Vol 36, No 3 (2025)

Objective. Comparative analysis of regional standardized mortality rates (SMR) among men and women from diabetes mellitus (DM) in comparison with mortality from cardiovascular diseases (CVD) in 2013 and 2022 and discussion of factors influencing mortality from DM.

Material and methods. Rosstat data obtained upon request on the average annual population and the number of deaths in one-year age groups based on the “Rosstat Brief Nomenclature of Causes of Death” (KNPSR) for the constituent entities of the Russian Federation in 2013 and 2022 (10 years). SMR were calculated using software (state registration number of computer program 216661114).

Results. Compared to 2013, in 2022, against the background of a decrease in SMR from CVD (–110.84 ± 66.54 per 100 thousand women and –181.85 ± 95.23 in men) in all regions (except for Trans-Baikal Territory – men), an increase in SMR from DM was registered in 86% of regions. The average regional increase in SMR from DM was 12.84 ± 12.93 per 100 thousand population in men (in 2013 6.94 ± 5.26 and in 2022 19.78 ± 13.65) and 13.3 ± 13.73 in women (8.69 ± 6.38 and 21.99 ± 14.26, respectively). In 6 regions, both in 2013 and 2022, the SMR from DM among men was higher than among women. Significant regional variability of SMR from DM and their changes by region and a statistically significant negative correlation between the difference in regional indicators of SMR from diabetes and CVD were revealed.

Conclusions. Against the background of a decrease in mortality from CVD, in most regions an almost threefold increase in SMR from DM was detected. The variability of SMR from DM and differences in their changes may be associated with the peculiarities of the choice of the initial cause of death in patients with comorbid pathology.

Review focuses on the clinical presentation and pathogenesis of COVID-19, particularly in the context of the interaction between SARS-CoV-2 virus and angiotensin-converting enzyme II (ACE-II), which plays a key role in viral entry into host cells. The article details the mechanisms underlying cytokine storm, coagulopathy and other important aspects of severe disease, including increased expression of pro-inflammatory cytokines and alterations in the haemostasis system. This article analyses the consequences of abnormal activation of the immune system leading to acute respiratory distress syndrome, disseminated intravascular coagulation and multi-organ failure. In addition, the role of anticoagulant therapy in the prevention and treatment of thrombotic complications is discussed. The study emphasises the need for an individual approach in the treatment and prevention of COVID-19 depending on the severity of the disease and other clinical parameters.

The exposome concept emphasizes the importance of taking into account the cumulative effects on the body during life, including environmental pollutants. The influence of these factors may increase the risk of developing chronic diseases.

Objective. Development of a clinical and environmental risk assessment model that allows predicting the level of sensitivity to chemicals based on measured biomarkers and the assessment of the Quick Environmental Exposure and Sensitivity Inventory (QEESI) index.

Material and methods. The study included 71 patients (32 men and 39 women) aged 18–65 years. The level of chemical sensitivity exceeded 20 points on the QEESI scale. The data was analyzed using Python and statistical libraries. A machine learning model (Random Forest Regressor) was created to assess clinical and environmental risk.

Results. Significant deviations of biomarkers (alanine aminotransferase, aspartate aminotransferase, low-density lipoproteins) from the normal distribution required the use of mathematical transformations. The model showed good predictive abilities, despite the high values of MAE and RMSE. The cubic and quadratic shape of bilirubin and the scale of symptoms were the most significant factors.

Conclusions. The developed model based on the Random Forest Regressor algorithm has shown high accuracy in predicting clinical and environmental risk. Optimization of hyperparameters, preprocessing of data using mathematical transformations (logarithmic, square, cubic), the use of the feature_importances_ attribute allowed a deeper understanding of the impact of environmental factors on health.

Objective. Improving the effectiveness of surgical treatment for dental patients through the experimental development of a laser seam for soft tissues in the maxillofacial area using laser radiation and biopolymer.

Materials and methods. The experimental research model was created on 8 laboratory rabbits of the Chinchilla breed. Linear wounds on the skin were made with a surgical scalpel No. 15C and sutured. All rabbits were divided into 3 research groups: group 1, wounds were sutured with Prolen 5.0 thread; group 2, the edges of the wounds were joined using laser tissue welding with a laser device with a wavelength of 970 nm and Bioadhesive No. 1 based on bovine serum albumin and indocyanine green; group 3, the edges of the wounds were joined using laser tissue welding with a laser device with a wavelength of 970 nm and Bioadhesive No. 2 based on bovine serum albumin, indocyanine green, and single-walled carbon nanotubes. In the postoperative period, the severity of edema, intensity of hyperemia, and the time of wound epithelialization were assessed on days 1, 3, 5, and 10 in points.

