Volgograd Journal of Medical Research

The relevance of the study is determined by the fact that there is currently insufficient information covering the entire range of stages of training and adaptation of young surgeons in medical organizations using the mentorship institute. Purpose: To develop and justify the implementation of the mentorship institute in surgical departments in order to improve the professional adaptation of young specialists and the quality of surgical care. Material and methods: A prospective comparative study was conducted using the method of random distribution of participants between groups. The study included 232 surgeon doctors working in state medical institutions in Volgograd. The groups were formed taking into account the participation of young surgeon doctors in the mentoring program. The analysis used methods of questioning and interviewing, observation, expert assessment, and testing of the study participants. Results and discussion: The study found that after completing the mentorship program, young doctors in the first group (n = 84) showed a significantly lower level of anxiety (32.1 ± 5.3) compared to the control group (n = 83) (47 ± 5.2), performed more independent surgeries (1 980 vs. 1 766), and worked more effectively as a team. They also used endoscopic methods and telemedicine more actively (1004 consultations and 986 consults vs. 301 and 542). Training in practical surgical skills is accelerated by 33.0 %, the average operation time is reduced by 15 minutes, diagnostic and management errors are reduced by 72.0 %, complications are reduced by 68.0 %, the hospital stay is reduced by 2 days, and patient satisfaction is increased by 13.0 %. Staff turnover is lower by 3.7 %. Conclusion: The conducted study proved the effectiveness of the mentoring program in developing the professional skills of young surgeons. The results of the study can be used by healthcare managers and heads of surgical services in practical activities, when conducting thematic master classes to improve the quality of medical care, in the educational process at the departments of the surgical profile and in the lecture course at the Department of Public Health and Healthcare of the Institute of Continuing Medical and Pharmaceutical Education of VolgSMU.

The digital transformation of healthcare is an urgent necessity, the key instrument of which is the creation of a unified medical information and analytical system. The relevance of the study is due to the fragmentation of existing IT-solutions in the industry, which reduces the effectiveness of interaction between institutions and the quality of medical care. Purpose: The study of the current state of the implementation of information systems in public medical organizations and the analysis of the regulatory framework for the digital transformation of healthcare in St. Petersburg. Materials and methods: The research material was data on the implementation of medical information systems in 241 medical organizations in St. Petersburg of federal and municipal ownership. Descriptive statistics, comparative analysis, and visualization methods were used to process the data, with an emphasis on the structure and prevalence of various systems. Results and discussion: The study revealed the use of 15 major information systems with a high degree of heterogeneity. The most common systems are Ariadna (31.5 % of institutions), WEB-polyclinic (16.2 %) and SP Samson (14.1 %). At the same time, a significant number of systems are used by individual institutions (0.4 % each), which indicates a pronounced fragmentation of the IT infrastructure. Conclusion: The analysis confirms the need to consolidate disparate information systems into a single digital platform as part of the implementation of national projects ("National Digital Platform "Health"). Successful digital transformation of the region's healthcare requires an in-depth analysis of the economic indicators and clinical effectiveness of the systems being implemented, improving the digital literacy of medical professionals, and ensuring the integration of existing information systems. This will create an integrated digital platform for improving the effectiveness of medical care.

The problem of antibiotic-resistant bacteria poses serious challenges for modern surgical dentistry, particularly in preventing purulent complications after the removal of impacted lower third molars. In response to this challenge, bacteriophages are being actively studied worldwide as one of the most promising solutions. Bacteriophages have the potential to effectively eliminate antibiotic-resistant bacteria, demonstrate a high safety profile, and offer a wide range of therapeutic applications. Purpose: Determination of the effect of complex antibiotic and phagotherapy on local immunity indicators in patients who underwent extraction of retained lower third molars. Materials and methods: The study involved 60 patients with retained lower third molars. After surgery, the patients were randomized into two groups: the first group (30 patients) received antibiotics to prevent complications, while the second group (30 patients) received a combination of antibiotics and polyvalent pyobacteriophage. To assess the dynamics of the immune response in the oral cavity, the levels of pro-inflammatory and anti-inflammatory cytokines, as well as immunoglobulins of classes A, G, and M, were measured before and 10 days after surgery. The obtained results were processed in accordance with medical statistics requirements using nonparametric analysis methods. Quantitative variables were assessed using the Mann-Whitney U-test (for independent samples) or the Wilcoxon T-test for connected samples. Differences between groups were considered significant at p < 0.05. Results and discussion: The study revealed a decrease in the activity of inflammatory processes, which is confirmed by a decrease in the concentration of IL-1β and TNF in the oral fluid. At the same time, there was an increase in the anti-inflammatory response, which is manifested in an increase in the level of IL-10, as well as an activation of humoral immunity, which is expressed in an increase in the levels of IgA, IgG, and IgM. Conclusion: The obtained data indicate that the inclusion of bacteriophages in the therapeutic protocol of the postoperative period contributes to the positive modulation of the immune response in patients, demonstrating the beneficial effect of phage therapy on the immunological status in the postoperative period.

