Vol 12, No 1 (2023): Материалы XVII Международной научно-практической конференции молодых ученых-медиков

This article is devoted to the analysis of the process of self-preparation of medical students for practical classes in histology, embryology and cytology, which is one of the key learning stages that determine the quality of their knowledge. The paper proposes ways and technologies to improve the effectiveness of teaching aids, which will offer several types of activities with educational material, from the simplest forms, such as watching a video lecture, to the most complex - solving clinical problems on the topic. The purpose of this study was to analyze ways to improve the effectiveness of the educational process with medical students in the study of morphological disciplines.

Connective tissue pathologies are diseases of a multifactorial nature, the manifestation of which is due to the presence of a genetic predisposition and external factors. Among the latter, an important role is played by the intake of organic and inorganic substances in the body. With a deficiency of certain groups of nutrients, the functional activity of enzymes and the structure of connective tissue are disrupted. This article discusses the influence of organic and inorganic substances included in the diet of students of the Kirov State Medical University on the manifestation of connective tissue pathology.

This article provides an analysis of the histories of patients of the Kursk City Hospital No. 3 who have arterial hypertension. The most common risk factors that contribute to the development of arterial hypertension in the human body were studied. As a result of the analysis, the following risk factors were identified in patients: 60% of patients were male; 56.6% of patients with arterial hypertension led a sedentary or sedentary lifestyle; relatives of 50% of patients had early cardiovascular diseases, as well as a burdened family history; 43.3% of patients were overweight (suffered from abdominal obesity); total cholesterol in 36.6% of patients with hypertension was elevated, among all patients 33.3% of women were menopausal, smoking was abused by 30% of patients and also, 30% of patients had elevated glucose levels (glucose tolerance was impaired). The study showed that the severity of risk factors was observed in people with arterial hypertension. To reduce the incidence of hypertension, as well as timely treatment of the disease, it is necessary to monitor people belonging to risk groups.

This article touches upon an urgent issue that unites medicine and law – the question of the legal foundations of the relationship between a doctor and a patient. In general, it is possible to analyze this issue only thanks to the introduction of the questionnaire method into this study. It is in connection with this fact that the article analyzes the results of an anonymous survey conducted to collect the necessary statistical data that make it possible to understand how acute this problem is in modern society. As part of this survey, its participants were asked questions to find out the main age group of the respondents and the gender-predominant group, questions to find out their social status, questions that were asked separately to the group representing the students (to understand which course of study the majority of respondents are in). A further set of questions that were asked to the respondents made it possible to fully determine the respondents' attitude to this problem, since thanks to these questions it was possible to find out which part of the survey participants had conflicts with doctors, what reasons they see in these conflicts and how conflict situations can be prevented. 

The problem of insomnia and its prevention is relevant in modern reality for people of all ages, including young people. Features of insomnia were studied in 155 students of Tver universities aged 18-26 years: 95 students of Tver Medical University (TvG-MU) and 60 students of Tver Technical University (TvSTU) using an original questionnaire that allows you to evaluate and compare the quality and quantity sleep.
An analysis of the results of a survey of medical students and programmers showed a high frequency of their dissatisfaction with the quality of sleep and high risks of developing insomnia due to the short duration of night sleep, late falling asleep and early rising. TvSTU students are characterized by late falling asleep and high labor activity at night, which negatively affects the quality of sleep, morning and afternoon activity. The students of the TV State Medical University had an earlier going to sleep and a greater susceptibility of its quality to the manifestations of stressful events, which can be explained, on the one hand, by their better professional awareness of the negative consequences of sleep deficiency, and on the other hand, by the peculiarities of learning with an emphasis on memorization of information and awareness of personal responsibility for the result.

The experiments were performed on male Wistar rats with a body weight of 180-240g, age 3 months, which were divided into two groups depending on the conditions of modeling chronic alcohol intoxication (CAI). The absolute number of erythrocytes (RBC; ×1012/l) and hemoglobin (HGB; g/l) was studied using the MicroCC-20Plus hematological analyzer. Analysis of the results of the study showed a significant decrease in the absolute number of red blood cells and hemoglobin levels in experimental rats compared with the control group, which indicates the development of anemic syndrome regardless of the conditions of CAI. At the same time, our study showed that the absolute number of erythrocytes in the CAI group 10% -30 is significantly lower than in animals in the conditions of CAI 40%-30 (p < 0.05).  Comparison of hemoglobin values between the groups of CAI 10%-30 and CAI 40%-30 did not reveal significant differences, which indicates the influence of the volume of ethanol-containing liquid consumption on the development of pathological changes in red blood cells.   It was found that the severity of the damaging effects of ethanol on red blood cells in conditions of chronic alcohol intoxication is due not only to the concentration, but also to the volume of ethanol-containing liquid, as well as the alcohol consumption regime.   

