Perm Medical Journal

Objective. To carry out twenty-year analysis of dynamics of antibiotic sensitivity of coagulase-negative staphylococcal strains isolated from surgical hospital patients.

Materials and methods. The antibiotic sensitivity of 191 strains of coagulase-negative staphylococci isolated in 2004, 2014, 2023 year from surgical hospital patients was studied with the disk diffusion method.

Results. A significant increase in the proportion of strains resistant to all antibiotics known, especially ciprofloxacin, was found.

Сonclusion. A twenty-year analysis of the dynamics of antibiotic sensitivity showed a significant increase of antibiotic resistance of coagulase-negative staphylococcus strains isolated from surgical patients.

Objective. To determine a list of psychological characteristics associated with the prognosis of prostate cancer outcome and rehabilitation potential in patients with cancer.

Materials and methods. The study of psychological characteristics (subjective and personal characteristics of study participants (n = 148)) associated with rehabilitation potential was carried out using the following psychological methods: Methodology of Subjective Control Level (E.F. Bazhin, E.A. Golynkina, L.M. Etkind), Questionnaire of ways to cope (adapted by T.L. Kryukova, E.V. Kuftyak, M.S. Zamyshlyaeva), Questionnaire SF-36 “Assessment of the quality of life”, Test of vitality (adapted by D.A. Leontiev, E.I. Rasskazova), Basic Beliefs Scale (adapted by M.A. Padun, A.V. Kotelnikova).

Results. A favorable prognosis for the outcome of prostate cancer is associated with the patient`s involvement in the events of his life and active participation in them, understanding of the significance of the problem, partial independence from others, slight limitation of role functioning due to the emotional state, optimal social functioning in combination with beliefs about the benevolence of the world around him and ability to control events.

Conclusions. A list of psychological characteristics associated with the course of the disease in patients with prostate cancer was obtained. These psychological characteristics can define the rehabilitation potential, being associated with the possibilities of recovery after antitumor treatment.

The current literature data on the etiology and pathogenesis of schizophrenia were analyzed. The research method is the analysis of scientific papers on this problem over the past 5 years, presented in the databases of eLibrary, National Library of Medicine and electronic versions of the journals “World Psychiatry Journal”, “The Lancet Psychiatry”, “Schizophrenia Bulletin” and others. Genetic, neurotransmitter, psycho-traumatic, sociocultural and other theories of the origin and development of schizophrenia are analyzed in the review. Schizophrenia is a disease difficult to verify and genetically determined. According to modern theories, the occurrence of schizophrenia and the appearance of symptoms can be influenced by metabolic disorders of neurotransmitters, psycho-traumatic factors, socio-cultural aspects of human life, while the anatomical subcortical structures of the brain are damaged.

To analyze affective-somatoform (dysphoric) disorders specific to epilepsy.

Dysphoric disorders can be divided into 3 groups: “periictal” disorders, interictal dysphoric disorder and alternative affective-somatoform syndromes. There are 3 groups of risk factors for affective disorders in epilepsy including depressive and dysphoric: those associated with the disease, those associated with the treatment and those associated with psychosocial aspects. Treatment for depression in epilepsy includes medication and psychotherapy. At the first stage of drug therapy, anticonvulsants are corrected, and at the second, an antidepressant is added. Cognitive behavioral therapy is the most effective method of psychotherapy.

Dysphoric disorders in epilepsy are presented by a wide range of conditions, both paroxysmal and non-paroxysmal, and have their own classification and development factors, which must be taken into account when choosing adequate therapy.

Objective. To improve the results of surgical treatment of Peyronie's disease.

Materials and methods. 20 patients with Peyronie's disease aged 22 to 60 were treated in the urological departments of the Private Clinical Hospital “Russian Railways Medicine” and Astrakhan City Clinical Hospital No. 3 named after. C.M. Kirov. A method of surgical treatment of Peyronie's disease using a shortening technique without opening the tunica albuginea includes the application of a pressure tourniquet to the base of the penis, puncture of the cavernous bodies, injection of sterile saline into them until an erection is achieved, determination of the angle of curvature of the penis, removal of the tourniquet and surgery to eliminate curvature of the penis.

