lifestyle and identify risk factors for disease development among students of a medical university.

Material and methods. 320 second-year students of the Medical Faculty of the Siberian State University (78 males and 242 females) took part in the study. An anonymous online questionnaire with the use of Yandex Forms was conducted among the participants.

Results. Girls had lower self-assessment of health. Among the respondents, 24.5% constantly take care of their health, 19.9% monitor their health only in case of illness, and 55.6% take care of their health periodically. Most students spend 2–3 hours (44.5% of girls and 61.4% of boys) or 4–5 hours (39.6% of girls and 30.0% of boys) to prepare for exercise. 30.9% of students do physical exercises and sports in their free time, 69.1% prefer other activities. 29.5% of surveyed boys and 27.0% of girls smoke. 49.3% of boys and 53.3% of girls use alcohol not more than once a month, 2–4 times a month - approximately equal number of respondents. More than half of the surveyed students noted that they do not use energy drinks. Among the respondents, 52.2% of girls and 49.3% of boys would like to get rid of bad habits, 26.1% of boys and 21.7% of girls do not see the need for this, the rest found it difficult to answer.

Conclusion. Despite the fact that students have sufficient awareness of the components of a healthy lifestyle and express the desire to follow its principles, there are significant violations in the lifestyle of the study contingent. The obtained data confirm the need to develop comprehensive programs aimed at preserving the health of students, taking into account the identified characteristics of lifestyle and health risk factors.