There is a need to develop tools to help route and prioritize patients for intensive chemotherapy. Objective: In this work, the development and evaluation of machine learning algorithms for predicting the mortality of hematological patients was carried out. Materials and methods: a database from medical electronic records of inpatients for 2018–2019 was used. A comparative analysis of several classification algorithms was carried out. The accuracy of the model on the test dataset was assessed using the ROC area under the curve parameter (AUC, ROC). Results: The study included data from 1278 patients with leukemia, logistic regression and random forest models demonstrated AUC=0.68. Conclusions: To improve the diagnostic accuracy metrics, it is necessary to increase the size of the training data set. Assessment of in-hospital mortality at the time of admission may be useful to hematologists in identifying patients at high risk of death.

Physical inactivity is a risk factor for the development of a large number of chronic diseases and pathological conditions. In addition, it provokes the development of obesity, which worsens the course of these diseases. Physical activity fights these manifestations, healing the body. Therefore, a study was conducted to determine the contribution of sports to maintaining normal body weight and well-being in students. The materials and methods were a survey of medical students, taking into account the data of their anthropometry and well-being. Students were divided into 2 groups depending on the frequency of sports activities. Group I - physical activity 2 times a week and more often, Group II - less than 2 times a week. The significance of the difference between these samples was assessed by Student's t-test. As a result, it was found that the body mass index is more stable in those students who go in for sports at least 2 times a week. Well-being also correlates with this factor. Thus, we can conclude that, indeed, to maintain a normal body weight, it is necessary to engage in physical activity at least 2 times a week, since it makes a statistically significant contribution to the formation of a healthy body.

The pandemic of a new coronavirus infection has influenced the opinion of the population about the need for vaccination. A closed lifestyle during the quarantine period, restrictive measures, a large amount of unreliable information on the Internet led to an increase in the number of anti-vaccinators and, as a result, to an increase in infectious morbidity. The problem of the population's distrust of vaccination is very relevant for most countries of the world. The aim of the work was to study the degree of adherence of the population to vaccination in the Republic of Karelia by means of a questionnaire on paper and electronic media. 402 residents of the Republic of Karelia took part in the study. When analyzing the questionnaires, it turned out that the majority of respondents believe that vaccination is necessary, but at the same time, a lack of confidence in the effectiveness of vaccines, a lack of adequate information in sufficient quantity and a fear of side effects were revealed. Doubts about the effectiveness and safety of new vaccines against Covid-19 in adult respondents led to a high percentage of refusal to vaccinate their children. This work demonstrates that due to the availability of modern technologies and software, it is necessary to constantly monitor the opinion of the population regarding the need for vaccination for timely management decisions and the formation of a strong commitment to the prevention of vaccine-controlled diseases.

Obesity is a chronic disease associated with high cardiometabolic risk and type 2 diabetes mellitus (DM). For its therapy, the drug "Liraglutide" (LG) is used. We experimentally evaluated the effect of LH therapy on the state of microcirculation (MC) and lipid metabolism in rats with diet-induced obesity. The studies were performed on 30 white outbred rats divided into groups: control, comparison, experimental. We studied the indicators of MC and lipid metabolism. The results of the studies indicate that LH therapy causes the normalization of lipid metabolism and MC, which makes it promising to use this drug in patients with alimentary obesity to reduce cardiometabolic risk and prevent the development of endothelial dysfunction (ED).

The psychophysical state of a child is one of the most important aspects of his future life. Timely and correct assessment of deviations from the norm of disease development. The goal is to assess the possibility of using parents in an objective assessment of the psychophysical state of children of primary school age. Methods. On the base of the Ivanovo Regional Clinical Center for Medical Treatment 1037 questionnaires of children aged from 6 to 12 years old were studied. For a more discrete analysis the questionnaire forms were divided into two groups: grades 1-3 - 687 questionnaires, grades 4-7 - 350 questionnaires. We offered two types of questionnaires. The first was identified to assess the signs of the psychophysical development of the child. The second questionnaire is found among the questions for an objective assessment of the dexterity of children. Results. The predominance of "agile" children among all groups (both boys and girls) over awkward ones was widespread. Regardless of the development of diseases of the musculoskeletal system and the cardiovascular system. When considering the hobbies of children, the predominance of swimming in the first group among boys, while in the second - martial arts, is excited. The children showed signs of presence in the detained groups. Conclusions. Thus, the subjective opinion of parents can be used to assess the psychophysical development of children.