Results. Experimental studies on rabbits in vivo showed that the best regeneration occurred when the edges of wounds were joined using laser skin welding with laser radiation and Biopreparation No. 2. In the postoperative period, there was minimal swelling and hyperemia, no suture dehiscence or tissue necrosis was observed, and earlier epithelialization and an aesthetic scar were noted.

Conclusion. The use of laser radiation and biopreparations is a promising method for joining the edges of wounds on the skin, as it accelerates regeneration and forms an aesthetic scar.

Treatment of cardiac arrhythmias has consistently attracted the interest of researchers and practicing physicians. Class Ic antiarrhythmic drugs (AADs) have been the most discussed in recent decades due to conflicting research results. The objective of this review is to analyze the efficacy and safety of class Ic AADs available in the Russian Federation: lappaconitine hydrobromide, prolonged-release lappaconitine hydrobromide, propafenone, flecainide, and diethylaminopropionylethoxycarbonylaminophenothiazine. The pharmacological features (pharmacokinetics, pharmacodynamics), electrophysiological effects of class Ic AADs, and data on their efficacy in supraventricular and ventricular cardiac arrhythmias, which served as the basis for clinical recommendations, are presented. The safety, adverse events, limitations, and contraindications for the use of class Ic AADs, as well as the possibilities of individualizing therapy when using them, are discussed.

Treatment and rehabilitation of wounded with severed limbs due to injuries sustained while performing combat missions, are an important complex issues of modern healthcare that require further development and improvement.

Objective. To evaluate the effectiveness of medical and rehabilitation measures using modern technologies of restorative treatment in military personnel after mine-explosive wounds (MEW) with limb separation.

Material and methods. 340 records of treatment and rehabilitation of military personnel with MEW in the period from 1995 to 2024, who were treated in the hospital, were reviewed. Group I included 275 (82.3%) wounded who were treated and rehabilitated in 1995-2017, group II – 59 (17.7%) who were treated in 2018 to 2024. In group II myoplastic amputations were performed, rehabilitation measures were based on the use of modern equipment, simulators and techniques.

Results. 363 amputations were performed on 334 wounded. The use of modern surgical tactics and a modern complex of rehabilitation measures in the wounded of group II led to decrease the number of postoperative complications, improved indicators of the Romberg test, carpal and stasis dynamometry, endurance of the muscles of the back and abdomen, stride length, pace and walking speed during various periods of rehabilitation.

Conclusions. In 2018-2024 there was a significant increase in the number of amputations at the foot and shoulder levels, and a significant decrease in the number of amputations at the forearm and hand levels in patients with MEW. The complex of medical and rehabilitation measures for military personnel after amputation with limb separation made it possible to optimize the formation of functional stumps and reduce the duration of prosthetics from 4 to 4.5 months in 1995-2017, to 3 months in 2018-2024. The use of modern methods of medical rehabilitation from the first days after the MEW accelerates the process of restoring functions in military personnel with limb separation, reduces the time of their treatment and return to military service duties.

Purpose. To evaluate the effectiveness of a combination of gas-liquid skin treatment in combination with barophoresis with autologous platelet-rich plasma in the treatment of patients with rosacea.

Materials and methods. The study involved 20 female patients with rosacea aged 43 to 62 years, barophoresis procedures with autologous platelet-rich plasma were performed. The results were evaluated after each visit according to the rosacea diagnostic assessment scale and facial imaging system.

Results. After completion of the course of procedures 90% of patients noted absence of rosacea influence on the quality of life, reduction of clinical symptomatology severity, also the index on the rosacea diagnostic assessment scale decreased.

Conclusion. In our study, the method of gas-liquid skin treatment in combination with barophoresis of autologous platelet-rich plasma showed high efficiency, which can be recommended for the course treatment of erythematotelangiectatic rosacea.

Back pain (dorsalgia) in children and adolescents is one of the pressing problems of modern medicine and attracts the attention of scientists from different countries of the world.