Results. Neither postoperative complications nor formation of hematomas were observed. The patients were discharged on the 4th day in satisfactory condition. 1.5 years` observation showed no progression of angular deformation of the penis which could impede sexual intercourse. The mobility of the skin of the penis was preserved.

Conclusions. In addition to the correction of penile deformity, our method eliminates the need for extensive incisions and preserves the physiological functions of the penis. As a result of using this surgical method, the following goals are achieved: minimal trauma to tissues in the surgical area, absence of scar processes in the plastic area and preservation of the skin of the penis mobility, absence of pronounced postoperative tissue edema, no need to drain the wound, reduction of the duration of the operation and minimal blood loss, short postoperative and rehabilitation period.

Objective. To determine the differences in the degree of tooth mobility in elderly patients with various types of dentition defects. To establish and differentiate the degree of tooth mobility in relation to the type of dentition defect in elderly and senile patients.

Materials and methods. 500 patients aged 60 to 75 divided into 4 groups were examined. In the first group of patients, terminal defects were revealed (on one or both sides). The second group consisted of patients with included defects (on one or both sides). The third group was presented by combined defects (included and not included). Patients with single standing teeth constituted the fourth group. Patients with complete absence of teeth were excluded from the study. The assessment of dental mobility was carried out using the Periodotest device. All studies on dental mobility were conducted as part of the initial examination of the patient. To obtain objective data, periotestometry was performed 2 times in each patient. Average periotestometry data were calculated for each patient. The average readings of periotestometry for different groups of patients were determined.

Results. On the basis of the data obtained while comparing the results of periotestometry, in relation to the type of dentition defect, statistically significant differences were established (p < 0.001) (method used: the Kraskel – Wallis criteria). The results of periotestometry obtained in patients of group 4 were significantly higher than in representatives of other examined groups. The least mobility according to the results of periotestometry was observed in groups 2 and 3.

Conclusions. The study revealed significant differences in the degree of tooth mobility in relation to the type of dentition defect. In patients with single standing teeth, 2–3 degree of their mobility was determined, while patients with included defects had 1–2 degree of the mobility of existing teeth. The obtained data of periotestometry indicate the need to use unloading dentures in elderly patients, in order to preserve the remaining teeth in patients with single-standing teeth, as well as in patients with terminal defects of the dentition.

Objective. To assess the relevance of immunomodulatory therapy of precancerous diseases of the cervix among medical professionals and students. Precancerous diseases of the cervix combine pathological processes characterized by the structural changes in the epithelium of the cervix. If not treated, they lead to the development of cervical cancer. At present there are no selective drugs for the human papillomavirus. To administer immunotropic medicines it is necessary to know the mechanism of effect on the immune system.

Materials and methods. The study was conducted using an anonymous online questionnaire on the Google Forms platform (https://vk.com/away.php?utf=1&to=https%3A%2F%2Fforms.gle%2FRtT7PktnCrLqBB1x8). The questionnaire is presented as part of a one-stage (cross-sectional) study. Data analysis was carried out using Microsoft Excel 2010 graphs and tables. Empirical, sociological and statistical research methods were used. The indicators of the structure of the respondents were calculated, the reliability of the differences was determined by the Student's t-criterion, confidence differences were considered at significance of p < 0.05.

Results. The average age of the respondents was 30.4 ± 10.8 years. 46 people (75.4 %) are aware of the possibility of using immunomodulation as therapy for precancerous diseases of the cervix, and 15 people (24.6 %) are not aware of it. 41 respondents (67.2 %) would administer the therapy themselves and their close people; 12 people (19.7 %) find it difficult to answer; 8 respondents (13.1 %) do not agree to administer the therapy.