The relevance is connected with the active demand for sports nutrition among professional athletes and sports enthusiasts, as a necessary component for the development of sports indicators: improving endurance, strength, immunity and muscle mass building.

The article presents the result of a study in which 83 patients in the early recovery period of ischemic stroke were examined at the clinic of the «Ivanovo State Medical Academy». The aim of the study was to evaluate changes in blood biochemical parameters in patients in the early recovery period of ischemic stroke against the background of the use of transcranial direct current stimulation. Methods. All patients were divided into 2 groups: patients of the 1st group received transcranial direct current stimulation in the complex of rehabilitation measures, and patients of the 2nd group did not use it. Before the start of the rehabilitation course and after its completion, a clinical and functional examination and venous blood sampling were carried out to determine biochemical parameters: highly sensitive C-reactive protein, sCD40L glycoprotein, homocysteine, malondialdehyde. Results. In patients of the 1st group, who underwent transcranial direct current stimulation in the rehabilitation complex, at the end of the course, there was a decrease in the levels of homocysteine, sCD40L glycoprotein, and blood malondialdehyde.Conclusions. The course of rehabilitation with the use of transcranial direct current stimulation in patients in the early recovery period of ischemic stroke is accompanied by a decrease in the level of sCD40L glycoprotein, homocysteine, malondialdehyde and stabilization of the level of C-reactive protein, having a beneficial effect on vascular inflammation, atherothrombotic changes and reducing the degree of lipid peroxidation.

The high prevalence of autism spectrum disorders (ASD) is causing increasing interest in this problem. In the microbiota of the gastrointestinal tract (GIT) of children with ASD, dysbiotic changes in both the frequency of occurrence and the amount of intestinal microbiota are observed. The material for microbiological research was feces. As a result of a bacteriological study of the microbiota of the gastrointestinal tract, it was revealed that Staphylococcus spp. (87%), E. coli (73%), Enterococcus spp. (60%), and anaerobic microorganisms were found less than in 50% of the subjects. The number of intestinal anaerobes, although it was an order of magnitude higher than the concentration of aerobic representatives of the normobiota, as well as conditionally pathogenic microorganisms, was several times lower than the quantitative indicators of healthy people [1].

An analysis of the dynamics of the spread of topical socially significant diseases (SPD) in the Russian Federation (RF) and in the Tver region - tuberculosis, syphilis, gonorrhea and malignant neoplasms - is presented. Socially significant diseases are diseases, the occurrence and spread of which largely depends on socio-economic conditions that harm society and require social protection of a person [1]. The purpose of the study is to assess the dynamics of the spread of these SPZs in the Russian Federation and in the Tver region for 2000-2021. The study used official data of the Federal State Statistics Service (Rosstat) and the Medical Information and Analytical Center (MIAC) of the Tver region. During the period under review, a significant decrease in the incidence of tuberculosis, syphilis and gonorrhea was revealed, but an increase in the incidence of malignant neoplasms in the Russian Federation and the Tver region was determined. The decrease in the number of registered patients with a diagnosis established for the first time in my life for a number of SPZs was facilitated by the planned work of the Ministry of Health of the Russian Federation within the framework of the National Health Project. Measures to reduce the incidence of malignant neoplasms are defined in the Federal Project "Fighting Cancer", the implementation of which is an important task of all medical workers.

The article presents the results of their own research on the catering of medical students. The respondents were 6th year students of the pediatric faculty of the Voronezh State Medical University. N.N. Burdenko. As part of the study, students were surveyed. The results of the survey showed a high interest and awareness of medical students in matters of rational nutrition. However, most students are not able to update their eating habits and build their own diet. Thus, there is a prevalence of pathology on the part of the digestive system in about a quarter of the surveyed graduates of a medical university with a predominance of gastritis in the structure of diseases.

Polymorphism of cytokine genes is a factor of susceptibility or resistance to infection, the development of the disease and a long, complicated course of influenza and SARS-CoV-2 (COVID-19). 

