卷 18, 编号 1 (2021)

The article is devoted to an urgent problem - kidney damage in diabetes mellitus. The analysis of Russian and foreign sources of literature on diabetic nephropathy has been carried out. Data on the prevalence of diabetic nephropathy are presented, and the role of individual risk factors for the development and progression of diabetic nephropathy is discussed.

Cervical insufficiency is the main cause of miscarriage in the second trimester of pregnancy (up to 40 %), and in the third trimester occurs in a one third of women with preterm birth. Diagnosis of this pathology is based on the identification of structural changes in the cervix, which determines the impossibility of predicting this pathology before pregnancy. Current morphological studies have shown that connective tissue predominates in the cervix, represented mainly by collagen, which provides up to 85 % of the weight of the cervical tissue, elastin and proteoglycans. A key factor in the development of CI is currently considered a defect in collagen synthesis and the development of cervical incompetence is considered as a manifestation of undifferentiated connective tissue dysplasia. The results of recent studies show that cervical insufficiency is a genetically determined condition and polymorphisms in genes related to the metabolism of connective tissue can play a role in the development of CI.

The article represents the first experience of using stereotaxic radiation therapy in hypofractionational mode and radiosurgery for metastatic brain lesions in the radiotherapy department of the Volgograd Regional Clinical Oncological Dispensary. The study involved 15 patients with secondary metastatic brain lesions by tumors of various localizations. Complete tumor regression was recorded in 4 (27 %) patients. In 10 (67 %) cases, a positive response was noted in the form of a decrease in tumor size from 50 to 20 %. No early radiation complications and deaths were detected during radiation therapy.

Introduction. In emergency surgery, one of the most important problems is to prevent the occurrence of suture failure in the area of surgical intervention. Accordingly, to prevent the development of infection in the area of surgery, it is promising to search for a universal suture material that has a long-lasting antiseptic effect. Materials and methods. The experiment was performed under in vitro and in vivo conditions. The examined samples of suture material were studied on the 1st, 2nd, and 3rd days of the experiment. Results. As a result of in vitro studies, it was found that all the presented samples of sutu re material that have an antiseptic miramistin on their surface have biocidal activity. According to the in vivo study, the greatest antiseptic effect was shown by filaments coated with miramistin at a concentration of 20 % against all strains of microorganisms. Conclusions. The results of the study indicate the prospects of using a suture material coated with miramistin.

Currently, in the clinical practice of a dentist-surgeon, patients with various diseases, anomalies and deformities in the oral cavity are often found. The red lichen planus (CPL) is not an exception. This paper discusses the main features of the course of the disease in the oral cavity and possible approaches to therapeutic tactics in surgical intervention. Thus, patients with CPL have edema, hyperemia, multiple or single nodular rashes on the oral mucosa (SOPR), enlarged and painful lymph nodes, and discoloration of the gums. Among the main complaints are pain and bleeding in the area of the changed SOPR, which aggravates the process of surgical intervention and creates certain difficulties for the dentist-surgeon. Due to the spread of this disease among people from 30 to 60 years old, who often require dental care, clinicians need and need to have knowledge about this pathology.

In this paper, the authors share their observations on the attitude of pediatricians who underwent advanced training during the pandemic of a new coronavirus infection in the framework of distance learning (DL). According to the results of a correspondence survey, 77,7 % of respondents noted that pre-school education can be an auxiliary form for traditional education. Just under a quarter point to the unacceptability of DO in medical schools. During training, doctors faced a difficulty-lack of skills to work with online services (68 %). Of all forms, UP to 71,7 % chose teleconferences. To the question: «How important is the moment of personal communication with the teacher for You?» 69,9 % indicated that it is important, and 30,1 % considered that it is fundamentally important.

The paper shows a comparative assessment of the effect of udenafil (Zidena®, Dong-A Pharmaceutical Co. Ltd., Korea) on the perfusion of healthy and ischemic tissues in critical ischemia of the lower extremities simulated in rats. Formed 4 experimental groups: 1 - intact; 2 - healthy animals with the introduction of udenafil (orally 8,6 mg/kg for 28 days); 3 - animals with ischemia without treatment; 4 - animals with ischemia and monotherapy with udenafil (similar to group 2). On the 21st and 28th days in all groups, the level of blood microcirculation in the leg muscles was recorded. At the same time, 10 animals were withdrawn from the experiment by anesthesia overdose and histological preparations of the leg muscles were prepared. The results obtained showed that udenafil increases regional blood flow both in non-ischemic tissues and in critical ischemia of the lower extremities.

