Objective: to evaluate the role of some indicators of antioxidant system and adipose tissue metabolism in predicting preterm birth in pregnant women with isthmic-cervical insufficiency.

Materials and methods: the study included 117 pregnant women divided in two clinical groups: group I — 57 pregnant women with isthmic-cervical insufficiency, who underwent surgical cerclage, group II — 60 women with a physiological pregnancy. Using enzyme immunoassay, we determined the levels of superoxide dismutase, catalase, ceruloplasmin, leptin, homocysteine, ghrelin, resistin and adiponectin in the blood serum of pregnant women of clinical groups.

Results: it has been established that catalase has the greatest prognostic significance in relation to isthmic-cervical insufficiency on the part of the antioxidant system, and leptin, resistin and homocysteine on the part of adipose tissue metabolism indicators.

Conclusions: determination of the level of some isthmic-cervical insufficiency associated indicators of oxidative stress and lipid metabolism in the first trimester of pregnancy can be successfully used to form a risk group, early prediction and timely prevention of isthmic-cervical insufficiency.

Objective: long-term evaluation of the results of surgical treatment of mixed urinary incontinence in women with pelvic organ prolapse by the Kelly method in its own modification.

Materials and methods: diagnosis and surgical treatment of pelvic organ prolapse and urinary incontinence were performed in 95 women aged 52–60 years. The patients underwent vaginal hysterectomy, anterior and posterior colporraphy, levatoroplasty, and perineoplasty. In order to optimize the surgical treatment of mixed urinary incontinence, urethral plastic surgery was performed using Kelly's method in its own modification. 3 years after the operation, the effectiveness of the operation was evaluated.

Results: the performed surgical treatment improved the quality of life of the patients during the next 3 years of life, since there were no violations of the anatomy of the vagina and bladder. There were good forces of contraction of the pelvic floor muscles, women fully retained urine. The patients are completely satisfied with the results of the operation, are able-bodied and take an active life position.

Conclusions: the proposed technique is a pathogenetically justified method of restoring adequate urination, reduces the number of relapses of the disease, and returns the main functions to the urethra: to retain urine in the bladder and ensure its release to the outside, which increases the effectiveness of surgical treatment and the duration of the positive effect.

In the structure of preterm labor, more than half of the cases occur in late preterm labor. Many aspects of this problem remain unexplored. The article analyzes the literature sources from 2018 to 2023 (domestic and foreign scientific studies, meta-analyses, and systematic reviews) devoted to late premature birth. Risk factors, prognosis, and management strategies for preterm birth in the period from 34 to 36 weeks of pregnancy are considered. Understanding risk factors and predictive capabilities are important to prevent late pregnancy and improve pregnancy outcomes. For ease of use, risk factors and prognostic criteria are summarized in tables with references and OR. Based on the analyzed data, an approximate portrait of a patient with late premature birth was compiled and the value of biochemical markers (PAMG-1 and fibronectin), as well as instrumental methods - cervicometry and elastography ultrasound examination of the cervix, as the most informative predictor tests of the onset of late preterm birth was confirmed. It seems optimal to assess risks using several methods for predicting the onset of premature birth. The information provided in this article allows for a correct assessment of the risks of premature birth, including late delivery, and to determine management tactics based on the use of informative and "fast" tests for threatening deliveries, which will improve their outcomes.

Objective: to study indicators of the quality of life of patients and features of the course of the postoperative period after minimally invasive video-assisted hemithyroidectomy (MIVAH) in comparison with traditional open hemithyroidectomy (OH).

Materials and methods: an analysis of the quality of life and postoperative results was carried out in 92 patients with benign nodular neoplasms of the thyroid gland. The study group included 45 patients who underwent MIVAH. The control group included 47 patients who underwent OH.

Results: pain levels were lower in the MIVAH group throughout the evaluation period. At the same time, the statistical significance of the differences (p<0.05) in the level of pain was noted at 24–-48 hours after the operation. Swallowing disorders were noted by patients less frequently in the MIVAH group (by 14.0% 1 month after surgery and by 8.0% after 6 months). Analysis of quality of life indicators on the SF-36 scale demonstrated that at 1 month after surgery, patients in the MIVAH group had higher values of the Physical Functioning (92.7±10.2 versus 83.1±15.3 points; p<0.05), Role-Physical Functioning (86.1±11.7 versus 63.0±14.8 points; p<0.01) and Social Functioning (82.4±13.9 versus 72.6±14.8 points; p<0.05). 6 months after surgery, all SF-36 scale indicators showed leveling off between the comparison groups.