At the present stage, the demand of society in the Russian Federation to the quality of training of graduates of medical universities is expressed in the number and level of formation of universal and professional competencies. Analysis of the current state of teaching morphological disciplines on the basis of the competence theory of learning dictates the need to discuss some issues of the quality of educational and methodological literature in order to find optimal solutions. The article presents the classical technology of teaching students of medical universities the recognition of histological preparations. The solution of the problems identified in the work will provide fundamental natural science training for future doctors.

This article is devoted to the actual problem of organizing preventive work on morbidity among employees of Mogilevkhimvolokno OJSC. In the course of work, the incidence of employees is monitored for 2017-2021. The article focuses on the most common group of diseases among employees of OAO "Mogilevkhimvolokno".

This article discusses an effective method of rehabilitation after anal canal surgery. The effect of the dietary supplement "Relibalance" as an auxiliary agent, which was taken by patients operated in the coloproctology department of the city clinical Hospital No. 6 in Tver, is described. An empirical analysis of groups of people in the early postoperative period with different methods of treatment was carried out, the study was carried out according to such indicators as pain - duration and frequency of the need for painkillers and their cancellation, a visual analog scale (VAS) of pain intensity; the time of onset of the first bowel movement and the consistency of the stool; the development of complications and other signs (bloating, false urges, assimilation of food).  According to this data collection, it was tracked in average values that the condition of the group taking this dietary supplement improved and stabilized faster. The authors proved the expediency and highlighted the advantages of prescribing dietary supplements "Relibalance" for patients who have undergone excision of a chronic anal fissure, hemorrhoidectomy, excision of rectal fistulas.

Analysis of data from SF-36 questionnaires completed by patients with ulcerative colitis and Crohn's disease determined the presence of lower scores in the observed group relative to the control group, indicating decreased quality of life in patients with inflammatory bowel disease.

116 protocols of ultrasound examination of abdominal organs of outpatient patients were studied, while signs of diffuse liver diseases were found in 68.9% of cases. Most often, their cause can be considered a metabolically associated fatty liver disease, less often hepatotoxic drugs, viral hepatitis and alcohol abuse are detected.

The result of the analysis of 454 online respondents showed that with an increase in the frequency of alcohol consumption in families: the detection of obesity in parents increased at the expense of fathers; in the latter, the frequency of registration of the optimal level of arterial pressure increased; the percentage of relatives who do not have hypertension and cardiovascular diseases decreased, while the opposite situation was revealed among grandmothers; the percentage of centenarians' grandparents was decreasing, but this concerned grandfathers. In fathers and mothers, the detection of hypercholesterolemia was not associated with the frequency of alcohol consumption in families.

Hypospadias are one of the most frequent congenital pathologies of the penis, which is characterized by the presence of an ectopically located myatus, accompanied by a violation of urination, as well as quite often a curvature of the cavernous bodies. The purpose of the correction is to restore the anatomically normal appearance of the penis, to ensure free, unhindered urination and the return of full sexual function. We present the results of the analysis of the treatment of hypospadias in 512 adolescents aged 12-17 years. The examination included a Hypospadias objective scoring evaluation (HOSE) scale, specially designed for this developmental anomaly, consisting of 4 items showing satisfaction with the surgical intervention performed to correct hypospadias (the position and shape of the myatus, the shape of the glans penis and the overall cosmetic result). This study is aimed at studying the psychosexual development of adolescents who underwent correction of hypospadias, compared with boys who underwent surgery at an early age. A later onset of sexual activity and less satisfaction with the overall cosmetic appearance was found in patients with hypospadias correction in adolescence. Adolescents with hypospadias demonstrate a more negative self-perception of the penis.

The article allows you to create an image of experimental and practical medical activity at the departments of the Kursk State Medical Institute in the first five years after its opening. The article introduces the peculiarities of the development of the scientific community of Kursk. This article is dedicated to the creation of the first volume of research papers, which are the results of many years of work of the founding scientists of many scientific schools of the Kursk State Medical Institute (KSMI). The purpose of the article was to form and preserve the memory of the first team of professors and teachers, the main topics of scientific research.