The variability of the shape and size of the Turkish saddle of the human sphenoid bone determines the relevance of the study, both from the point of view of morphology and clinical dentistry. Purpose: To determine the main variants of the shape and size of the Turkish saddle and to evaluate their significance in clinical diagnostic practice based on the analysis of lateral telerentgenograms. Materials and methods: 112 archived telerentgenograms images of young patients were analyzed. The study was retrospective and stratified. Generally accepted point landmarks were installed along all contours of the Turkish saddle, allowing measurements to be made in the sagittal and vertical directions. The modulus and index of the Turkish saddle were calculated, which made it possible to distribute the analyzed material into 3 groups. Results and discussion: The maximum height of the bone structure of the Turkish saddle was 11.8 mm, and the minimum was 6.09 mm. The front-rear size of the Turkish saddle ranged from 9.32 to 13.44 mm. The size of the entrance to the Turkish saddle ranged from 6.22 to 14.2 mm. Conclusion: The X-ray anatomical features of the Turkish sphenoid saddle are determined by its typological features. The basis for distinguishing the types of Turkish saddle can be the value of the index, determined by the ratio of height to sagittal size. With an index value from 0.67 to 0.87 c. u., the Turkish saddle can be classified as an average type. An increase of more than 0.88 indicates a high type of Turkish saddle, while a decrease (less than 0.66) indicates a low and wide type of Turkish saddle. The variability of the shape and size of the Turkish saddle can be used in clinical practice when analyzing lateral telerentgenograms to determine the most stable and well-projected point landmarks on the contours of the Turkish saddle.

The air basin is the most important part of the environment, largely determining its quality and the degree of potential danger to public health. Benz(a)pyrene belongs, on the one hand, to the most common aeroplutants, and on the other, to the most toxic air pollutants, especially in technogenic regions such as Donbass. Purpose: To establish the current patterns of distribution of this xenobiotic in the air environment of cities in the Donetsk industrial region. Materials and methods: With the help of sanitary-hygienic and medical-statistical research methods for a 36-year time period (1985–2020), the potential of technogenic pollution of the atmosphere with benz(a)pyrene was determined, the features of its average long-term content in the atmospheric air of the eight largest cities of Donbass, as well as the patterns of long-term dynamics of this indicator. Results and discussion: The data obtained in the course of this study reflect the impact of hygienic features of industrial development and the main sources of technogenic release of BP into the air basin on the content of the analyzed xenobiotic in the atmosphere of populated areas, which is consistent with the results of other researchers who noted an increase in atmospheric concentrations of BP as the amount of hydrocarbon fuel burned increased in industrial enterprises and in heating systems of utilities. The greatest potential for technogenic pollution of the WS air basin is established in the largest industrial-urban agglomerations of the Central Donbass, in the structure of atmospheric emissions of which the maximum specific gravity (39.3–85.5 %), belongs to industries based on the combustion of large amounts of hydrocarbon fuel (ferrous metallurgy, chemistry, coke chemistry). Conclusion: The results obtained will further optimize the scheme of socio-hygienic monitoring, reduce the degree of contamination of the air environment by the studied aeroplutant and, thereby, reduce the carcinogenic load on the population of Central Donbass.

One of the complex and urgent problems in modern Russia is the preservation of the health of the working population, including medical professionals, and the prevention of professional burnout, which can lead to decreased productivity and professional longevity. Рurpose: Тo analyze the main risk factors for the formation of professional emotional burnout of medical workers, including doctors of multidisciplinary polyclinics in modern conditions. Materials and methods: Sanitary-statistical, socio-hygienic, sanitary-epidemiological, and mathematical-statistical methods were used. To assess the signs of professional emotional burnout (PEB) in polyclinic doctors, a questionnaire was conducted using a traditional method with a standardized questionnaire based on the MBI test (K. Maslach, S. Jackson, adapted by N. E. Vodopyanova). The study involved 173 surgical doctors from polyclinics in Volgograd. The observation groups were formed based on the doctors' work experience through interviews. The data of a special assessment of working conditions were used to characterize the hygienic factors of the working environment and the work process of doctors in multidisciplinary polyclinics. Results and discussion: The dynamics of the prevalence of PEV among medical workers for the period 1980–2026 was analyzed, which allowed to identify 3 peaks of the increase in the prevalence of PEV among doctors: 2017–2018, 2019–2020, 2023–2024. The prevalence of professional emotional burnout among doctors of the surgical profile of multidisciplinary polyclinics of the city of Volgograd was analyzed. The features of the manifestations of PEV in doctors with different work experience were revealed: less than 5 years, 5–10 years, 10–15 years, 15–25 years, more than 25 years. The determinants of the formation of PEV were considered, and a formalized model was formed. The main controllable factors of the formation of PEV in healthcare workers, including doctors of multidisciplinary polyclinics, were identified. Conclusion: A high prevalence of emotional burnout was identified among doctors of multidisciplinary polyclinics, which is largely determined by the intensity of the work process. A possible confirmation of the significance of this factor is the sharp increase in cases of PEC among doctors against the backdrop of active digital transformation of the healthcare system (2017–2018), work in the context of the COVID-19 pandemic (2019–2020), and the modernization of primary healthcare (2023–2024). Special attention should be paid to doctors with up to 5 years and 20–25 years of experience when identifying PEC. Due to the ambiguity of the prevalence of PEB in different seniority groups, it is advisable to consider the entire complex of factors presented in the formalized model of determinants of professional emotional burnout of medical workers when assessing the risk of developing PEB.