Vrach

Objective. To evaluate the effect of different rehabilitation programmes on the sexual health of women in the recovery period after surgical treatment of early stages of cervical cancer (CC).

Materials and methods. The study included 103 patients with СС, divided into the group receiving a personalised programme of comprehensive «active» rehabilitation (CC-1; n = 51) and rehabilitation according to the principles regulated in the local clinical guidelines (CC-2; n = 52). The control group included 80 women without gynaecological oncological diseases. Sexual health was assessed using the Female Sexual Function Index (FSFI) before and 36 months after surgery. Scores were expressed as Me (Q₂₅; Q₇₅), and differences were considered reliable at p < 0.05.

Results. Surgical intervention led to a decrease in all FSFI domains with a minimum score in the 1^st month after surgery (total score 7.1 [6.0; 8.3] in the CC-1 group and 6.6 [5.8; 7.3] in the CC-2 group), after which faster and more pronounced recovery dynamics were observed in the CC-1 group from the 3^rd (satisfaction), 6^th (desire, arousal, lubrication) or 12^th (orgasm) month of the study. Differences between the CC-1 and CC-2 groups in the FSFI total score also became significant from the 6^th month of follow-up. This index reached normal values by the end of follow-up, totalling 27.1 (26.7; 28.0) points at the last visit. No adverse events were registered.

Conclusions. This study provides strong evidence for the efficacy of a personalised comprehensive rehabilitation programme to improve sexual function after early-stage CC surgery. However, further research is needed to determine the optimal duration and intensity of such programmes.

Hip replacement surgery is currently the only effective surgical treatment option for patients with severe forms of degenerative-dystrophic diseases of the hip joint, so the problem of medical rehabilitation of such patients remains very relevant.

One of the problems that arise after hip replacement surgery is a violation of the biomechanics of the artificial joint. The leading role in this process is played by the functional state of muscle tissue, which determines the problem of adaptation of the endoprosthesis components and can subsequently cause complications. The solution to this problem lies in timely comprehensive medical rehabilitation, individually selected for each patient, taking into account the characteristics of the postoperative period.

Traditional methods of medical rehabilitation, including various methods of therapeutic exercise, natural and preformed physical factors, are undoubtedly effective, as indicated by an extensive scientific evidence base, but despite the proven effectiveness, these methods are time-consuming and require the presence of specialists. Along with traditional methods of medical rehabilitation, new technologies are currently used, including telerehabilitation, digital products based on virtual reality and artificial intelligence, robotic mechanotherapy, the effectiveness of which has been proven by scientific works of domestic and foreign colleagues and is in no way inferior to classical methods of rehabilitation treatment.

The main methods of surgical treatment of peripheral nervous system injuries are reviewed: neurolysis, epineural suture, autoneuroplasty, neurotization, tendon-muscle transposition, orthopedic interventions (arthrodesis, etc.), neurostimulator implantation and interventional interventions (radiofrequency neuroablation, cryoneurolysis).

In recent years, bioplastic collagen-based materials have become widespread in reconstructive surgery due to their unique biological and mechanical properties. The article reviews modern advances in the development and application of collagen-based biomaterials for soft tissue, bone and cartilage repair, as well as their effectiveness in comparison with other types of materials used in rehabilitation. Special attention is paid to the improvement of collagen materials properties due to their chemical modification, crosslinking and combination with synthetic polymers, which allows increasing their biocompatibility, resistance to degradation and mechanical strength.

The article reviews key applications of collagen-based materials, including chronic wound healing, cartilage repair in osteoarthritis, and bone regeneration after trauma and surgery.

A comparative analysis of collagen materials with alternative biomaterials such as synthetic polymers and ceramics has been performed. It is shown that collagen materials are superior to synthetic analogs in terms of biocompatibility and ability to stimulate cell proliferation, but combined materials based on collagen and synthetic polymers show the best results in terms of mechanical stability and bioactivity.

The presented data indicate a high potential for the use of bioplastic collagen-based materials in reconstructive surgery, and emphasize the need for further research to optimize their properties and expand their application in clinical practice.

The article presents the results of a comparative analysis of clinical and anamnestic data and laboratory parameters in autoimmune liver diseases, depending on the combination with opisthorchiasis invasion. It has been determined that chronic opisthorchiasis has a negative impact on laboratory parameters and also complicates the diagnosis of autoimmune liver diseases, which leads to a late start of therapy and the development of irreversible complications.

At the present stage in practice enterosorbents are used, which differ in dosage form, chemical structure, selectivity and mechanisms of action. When choosing an enterosorbent to include it in the complex therapy it is necessary to take into account the presence of high adsorption activity (AA) of the drug.

Objective. To compare AA of sorbents under conditions close to physiological
ones.

Materials and methods. The AA of medical sorbents (Alesorb^®) in the form of ALESORB^® “Enterosorbent” powder and Polysorb^® powder; ALESORB^® “Enterosorbent Gel” ERCIG without flavourings and Enterosgel^® paste was studied by spectrophotometric method using methyl orange and gelatin as adsorption markers at pH = 2.0 and pH = 7.5, simulating the environment of the stomach and duodenum.

Results. The obtained data indicate that the level of AA of sorbing agent (Alesorb^®) in the form of ALESORB^® “Enterosorbent” powder and ALESORB^® “Enterosorbent Gel” ERCIG without flavourings with respect to the used marker substances, are superior to Polysorb^® powder and Enterosgel^® paste. The obtained results give a reason to consider sorbing agents (Alesorb^®) in the form of ALESORB^® “Enterosorbent” powder and ALESORB^® “Enterosorbent Gel” ERCIG without flavourings as effective and priority means for prevention and treatment of diseases, in the therapy of which enterosorption is envisaged.