Conclusions: the MIVAH technique, compared with traditional open surgery, is characterized by an improvement in a number of indicators of the postoperative period. After MIVAH, the quality of life of patients is significantly higher in the early postoperative period, but in the long-term postoperative period, the quality of life shows comparable indicators both after MIVAH and after OH.

Objective is to analyze the clinical outcome of patients with varying degrees of hepatic encephalopathy (HE) on the waiting list for liver transplantation (LT) within one center. Materials and methods are clinical, laboratory and instrumental data of 847 patients from LT. A retrospective clinical and laboratory analysis of patients divided into 5 groups according to the clinical outcome in LT (delisting due to persistent recompensation of liver function, observation on the waiting list, delisting due to patient death, delisting due to orthotopic liver transplantation (OLT), as well as patients observed in the center, but not included in the Treatment data were evaluated and presented depending on the stage of hepatic encephalopathy. A retrospective analysis of the implementation of the organ transplantation program in our center showed that a prerequisite for reducing mortality in LP TP and developing an effective algorithm for monitoring patients from LP TP is the development of criteria for the priority and timeliness of measures to prevent PE, as well as systematic clinical and diagnostic monitoring of patients with various forms of PE in parallel with other manifestations of decompensation of liver function. Timely detection of HE and the urgent implementation of measures that stop PE and prevent its progression is a prerequisite for reducing mortality in LT.

Objective: to improve the results of treatment of patients with complicated intrahepatic portal hypertension by developing optimal surgical treatment tactics and choosing drug correction aimed at preventing thrombotic venous complications.

Materials and methods: 82 patients with clinically significant portal hypertension of cirrhotic origin were examined and treated. The I group consisted of 24 patients who underwent transjugular intrahepatic portosystemic stent bypass surgery, the II group included 58 patients for whom the operation was supplemented with selective embolization of the gastric veins. Methods: clinical and laboratory examination, “Thrombodynamics” test using a “prognostic calculator” (RF patent), surgical, statistical.

Results: it was established that 26,8% of patients had a risk of developing venous thrombotic complications: in group I 4/24 (16,6%), in group II — 18/58 (31,0%). Personalized drug correction carried out in the postoperative period led to the absence of risk in 2/22 (9,1%) patients in group I and in 8/53 (15,1%) in group II. The number of deaths in group I was 2/24 (8,33%) and in group II 5/58 (8,62%). Shunt thrombosis was detected in 3/22 (13,63%) patients of group I and in 1/53 (1,88%) patients of group II in the period from 24 to 32 months after surgery. Varicose esophageal-gastric bleeding occurred in 2/22 (9,00%) patients with shunt thrombosis of group I and in 1/53 (1,88%) of group II patients who underwent endoscopic ligation of esophageal varices.

Conclusion: a method for predicting the risk of developing thrombotic complications in patients with liver cirrhosis is a convenient tool for risk stratification of patients. An individual approach ensures monitoring of the patient not only before, but also after the operation. Drug correction regimens for identifying high, moderate and low risks of complications made it possible to prevent them. TIPS surgery alone and in combination with selective embolization of gastric veins allows achieving comparable results in observation groups against the background of corrective therapy.

Objective: to identify IR indices for diagnosing the GDM subtype.

Materials and methods: carbohydrate metabolism (venous plasma glucose on an empty stomach, oral glucose tolerance test with 75 g of glucose with insulin determination), and lipid metabolism were assessed in 130 pregnant women. The following indices were calculated: HOMA-IR, QUICKI, Matsuda, McAuley, Belfiore, Gutt, Stumvoll, Avignon. According to the Matsuda index, patients were divided into subgroups: Group I — 45 pregnant women with GDM and β-cell dysfunction, Group II — 43 with GDM and IR, group III — 42 without GDM. Statistical processing was carried out using comparative analysis. Data are presented as medians and interquartile ranges of quantitative indicators in groups.

Results: statistically significant differences in the severity of IR were obtained when calculating all indices. When calculating HOMA-IR, patients in group II showed the best results: group I [1.13 (0.85; 1.34)], group II [2.33 (1.76; 4.23)], group III [1.25 (1.01; 2.43)]. When calculating the remaining indices, differences were also revealed that demonstrate heterogeneity. Using the HOMA-B insulin secretion assessment index, it was revealed that patients with GDM without IR had the lowest score, while the results did not differ among other groups: group I [15.3 (11.1; 18.0)], group II [36.9 (19.4; 57.0)], group III [25.9 (20.4; 59.9)].