The article presents the results of the examination of young people of conscription age living in Altai Krai. The measurement of anthropometric indicators and further assessment with the application of the indices method were carried out. According to the results of the study, it was revealed that 19-year-old young men of Altai Krai are normosthenics and hypersthenics in the majority, developed harmoniously, with the predominant andromorphic constitution type, with no serious and significant deviations in physical development.

Viral hepatitis is an international public health threat. With the adoption of the UN Assembly Resolution in 2016, the problem of hepatitis no longer remains in the shadows. An important step towards eradicating chronic hepatitis C (CHC) is the introduction of direct-acting antiviral drugs into treatment standards. They appeared in the WHO List of Essential Medicines for the first time since 2014. On the territory of the Russian Federation, the number of registered international nonproprietary names increased in 2014-2020 by 3.5 times and at the time of 2020 it was 10. Direct-acting antiviral drugs were included in the Vital and most Essential Drugs List since 2017 (10 %), and by 2020 this indicator had increased by 7 times. In general, in the Russian Federation since 2017, there has been progress in solving a global problem through the use of more effective drugs, which cannot be said about the regions of our country. So, in the Volgograd region, not a single Direct-acting antiviral drugs of preferential leave for the treatment of CHC on an outpatient basis has been registered.

Analyzed 2 deaths from pathological and forensic practice in order to show that comorbid diseases in young patients in the context of the COVID-19 pandemic increase the risk of an adverse outcome due to the potentiation of the systemic damaging action of the viral agent, decompensation of chronic therapeutic pathology, the development of acute complications and status, possible drug interactions. The management of this category of patients requires knowledge of the characteristics of a viral infection, its clinical manifestations in combination with comorbid diseases.

The article presents clinical and epidemiological characteristics of children 0-16 years old with a laboratory confirmed diagnosis of COVID-19, hospitalized in the state children's infectious clinic in April-August 2020. The diagnosis was verified by nucleic acid amplification: isolation of SARS-CoV-2 RNA by polymerase chain reaction (PCR) from the upper respiratory tract mucosa. The study did not include non-hospitalized patients. The authors highlight some features of the clinical symptoms of the nosology in question in childhood, and show the compliance of therapeutic and diagnostic techniques used in inpatient treatment with the requirements of regulatory documents.

Currently Russia is experiencing a decrease in the birth rate, the number of women of fertile age. The statistics on the decrease in abortions is not objective since a certain portion of abortions made at private clinics remain unrecorded. Risky sexual behavior of young people, their lack of awareness of the consequences of abortion and modern methods of contraception have a negative impact on the nation's reproductive potential. The paper presents findings of a questionnaire survey of medical students on reproductive behavior, complications of abortions, and contraception.

In connection with the spread of the new coronavirus infection, the number of the oral mucosa diseases caused by COVID-19 is also growing. Effective diagnosis and rational pharmacotherapy of the oral mucosa pathology caused by COVID-19 is actual problem for dentists. In this work, on the basis of clinical and laboratory methods, diagnostics and treatment of the oral mucosa diseases were carried out in 43 patients who had previously undergone COVID-19. Oral examination results in patients with COVID-19 show a variety of oral manifestations. The obtained data substantiate the necessity and advisability of including a dental examination in this category of patients after their clinical recovery.

The purpose of the study. To study and analyze the epidemiological situation of malaria in children in the Astrakhan region for 1996-2020. Materials and methods. Epidemiological maps of individuals malaria cases (n'164 epidcards), reporting forms of FBHI «Center for Hygiene and Epidemiology in Astrakhan Region» (form 2) for 1998-2020 (25 documents), the journal of the population survey on malaria (18 journals), as well as microreparates with malaria «fat» and «thin ointment» (82 drugs). Results of the study. The largest number of cases of malaria were reported in 1999 and 2000. In these years, cases of three-day malaria were recorded, except in 2000, when in 1 case four-day malaria was recorded. In the previous 2008 and other years, only three-day malaria cases were reported. Most often, malaria was registered in children aged 2, 13 and 15 years. Thus, in children aged 2 and 15 years, malaria was registered in 12,2 % (5 people each), and at the age of 13 years - in 17,1 % (7 people). In children of other ages, cases of malaria were recorded in isolated cases. In most cases, imported cases of malaria were recorded -90,2 % (37 people). The import of malaria to the Astrakhan region was mainly carried out from Azerbaijan - 86,5 % (32 people), also from Tajikistan - 8,1 % (3 people), Armenia and Uzbekistan - 2,7 % each (1 person). In all cases, only three-day malaria was recorded. The clinical diagnosis of «Malaria» was made on the basis of a laboratory blood test - the preparations «thick» drop and «thin» smear and confirmed by employees of the Laboratory of Bacteriological and parasitological studies of the Federal Budgetary Healthcare Institution «Center for Hygiene and Epidemiology in the Astrakhan region». Conclusions. In recent years, the Astrakhan region has seen a decrease in the number of cases of imported malaria not only among children, but also among the adult population. Malaria was imported to the Astrakhan region mainly from Azerbaijan. Cases of malaria in children were reported most often from April to July, when the optimal temperature for malaria transmission is maintained in malaria-endemic countries. Detection of a case of malaria in a child in March 2008 indicates a long incubation of P. vivax (+24-25 °C for 10-11 days) in the fall of 2007.