Chronic generalized periodontitis (CGP) is a common pathology, the key role in the etiology of which is played by the metabolic activity of the microbiota. The article describes the results of the gas metabolic activity of streptococci and staphylococci isolated from healthy patients and patients with CGP. A special role belongs to gaseous compounds of microbial origin: NO, CO, N_2, СО₂, О₂.It is known that in humans, NO regulates regional blood flow, transport of water and electrolytes, immunity, energy metabolism, acts as a neurotransmitter in the nervous system. CO molecules in low concentrations have anti-apoptotic, anti-inflammatory and anti-proliferative effects. N2 and O2 characterize the level of influence of microorganisms on the periodontal tissue under the conditions of inflammation established that streptococci and staphylococci cavity of patients with CGP patients in large quantities are distinguished by CO2 and CO and in small quantities-no compared to allocated staphylococci and streptococci from patients not suffering from pathology . There was also a low concentration of N2 and O2 in the microbiota isolated from patients with CGP. The results obtained can be used in the diagnosis, treatment and prevention of diseases of periodontal tissues.

Orthodontics is a section of dentistry that studies the causes of the formation of bite pathology and the impact of bite status on the body. As social issues, including mine, show, people turn to orthodontists mainly in two cases: because of the desire for an aesthetic smile or with extreme violations of the dentoalveolar apparatus. However, pathological bite is the cause of diseases not only of the musculoskeletal system, but also of the body as a whole. That is why the importance of orthodontics in medicine cannot be underestimated.

Community-acquired pneumonia is widespread in all countries of the world and is among the leading causes of death from infectious diseases. We conducted a retrospective epidemiological analysis to assess the epidemic situation of community-acquired pneumonia in the Donetsk People's Republic in 2022. 9140 cases of community-acquired pneumonia were registered. The incidence of them decreased by 6.4 times compared to 2021. The age structure of the sick was dominated by adults, however, the proportion of sick children increased by 2 times compared to 2021. Among adults, the high-risk group for VP were people aged 65 years and older who were sick 2 times more often than the rest of the adult population. In the future, the epidemic situation of community-acquired infections will be determined by the activity and etiological structure of pathogens circulating among the population, the state of immunity of the population and the quality of early etiological diagnosis. Taking into account the current situation in the Donetsk People's Republic regarding the registration of community-acquired pneumonia, the incidence of which is still insufficiently analyzed by the epidemic departments of the sanitary and epidemiological surveillance centers, the possibilities of forecasting and developing effective measures to combat this group of infections remain severely limited.

Home teeth whitening is in high demand among patients. For whitening at home, enzyme-based pastes and hydrogen peroxide-based strips are more in demand than other products. To recommend the most effective remedy to the patient, it is necessary to compare whitening pastes and whitening strips.

The article presents the results of a study of the effect of coronavirus infection on the structural organization of the skin of men in the older age period. The study was conducted using pathoanatomic material of 60 elderly and senile men who died (the cause of death is not related to Covid-19 and skin diseases) for the period from January 2021 to February 2022. The material was skin fragments (2x2 cm). The slices were stained with hematoxylin and eosin, according to Mallory, according to Van Gieson. The patients were divided into groups: group I (control) – it included 30 people who did not have COVID-19 disease, group II (experimental) – it included 30 people who had COVID-19 disease. The study revealed the following changes in indicators: a noticeable increase in the number of lymphocytes by 30 cells, a slight increase in the thickness of the mesh and papillary layer, in the experimental group, an increase in the ratio of the papillary layer to the mesh, in the experimental group, compared with the control. Based on the above, we draw attention to the fact that men infected with SARS-CoV-2 had pronounced inflammatory changes on the skin. It can be assumed that these manifestations are the effect of the SARS-CoV-2 virus on the microcirculatory bed of the skin.

In this research paper, we consider the use of an insulin pump as one of the methods for preventing microangiopathy in patients with type 1 diabetes. Diabetes mellitus is one of the most serious medical, social and economic problems of the healthcare system worldwide [1]. DM is one of the most common chronic diseases in the Russian Federation. As of the end of 2020, there were about 4.8 million patients with diabetes, according to the federal registry. With decompensation of this disease, various complications arise. The most dangerous of them are cardiovascular diseases. Insulin pump therapy helps to avoid the development of complications in the form of microangiopathies. It can help reduce high blood glucose levels and stop the supply of insulin in case of hypoglycemia. In order to ensure effective glycemic control throughout the day, the patient must use a continuous monitoring system. Monitoring allows you to see your glucose levels in real time. This allows you to timely correct fluctuations in glycemia during the day. Thus, using insulin pump therapy, it is possible to achieve compensation for type 1 diabetes mellitus and reduce the risk of developing microangiopathies.