Conclusion: we studied the features of IR indices in pregnant women with different subtypes of GDM. Indices have been determined that allow differentiating different subtypes of GDM.

Diabetic foot syndrome (DFS) is a dangerous complication of diabetes mellitus. Despite numerous studies dedicated to the wound healing process in patients with diabetic foot syndrome, surgeries in this pathology are often accompanied by surgical suture failure due to insulin therapy and require repeat surgical intervention. The aim of this study is to analyze the biochemical mechanisms involved in the wound healing process in patients with diabetic foot syndrome. To achieve this goal, articles from foreign databases such as PubMed, MedLine, Google Scholar, and the Russian Index of Scientific Citation (RISC) were selected and analyzed for the period from 2017 to 2023. The search was conducted using keywords such as diabetic foot, wound healing, molecular mechanisms, and their Russian equivalents. A total of 74 publications were identified through the literature search, of which 24 literature sources from 2017 to 2023 were included in the review, corresponding to the direction and purpose of the study. In addition, 18 sources older than 2017 were used to reveal the subject of the study from the references in the literature lists. The literature review discusses various factors that influence the wound healing process: the function of the skin barrier, activity of immune system components, as well as the contribution of hypoxia and endothelial dysfunction to tissue regeneration mechanisms in patients with DFS. Despite the available literature data, it is advisable to search for new factors involved in the development mechanisms of DFS to prevent complications and increase the effectiveness of treatment.

Objective: to analyze the incidence of type 1 diabetes mellitus in the Republic of Sakha (Yakutia).

Materials and methods: the article presents a retrospective analysis of the primary and general incidence of type 1 diabetes mellitus in the Republic of Sakha (Yakutia), as well as socio-demographic information, main complications and therapy according to the regional register of diabetes mellitus.

Results: In 2018–2022 in the Republic of Sakha (Yakutia), there is a certain tendency to decrease the general and primary morbidity of the adult population with type 1 diabetes mellitus. The increase in the general and primary morbidity of the child population with type 1 diabetes mellitus in 2021-2022 is especially alarming.

Conclusion: the data of the retrospective analysis clearly define the concept of improving the endocrinological service in the Republic of Sakha (Yakutia) on the basis of clinical and epidemiological monitoring of type 1 diabetes mellitus.

Objective: comparative evaluation of the effectiveness of combined lipid-lowering therapy with rosuvastatin and ezetimibe in fixed and separate combinations with PCSK9 inhibitors in patients with very high cardiovascular risk.

Materials and methods: 65 study participants were divided into 2 groups depending on the method of combined lipid-lowering therapy and were observed for 5 months on 6 visits. The effectiveness of the hypolipidemic response in each of the studied groups was evaluated.

Results: in the group with separate administration of lipid-lowering drugs, the target values of LDL cholesterol reached 50% of patients, the level of LDL cholesterol during 5 months of treatment decreased by 38.22% from 2.25 [1.82; 2.47] mmol/l to 1.39 [1.21; 1.59] mmol/l (p <0.001). In the group with a fixed combination of rosuvastatin and ezetimibe, 61.29% of the study participants reached the target ranges of LDL cholesterol, the concentration of LDL cholesterol decreased by 47.46% from 2.36 [1.92; 2.57] mmol/l to 1.24 [1.18; 1.56] mmol/l (p <0.001). Logistic regression analysis showed a significant association of females with a higher risk of not reaching the target ranges of LDL cholesterol (χ²<0.001; OR 0.13 95 % CI 0.04-0.39; p<0.001).

Conclusion: the use of a fixed combination of rosuvastatin and ezetimibe in combination with PCSK9 inhibitors in patients with very high cardiovascular risk makes it possible to reduce the concentration of LDL cholesterol by 9.24% more intensively relative to the drug regimen with separate administration of drugs.

Objective: studying the influence of various factors on the course and outcomes of COVID-19 in children of different ages, to determine patient management tactics.

Materials and methods: the article presents the results of a retrospective assessment of the course of COVID-19 in 89 children observed in clinics of Samara city. A comparative analysis of the course of COVID-19 and post-COVID in children of different ages was carried out. Statistical analysis was carried out by IBM SPSS Statistica 25, p<0.05 was considered the criterion for significance.