For the substance under the code DAB-21, a pronounced neuropsychotropic potential was previously shown. In this study, possible directions of the influence of the studied substance on basic mediator systems of the CNS are considered. According to the results of the study, a benzodiazepine-like effect of DAB-21 was found in the «Elevated plus maze» test with flumazenil, as well as potentiation of the effects of phenamine, and some serotoninergic effect in the test with 5-GTP, and a weak a2-adrenoblocking effect, revealed using the «Clofelinic hypothermia» test. There was also a D2-activating effect according to the haloperidol test, a weak M-anticholinergic effect in the arecoline test. Some MAO-inhibitory effect was found, suggested by antagonism with reserpine, as well as the results of the L-DOPA test. The compound did not interact with nicotine and apomorphine. The neurotransmitter profile of the compound DAB-21 is of interest for further study and clarification of the mechanism of action of the substance.

The article describes clinical examples of hemorrhagic rash in children of various genesis, taken from the outpatient practice of a pediatric hematologist. The presented clinical cases reflect the variety of causes of hemorrhagic rashes in children.

The article presents a survey of clinical, epidemiological and laboratory features of the modern course of influenza among elderly patients. The article demonstrates the dominance of typical moderate and severe forms of the subtype A(H1N1) influenza among unvaccinated elderly patients taking into account of concomitant chronic cardiovascular, bronchopulmonary and endocrine diseases, in conditions of untimely hospitalization.

The article presents a clinical case of dysplastic march in a child with non-hereditary connective tissue dysplasia.

In the dental clinic GAUZ KSP No. 10, Volgograd examined 80 patients who applied for dental care at the age of 25-30 years. Before and after the dental appointment, blood pressure - systolic (SD), diastolic (DD), pulse rate (HR), and respiratory rate (RR) were measured. The indirect method of Star (1954) was used to calculate the minute volume of blood circulation (MVC), according to the formula of F. Poiseuille (1839), peripheral vascular resistance (PSS) was determined, according to the formula of N.N. Savitsky (1974) calculated the average hemodynamic pressure of the SRS. The vegetative status was calculated according to the values of the Kerdo vegetative index (VI). The patients were divided into 3 groups, depending on the type of ANS, sympathotonics in 36 patients (including 25 men and 11 women), normotonics 18 people (8 men and 10 women), vagotonics 26 people (5 men and 21 women). During a dental appointment, patients with a symptomatic type of autonomic regulation had high blood pressure (SD, DD), PD, and heart rate, IOC, SRS. With the vagotonic and normotonic type of autonomic regulation, DM and DD were within the normal range, but before taking the numbers were higher than after it. Analysis of hemodynamic parameters in patients during a visit to the dentist made it possible to identify the features of regulation and mechanisms of tension of adaptive capabilities depending on the type of the autonomic nervous system.

Smile-expressive movements of facial muscles accompanying emotions, showing a disposition to laugh and expressing pleasure, greeting, joy, goodwill, emotion, irony, disdain, ridicule, suffering. Currently, the design of a smile is quite relevant direction not only in image-making, but also in aesthetic medicine and dentistry. Nowadays, people have become more demanding about their appearance. Modern people want to have a beautiful, healthy smile. Demand creates supply. Not so long ago, aesthetic dentistry entered the dental practice as a science at the intersection of dental specialties. A relatively new direction that deals with aesthetic issues through a comprehensive, consistent approach. This article describes a harmonious smile, the factors that make up a harmonious smile, from the perspective of aesthetic dentistry. A detailed analysis of the shape of the face is carried out, and the main landmarks that should be paid attention to when determining the parameters of the face are described. Dental rows, parallelism of key lines, analysis of the gingival edge in normal and pathological conditions are described. Based on these parameters, the dentist can determine the factors of a harmonious smile, their pathology in order to make a further treatment plan in order to make the patient's smile beautiful and happy.