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver diseases that is a current global problem affecting all corners of the world and is characterized by excessive accumulation of fat in the liver. The diagnosis of NAFLD often coexists with type 2 diabetes mellitus (DM2), obesity, and heart disease. The article deals with the prognostic and diagnostic significance of the ratio of neutrophils to lymphocytes (ONL) and C-reactive protein (CRP) in patients with NAFLD complicated by decompensated type 2 diabetes.

External arterial bleeding (AC) is one of the main causes of death in emergency situations. That is why the study of the features of stopping the AK is a priority task not only for medical workers, but also for participants in hostilities, as well as the civilian population [1]. The article highlights the modern aspects of the use of a hemostatic tourniquet (QL) in the provision of first aid and medical assistance to victims in cases of damage to the main vessels of the extremities in an emergency. In the course of the study, the indications and the algorithm of temporary stopping of AK at the prehospital stage were analyzed using modern medical devices - QL. In the course of the work, a comparative assessment of the main types of modern QL (elastic, pneumatic and turnstiles), as well as the most common modifications of QL, which are currently most widely used in providing assistance to victims of emergencies, was carried out. The quality of the materials that served as the basis for the manufacture of QL and their most important technical features are analyzed. Attention is drawn to the advantages and disadvantages of various QL. Based on the results of the study, proposals have been developed for the use of modern QOL in various emergency conditions.

The issue of the increase in the incidence of acne among young and middle-aged people is raised by many authors. Acne tends to become chronic, contributing to the spread of foci of infection on the skin of the face and beyond. However, in addition to physical discomfort, this pathology entails social and psychological problems for patients. A change in the appearance of facial skin contributes to a decrease in self-esteem and quality of life of a person, complicates his social interaction. Acne is a multifactorial, polyetiological disease, and therefore the prognosis of the occurrence and development of this nosology is very difficult. Cicatricial processes and post-acne also contribute to a change in the condition of a person's skin and his sense of self. Studying the level of quality of life of patients with acne is an important step towards stabilizing their psychological state. During the study, the dermatological index of the quality of life of patients with acne was determined, and the severity of the course of the disease was also assessed. So, often even with a mild course of acne, changes in self-esteem and social behavior of a person are observed, which necessitates expanding the range of therapeutic measures. Working with a psychologist on self-esteem and self-awareness can help change the patient's attitude to his disease, achieve a sense of inner harmony, which will also have a beneficial effect on the course of acne.

A significant increase in cardiovascular morbidity in 2020-2022 is objectively associated with COVID-19, which is characterized not only by a pandemic level of prevalence, the development of severe and fatal complications in a large percentage of cases, but also by a variety of changes from different body systems, including cardiovascular complications that occur both in acute and post-acute period. The aim of the work was to study the prevalence and structure of cardiovascular complications of COVID-19 in patients who have suffered an ischemic stroke. Data from the BARS medical electronic system of 109 patients who suffered an ischemic stroke in the middle cerebral artery basin were analyzed. A search was conducted for patients who underwent COVID-19 in the period from April 2020 to December 2022, as a result of which 33 patients were identified who met this criterion. Distribution of patients by gender: 14 (42%) women (average age – 70 (56;85) years) and 19 (58%) men (average age - 63 (53;75) years). Acute complications included myocardial infarction, venous and arterial embolism, newly diagnosed heart failure or decompensation of previously existing heart failure, repeated ischemic stroke detected within 4 weeks after confirmation of COVID-19. As a result, which were detected in patients, but already in the post-ovoid period (more than 4 weeks later). Analysis of the data obtained indicates that in the acute period in 3 patients (9%; 2 women and 1 man) were diagnosed with: myocardial infarction, embolism of the arteries of the lower extremities, heart failure. Two of these patients underwent inpatient treatment according to clinical recommendations, the severity of COVID-19 was assessed as moderate and severe; the development of severe pneumonia complicated by respiratory failure was noted in both cases. The development of myocardial infarction in one patient led to a fatal outcome, and the course of COVID-19 in this case was characterized as mild and the patient did not receive treatment at the outpatient stage. In the long-term period, 4 patients (12%; 3 women and 1 man) had newly diagnosed heart failure (2 patients), myocardial infarction (2 patients), repeated ischemic stroke in the BBA (1 patient). Two of these patients suffered COVID-19 easily and received outpatient treatment, while the rest were treated in a hospital, the course of COVID-19 was characterized as moderate severity and was accompanied by the development of severe pneumonia complicated by respiratory failure. The development of such a variety of cardiovascular manifestations in COVID-19 may be due to the presence of interrelated pathogenesis links, such as endothelial dysfunction, coagulopathy, systemic inflammation and hypoxia.