Results: the severity of COVID-19 was independent of age. For children from 3 to 6 years of age, a severe course of ARI in anamnesis mattered, and in the group of children from 7 to 11 years old - compliance with the national calendar of prophylactic vaccinations. Post-COVID had different frequency and duration.  In children older than 7 years old, asthenovegetative syndrome occurred more often and was quickly eliminated. In children aged 3-6 years asthenovegetative and dyspeptic syndromes disappeared during a longer period. 2 - 3 months after recovery from COVID-19, exacerbation of allergic diseases was observed in children over 3 years old. Decrease in immunoresistance occurred one month after recovery in children under 6 years of age.

Conclusions: it is important to take into account the age-related characteristics of the course of COVID-19 and post-COVID to predict the risks of severe COVID-19 and deterioration of the child’s health.

A clinical observation of congenital malformation of the brain in a newborn child is presented. Diagnosis and comprehensive treatment of newborns with such pathology is extremely difficult due to the variety of causes that cause irreversible structural defects of brain tissue in violation of its normal pre- or postnatal development. The uniqueness of this case is the postnatal detection of multiple malformations in a newborn child against the background of a complex clarification of the nature of hereditary metabolic disorders. Unfortunately, in this clinical case, the relatively early diagnosis of peroxisomal pathology did not allow a complete clinical diagnosis to be made quickly and specific therapy to be given to the child, which made the prognosis of the disease more difficult. Only a further in-depth examination (consultations of a geneticist, neurologists, MRI of the brain, medical and genetic research) allowed us to clarify the nature of the pathology. Delayed clarification and confirmation of the cause of encephalomyelopathy (peroxisomal disease) is associated with the material and technical capabilities of children's hospitals, although this did not affect the timing of the start and volume of complex symptomatic therapy for the child.

The article presents the work experience and retrospective analysis of the indicators of the emergency department for children of the "Children's Clinic No. 5" in Ufa for 2023. The average number of calls to emergency services was 3491 calls per year. On average, one doctor in the department handles 10–12 calls per day. However, throughout the year there is an uneven load on the emergency department: in the autumn-winter period the frequency of calls increases to 20–30, in the summer months it decreases to 3–5 calls. The overwhelming majority of calls were made by those aged 3–7 years (35% of cases); teenagers sought emergency help least often (6% of cases). The largest percentage of visits was due to hyperthermic syndrome (43% of cases), obstruction of the upper and lower respiratory tract was recorded in second place (21% of cases), and calls related to pain syndrome were in third place (12%). Analysis of the morbidity structure by nosology demonstrated the following results: the leading pathology (70,2% of cases) was acute respiratory viral infection, the second place was occupied by diseases of the gastrointestinal tract (15,5% of cases). Thus the emergency medical care department contributes to the timely and effective provision of emergency care to children at home, prevents the development of decompensation of body functions, reduces the risk of disability and promotes the health of young citizens of the Russian Federation.

Objective: to study the features of the epidemic process of salmonella infection under current conditions. To establish a causal relationship between the incidence of salmonellosis and the functioning of public catering enterprises, which can form the epidemiological risks.

Materials and methods: to assess the intensity, dynamics and structure of the epidemic process of salmonella infection, methods of operative and retrospective epidemiological analysis used, to identify and characterize etiological agents — laboratory methods: bacteriological, serological, molecular genetic analysis.

Results: in the course of the study, the epidemiological features of the spread of salmonellosis in the Rostov region were established, the main risks which can form multiple foci were determined on the example of a specific epidemic situation: the possible source of infection, pathways and transmission factors, the etiological agent — Salmonella enteritidis gr. O:9 (D1). Gross violations of sanitary legislation in organizing the work of a public catering enterprise caused a wide contamination of finished culinary goods by pathogens of salmonella infection.

Conclusion: based on the identified features of the epidemic process, a complex of measures developed; the focus of infection localized and eliminated. Recommendations for the prevention of salmonellosis for workers in objects of a similar profile and the population are given.

Objective: analysis of the current epizootological and epidemiological situation on anthrax and characteristic of stationary hazardous for this infection areas (SHAs) in the South of Russia.

Materials and methods: we used data on SHAs and anthrax burials from the Rospotrebnadzor Directorates for the subjects of the Southern (SFD) and North Caucasus (NCFD) federal districts, regional Veterinary Directorates, official data from Rospotrebnadzor and Rosselkhoznadzor on morbidity in humans and livestock.