In the Russian healthcare system, the main method of preventive medicine is regular preventive examinations and medical examinations.

Purpose. To study the population’s awareness of preventive examinations and medical examinations and participation in them; analyze methods for performing medical examinations in relation to oncological diseases (OC) and their results.

Material and methods. An observational study was conducted with a survey of a random sample of the adult population of Moscow; 461 respondents aged 18–79 years took part in the survey. The main research method is personal interviewing using a unified questionnaire regarding the set of characteristics being studied.

Results. In the study sample, 33.2% (95% confidence interval [CI] – 28.8–37.6) of respondents knew nothing about the purposes of medical examination or had incorrect ideas; 65.5% (95% CI – 61.07–69.9). 40.6% (95% CI – 36.03–45.07%) of respondents knew nothing about methods of preventing OH or had incorrect knowledge. Of the 4 screening tests for early diagnosis of certain most common forms of OH, only 2 tests were carried out in the majority of people undergoing clinical examination: examination by a gynecologist with a cytological examination of smears from the cervix - in 83.2% of women; mammography – in 77% of women aged 40–70 years. A stool test for occult blood was performed in only 31% of respondents aged 40–70 years; a full examination to identify visual localizations of OA was performed in 7.8%.

Conclusion. Opportunities for the prevention of OH remain largely unrealized. The results of this study show that clinical examination is carried out in a small part of the population. At the same time, in persons undergoing medical examination, it is rarely performed in full.

Objective. To evaluate the regenerative potential of a bioplastic material (BPM) based on a soluble form of a stabilized extracellular matrix.

Materials and methods. Using light and fluorescence microscopy, we assessed the morphometric characteristics of cells, using flow cytometry and commercial kits, we assessed the expression of cell differentiation markers (CD16, CD14). Modeling of severe thermal burns was carried out on laboratory rats, in accordance with ethical principles (principles of "3R": replacement, reduction, refinement) under general anesthesia to reduce stress and pain.

Results. BPM is a porous film, the sorption capacity of BPM is 3.5 mg/mg. It was found that when co-incubated with human fibroblasts, BPM does not have a cytotoxic effect. It was revealed that the cultivation of BPM by human peripheral blood monocytes (PBMCh) prevents spontaneous activation of PBMCh into a proinflammatory phenotype. In vivo, it was shown that BPM promotes skin restoration in experimental rats after thermal injury.

Conclusion. Wound dressing based on a soluble form of stabilized extracellular matrix inhibits spontaneous activation of monocytes and their differentiation into a proinflammatory phenotype, stimulates the regeneration of tissues damaged by a thermal burn. At the same time, the effectiveness of the biomaterial exceeds therapy using anti-inflammatory ointment.

Objective. To study the efficacy of using an aqueous solution of hydrolyzed collagen in phosphate buffer (drug Compositron) and vitamin D in patients with osteoarthritis (OA) of the knee joint.

Material and methods. The study included 17 patients aged 60 to 70 years with stage II OA and medial meniscus injuries according to magnetic resonance imaging, as well as with deficiency or insufficient level of vitamin D in blood. Patients were prescribed therapy including intra-articular injection of Compositron and vitamin D supplementation (Osteo-Vit D₃).

Results. In patients with OA stage II with medial meniscus damage after the course of treatment there was a decrease of pain syndrome according to the visual analog scale.

The study examines aspects of the formation of nicotine dependence in female smokers of fertile age, as the main factor in the development of chronic obstructive pulmonary disease (COPD). Prolonged tobacco smoking leads to persistent nicotine dependence, changes in respiratory system functionality that lead to earlier development of COPD. The cyclical hormonal background of a fertile woman has its own characteristics. Pregravidarial preparation should assess the possibilities of nicotine dependence correction at the outpatient stage and model motivation to quit smoking in order to prevent the development of COPD, as well as complications during pregnancy in the woman and the fetus.

Purpose. To determine the tactics of treatment and prevention of complications of odontogenic sinusitis in dental patients.

Material and methods. The study involved 40 patients with chronic odontogenic sinusitis, divided into 2 groups depending on the therapy received: 1^st (n = 20) – patients receiving dental and otorhinolaryngological treatment; 2^nd (n = 20) – patients who received only otorhinolaryngological treatment.

Results. It has been established that chronic odontogenic sinusitis in the early period of development is accompanied by significant homeostatic disorders, including clinical (the appearance of toothache, malaise, weakness), laboratory (endogenous intoxication, prolongation of blood clotting time, depression of fibrinolytic activity) and instrumental (inflammatory changes in the maxillary sinuses, communication between a carious cavity and a tooth cavity, etc.). After 1 month of treatment, complete restoration of the structures of the maxillary sinus was observed in 90.0% of patients in group 1, and in 60.0% in group 2. The quality of life in group 1 was assessed in most cases as excellent and good, in group 2 – satisfactory.

Conclusion. Endodontic root canal treatment in the treatment of concomitant odontogenic sinusitis can prevent tooth extraction, reduce the likelihood of using surgical treatment methods, complications and progression of the disease. Thus, an interdisciplinary approach to the treatment of odontogenic sinusitis can increase the effectiveness of treatment.

An original method of treating patients with fractures of the lower wall of the orbit with access through the maxillary sinus and the use of an F- or H-shaped titanium miniplate as a fixation device is presented. A clinical case of the use of transantral access in a patient with a fracture of the lower wall of the orbit is presented.