The presented work reflects the results of morphofunctional changes in gum tissues after modeling periodontitis in the oral cavity of experimental male rat animals and subsequent treatment with combined action polymeric dental films based on Na-CMC. After the histological study, it can be concluded that the developed films have a high wound healing and anti-inflammatory effect.

Autoimmune hepatitis is a severe immunoinflammatory chronic liver disease with various clinical manifestations. The main treatment is a combination of corticosteroids. Liver transplantation remains the leading treatment for this pathology. Autoimmune hepatitis remains a disease that requires further development in treatment tactics. Purpose. To analyze the results of surgical treatment of a patient with autoimmune hepatitis who underwent liver transplantation. Materials and methods. The material of the study was patient K., 9 years old, who developed icterus of the skin and sclera. The patient was diagnosed with hepatitis with an outcome in cirrhosis of the liver, a high degree of activity. Results. The patient underwent hepatectomy with preservation of the inferior vena cava. Orthotopic transplantation of the right lobe of the liver from a living related donor. The patient was discharged for outpatient aftercare at the place of residence. After the surgical treatment, the patient lives a full life, without tangible deviations. Conclusion. Liver transplantation is the treatment of choice for severe forms of autoimmune hepatitis. 

The article presents the results of studies of the structure of the central and peripheral nervous system by Kursk morphologists. The results of scientific research obtained at the Department of Normal Anatomy and the Department of Histology and Embryology of the Kursk Medical Institute in the second half of the 20th century are shown. First of all, these are the results of scientific research by professors-neuromorphologists of the city of Kursk, L.A. Shangina, A.A. Otelina, D.A. Sigalevich and Z.N. Gorbatsevich. Their research was devoted to the study of the receptors of the membranes of the brain, receptors located in the nerve trunks, receptors of internal organs and skin, as well as general issues of the structure and regeneration of nervous tissue in humans and animals.

Spinal trauma is an extremely serious condition that impairs the physical, mental and social well-being of patients and places a great burden on the social health care system. Spinal trauma can lead to impaired motor and sensory activity of the victim (neurological deficit). Our goal was to study and use available methods to model spinal injury in rats and determine their effectiveness for experimental scientific work.

The article presents the results of a study of the effect of coronavirus infection on the structural organization of the skin of men in the older age period. The study was conducted using pathoanatomic material of 60 elderly and senile women who died (the cause of death is not related to Covid-19 and skin diseases) for the period January 2021 – February 2022. Skin fragments (2x2 cm) served as the material. The sections were stained with hematoxylin and eosin, according to Mallory, according to Van Gieson. The patients were divided into groups: group I (control) – it included 30 people who did not have COVID-19 disease, group II (experimental) – it included 30 people who had COVID-19 disease. During the study, the following changes in indicators were revealed: a noticeable increase in the number of lymphocytes by 30 cells, a slight increase in the thickness of the mesh and papillary layer, in the experimental group, an increase in the ratio of the papillary layer to the mesh, in the experimental group, compared with the control. Based on the above, we draw attention to the fact that women infected with SARS-CoV-2 had pronounced inflammatory changes in the skin. It can be assumed that these manifestations are the effect of the SARS-CoV-2 virus on the microcirculatory bed of the skin.

Porphyrias are a group of hereditary diseases caused by a deficiency of one of the heme synthesis enzymes, protoporphyrin. The most common of the acute porphyrias is acute hepatic porphyria (AHP), in which there is an excessive accumulation of porphyrins and their precursors - δ-aminolevulinic acid (ALA) and porphobilinogen (PBG), which have pronounced neurotoxic effects and mediate the development of an acute attack of porphyria.

This paper presents an analysis of the available medical literature on the conducting system of the heart and its pathologies.