Results: anthrax is almost ubiquitous in the regions of the SFD and NCFD. According to data updated in 2023, in the South of Russia, 3845 SHAs were taken into account, in which 9815 outbreaks were registered. In 1999-2023 92 SHAs showed activity, 23 of which are new. There are 350 anthrax burials located in the SHA’s territories. Over 25 years, there were 104 outbreaks affecting at least 269 livestock and 134 people, with 4 deaths. Human infection occurred mainly during the forced slaughter of sick cattle, unvaccinated against anthrax, through contact with contaminated meat.

Conclusion: the epidemiological and epidemiological situation on anthrax in the South of Russia continues to remain unstable. The problem is due to the presence of a significant number of soil hotspots against the backdrop of incomplete implementation of preventive measures. Stabilization of the anthrax situation can only be achieved by implementing a full range of preventive and anti-epidemic measures in the format of interdepartmental interaction.

Objective: to form a brief overview of data on the interactions of the Rostov-on-Don Anti-plague Research Institute with the other state institutions ensuring the sanitary and epidemiological population wellbeing.

Materials and methods: analysis of archive materials and literature sources from databases and electronic libraries such as E-library, CyberLeninka, etc.

Results: We have described the main directions of the interactions of the Rostov-on-Don Anti-plague Research Institute with the institutions of Rospotrebnadzor (Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing) and the Ministry of Health of the Russian Federation, that have been directed on realization of collaborative studies, planning of cooperative publications, organizing and conducting advisory, methodological and practical assistance. Special attention has been paid to the activities that bring together specialists from both research and educational institutions and practical health-care in the Rostov region.

Conclusion: Coordinated actions of specialists from the Rostov-on-Don Anti Plague Research Institute with the bodies and organizations of Rospotrebnadzor, Ministry of Health of the Russian Federation on improvement of epidemiological surveillance, diagnostics and prevention of infectious diseases allow us to carry out effective surveillance of especially dangerous infections and to promote improvement of professional level of profile specialists.

Objective: to characterize the dynamics and intensity of the incidence of Q fever for the period from 2015 to 2022, to determine the risk areas for human infection in the Southern and North Caucasian Federal districts and in the new subjects of the Russian Federation.

Materials and methods: for epidemiological analysis, materials from analytical reviews "The epidemiological situation of natural focal infectious diseases in the Southern and North Caucasus Federal Districts" and state reports "On the state of sanitary and epidemiological welfare of the population" for 2015-2022, reporting data from the Rospotrebnadzor Department for the Rostov region, «Center for Hygiene and Epidemiology in Russia Rostov region» and the Departments of Rospotrebnadzor for the DPR and LPR. From 2022–2023 PCR study was conducted for the presence of Coxiella burnetii DNA in samples of ixodic mites and small mammals in the Rostov region and in 2023 – in the DPR, LPR, Zaporizhia and Kherson regions.

Results: the analysis of the territorial distribution of cases of Q fever in the Astrakhan region and Stavropol Territory revealed a cluster of the most disadvantaged areas. An analysis of the conditions of infection of patients with Ku fever in the Rostov region has established that the most likely transmission factors are environmental objects in private farms. The circulation of C. burnetii in natural biotopes of the Rostov region, DNR and LNR regions.

Conclusions: the epidemic process of Ku fever is mainly local, limited in the context of municipal districts of Astrakhan and Rostov regions, Stavropol Territory. The sporadic incidence of Ku fever does not reflect its actual level. There is no convincing evidence indicating the leading role of farm animals as a primary link in the formation of the epizootic process of Q fever in anthropurgical foci.

Objective: a hygienic assessment of working conditions and an analysis of the morbidity of aircraft workers.

Materials and methods: the study was carried out on the basis of data from the Office of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being in the Republic of Tatarstan (Tatarstan) and the Center for Occupational Pathology Scientific and Clinical Center for Preventive Medicine of the Institute of Fundamental Medicine and Biology of the Kazan (Volga Region) Federal University.

Results: hygienic monitoring of the working conditions of employees of the aviation plant showed a combined effect of harmful factors of the production environment and the labor process, corresponding to classes 3.1–3.2 in a number of professions. Among the diseases identified in employees of the enterprise, diseases of the eye and its accessory apparatus, circulatory organs and hearing predominate. According to the results of the medical examination, 6.4% of the subjects were found to have a suspicion of occupational chronic bilateral sensorineural hearing loss.

Conclusions: research results indicate that there is a risk of developing occupational pathology as a result of exposure to physical factors. The employer was given recommendations to improve working conditions and preserve the health of workers.