The aim of the work was to study the prevalence and structure of back pain in adolescents depending on gender and the presence of recurrent headaches. The article analyzes gender differences in the frequency of occurrence and structure of back pain of various localizations (in the cervical, thoracic, lumbar spine and their combinations) in adolescents.

The results of our own study revealed the overall prevalence of dorsalgia in 21.7% of adolescents, its more frequent occurrence in girls (27.5%) than in boys (15.3%), a higher overall prevalence of rare (38.5%) than in frequent (18.8%) episodes of back pain in the examined adolescents. Statistically significant gender differences in the prevalence of dorsalgia (both rare and frequent pain episodes) were established with a predominance in girls compared to boys. The features of the structure of dorsalgia by pain localization were determined with dominance in the cervical (28.0%) and lumbar (24.7%) spine, and a rarer occurrence of dorsalgia in thoracic (13.2%) and combined (9.2%) localization. Gender differences in the overall prevalence and structure of dorsalgia associated with recurrent headaches (RH) were revealed in the groups of examined adolescents. The fact of a higher prevalence of dorsalgias of varying frequency and localization in adolescents with RGB with a predominance of the analyzed indicators in girls has been established.

The authors come to the conclusion about the need to continue scientific research on the prevalence and structure of dorsalgia in adolescent populations of different regions, the advisability of using standardized methodological approaches and examination methods for the comparability of the results of the studies conducted in order to develop sound methods for the prevention and treatment of these types of pathology, including the use of osteoprotectors such as Osteomed, Osteomed Forte, Osteo-Vit D₃.

This study is devoted to the analysis of modern methods of vertical tooth preparation and their integration with digital technologies in dentistry. A systematic review of the literature for the last 5 years was conducted using leading electronic databases. Particular attention is paid to the biologically oriented preparation technique (BOPT) and vertical edgeless preparation (VEP). The application of digital technologies, such as CAD/CAM systems and robotic preparation, in the context of vertical preparation is analyzed. A clinical case of the BOPT method is presented, demonstrating a significant improvement in esthetic results and periodontal health.

Wernicke-Korsakoff encephalopathy is difficult to diagnose an urgent condition, caused by a deficiency of vitamin B₁ (thiamine). The main reason for the development of the disease is chronic alcoholism. Non-alcoholic causes of Wernicke-Korsakoff encephalopathy include acquired immune deficiency syndrome, malnutrition, pathology of the gastrointestinal tract and surgical interventions on it, multiple organ failure, program hemodialysis, long-term treatment with furosemide, etc. In Russia, the number of bariatric surgeries is increasing annually; therefore, not only neurologists, but also physicians of other specialties are increasingly likely to encounter this pathology in clinical practice. It must be remembered that neurological disorders after bariatric surgery due to vitamin deficiency may be of an erased nature, and diagnostic tools that allow timely recognition of encephalopathy are far from perfect. All of the above determines the need to conduct new experimental and clinical studies in this area of neurology. In order to raise awareness and improve clinicians' professional knowledge of the gastroenterologic causes of vitamin B₁ deficiency, this article presents a clinical case of Wernicke-Korsakoff syndrome that developed after bariatric surgery.

Objective. To evaluate the mechanical strength, biodegradability and biocompatibility of composite hydro- and xerogels made from hydrolyzed type I collagen and kappa-carrageenan.

Materials and methods. Using the TA.XTplus texture analyzer, the strength of composite hydro- and xerogels, as well as the intensity of their biodegradation in acidic, neutral and alkaline environments, were estimated. Using light and fluorescence microscopy, the morphometric characteristics of human fibroblasts and their proliferative activity were estimated.

Results. It was found that carrageenan in the hydrogel increases the strength of the structure. Lyophilization of the G4C4-Hydro composite hydrogel allows obtaining a biomaterial with improved mechanical characteristics and increased resistance to destruction in acidic, neutral and alkaline salt solutions. It was found that the G4C4-Hydro and G4C4-Xero samples do not have an inhibitory effect on fibroblast proliferation. It was found that, unlike hydrogel, xerogels not only support fibroblast adhesion on their surface, but also provide favorable conditions that keep fibroblasts viable.

Conclusion. The composite xerogel G4C4-Xero containing hydrolyzed type I collagen and kappa-carrageenan can be used both as an extracellular scaffold for creating tissue-engineering structures and as an independent biomaterial for filling the volume of tissue lost as a result of surgery or injury.