Conclusions. Medical students have an idea about immunomodulatory therapy in gynecology in 55.9 % of cases. Doctors of different specialties in 100 % of cases are aware of the treatment, see the benefits of prescribing drugs. Students` awareness of the possibilities of immunomodulatory therapy is sufficient, they get additional knowledge from clinical recommendations on the specialty in the practical course.

To study the clinical features and course of urolithiasis in a young female patient, to suggest the cause of the simultaneous sudden formation of kidney stones in the patient and her mother within a year.

Main provisions: urolithiasis (KSD) is one of the most common diseases of the urinary tract. The relevance of effective treatment of this problem arises from the steady increase in the number of patients around the world, especially in Russia. According to many researchers, this trend is due to the increase in life expectancy, changes in lifestyle and nutrition, as well as changes in the composition of water and climate conditions. Approximately two thirds of patients, develop the disease at the age from 30 to 60. Characteristic features of urolithiasis are repeated recurrence and a high incidence of complex forms, which complicates the treatment of such patients significantly.

Diagnostic algorithm and treatment of urolithiasis are demonstrated in this article on the example of a medical history of a young patient with rapidly progressing urolithiasis.

A similar disease with the same symptoms of urolithiasis was revealed in the patient’s parent a week later, which suggests a hereditary predisposition factor or manifestation of urolithiasis being dependent on the hard drinking water.

The simultaneous sudden formation of kidney stones within a year in a patient at a young age and her mother emphasizes the hereditary nature of the disease. Probably, the peculiarities of national cuisine or the individual preferences of patients played a significant role in the development of the pathology. The composition of drinking water is extremely important. The patient is from the Republic of Bashkortostan, where water hardness is 7.8–8.0, which does not meet the standard.

Objective. To give a comparative evaluation of the effectiveness and safety of acne treatment with systemic isotretinoin in monotherapy and together with combined oral contraceptives in women.

Materials and methods. 65 women with severe papulo-pustular acne took part in the study. They were divided into two groups: group I consisted of 35 women who used systemic isotretinoin for acne in monotherapy; group II included 30 women who took systemic isotretinoin together with combined oral contraceptives. A comprehensive clinical and laboratory study was conducted. The study included a biochemical blood test to determine the lipid profile, liver transaminases, and hormonal homeostasis. The obtained results were analyzed using the methods of parametric and nonparametric statistics, the standard error (m) was used in the calculations, the level of statistical significance was noted at p < 0.05.

Results. In women treated for acne with systemic isotretinoin in monotherapy relief occurs in 4 weeks, and complete clinical recovery in 24 weeks after the beginning of therapy; when using systemic isotretinoin together with combined oral contraceptives, relief is determined in 2 weeks, and complete clinical recovery in 16 weeks of treatment. The main side effects of systemic isotretinoin were cheilitis, skin xerosis, retinoic dermatitis and telogen alopecia. Cheilitis was revealed in the majority of patients in both groups equally. Xerosis of the skin, retinoic dermatitis and telogen alopecia were more often observed in the 1^st group. In women of the 1^st group, the level of progesterone was significantly higher and the level of estradiol was lower than in women of the 2^nd group.

Conclusions. Systemic isotretinoin has shown high efficacy and safety in treatment for acne in women. Combined oral contraceptives normalize hormonal homeostasis, which helps to eliminate acne. When using systemic isotretinoin in combination with combined oral contraceptives, the main clinical effect occurs earlier, and adverse reactions are less frequent and less severe than in monotherapy. The combined use of systemic isotretinoin and combined oral contraceptives is the optimal method of acne treatment in women.

The life and professional path of Alexander Alekseevich Shutov, the Doctor of Medical Sciences, Professor, the head of the Department of Neurology and Medical Genetics of E.A. Vagner Perm State Medical University, are described in the article, as well as his scientific achievements, contribution to the organization of the university’s work, success in training of scientists, educators and neurologists of the Perm Region.