Identification of factors influencing the occurrence of candidiasis of the oral mucosa in patients with removable dentures. Methods. The study involved patients with acrylic removable dentures aged 65–80 years. Clinical examination of patients, questioning, determination of the hygienic state of removable dentures and the index of oral hygiene were carried out. Identified nutritional features, assessing the quality of fit of prostheses. When signs of candidal stomatitis were detected, patients were sent for a cultural study to detect fungi of the genus Candida. Results. In 23.3% of cases, atrophic candidiasis of the oral mucosa, 4.6% angular cheilitis, 2.3% cheilitis, and 4.6% candidal glossitis were detected. In 6.9%, a decrease in bite height was recorded. Carriage of fungi of the genus Candida was determined in 18.6% of cases, and in 4.6% with a significant content of colonies in swabs (more than 104 CFU/ml), candidiasis was diagnosed. In 70% of cases, the hygiene of the oral cavity and prostheses was unsatisfactory. According to the survey data, diseases of the gastrointestinal tract were detected in 46.5% of cases, type 2 diabetes mellitus in 13.9%, and smoking in 11.6%. Conclusions. Prolonged wearing of removable dentures during the day, especially at night, has an adverse effect on the condition of the palatal mucosa as a result of mechanical pressure and biofilm fixation on the denture. The presence of a comorbid pathology that reduces immunity, as well as the deterioration of the manual skills of patients with age and the progressive weakening of visual acuity contribute to the development and exacerbation of oral candidiasis. 

Relevance. 2023 marks exactly 180 years since the birth of Heinrich Hermann Robert Koch, the great explorer, physician and microbiologist.
Purpose. Get acquainted with the biography of a brilliant scientist, one of the founders of today's epidemiology and bacteriology, and his great contribution to such an important science as microbiology.
Methods. Review and careful study of the literature that is devoted to this topic. The study of information from the archives of the university. Consolidation of information from historical sources about the life of Robert Koch.
Results. Koch had an enormous influence on the development of modern microbiology. He was the first to identify and cultivate the causative agent of anthrax, and also, to the smallest detail, managed to explain the life cycle of Bacillus anthracis, the features of which play an important role in human infection. It was the discovery of the causative agent of tuberculosis that brought Robert Koch the greatest fame, as well as the method he proposed for diagnosing this widespread infectious disease in the world. Thanks to his research, he was able to formulate three postulates, thanks to which it was possible to associate specific microorganisms with certain diseases, these important statements are known to many today as the Koch triad. It is also worth noting that, among other things, he also introduced into practice new methods for staining microbiological preparations, a special method of inoculation on dense nutrient media, as well as a method of microphotography that was revolutionary at that time. In 1905, Robert Koch received the Nobel Prize in Physiology or Medicine for his discoveries.
Conclusion. Knowledge of biographical information about world-famous scientists is an integral step in preparing students of medical universities for future professional activities [1].

The study is devoted to the study of adaptive reactions of the cardiovascular system to changes in body position in space. The dependence of the nature of the manifestation of adaptive processes on the characteristics of the reactivity of the parts of the autonomic nervous system was revealed.

The problem of complications of testicular prosthetics in both adult patients and adolescents is rather sparsely and fragmentally sanctified in the few domestic and foreign specialized literature. Most publications demonstrate their own results, with a small number of patients. For the first time, a comprehensive multifactorial analysis of the identified complications was carried out in various age groups in order to select the tactics of surgical treatment of patients and minimize the number of postoperative complications. High-quality selection of patients, according to several criteria, allows you to compile correct statistics on surgical interventions performed and determine treatment tactics that contribute to the reduction of all possible postoperative complications, including long-term results, to a minimum number. Also, the correct selection of the implant by size, materials used, and the choice of surgical access leads patients to satisfaction with postoperative results. Timely surgical intervention allows patients to continue to live a full social life without experiencing discomfort, feelings of inferiority, depression and other psychological disorders, both in adolescence, when the formation of the patient's personality in society is particularly important, and at a more mature age.

The purpose of the study is to study and analyze the medical and social characteristics of pregnant women suffering from diseases of the genitourinary system using a random sampling method. Statistica 10.0 and Microsoft Exsel programs were used to analyze the obtained data. As a result of the study, a regularity in the presence of a burdened obstetric-gynecological and general somatic history in the studied contingent of women was noticed. Also, a complicated course of pregnancy, childbirth and the postpartum period in women with diseases of the genitourinary system was noted.

Alcoholism is a global problem of modern society. Currently, the number of drivers who drink alcohol is growing, which can lead to an increase in the number of accidents [1]. The aim of the study was to analyze the statistics of traffic accidents for reasons related to alcohol intoxication and to assess the nature of dynamic indicators. In this regard, the official data of the traffic police of Russia for 2018-2022 in the Tver region were studied in three categories: traffic accidents with drivers in a state of intoxication; road accidents with drivers with signs of intoxication; Road accidents with drivers who refused medical examination [2]. The obtained indicators were analyzed and mathematically processed, the absolute numbers were converted into relative ones, graphs were drawn showing the dynamics of the accident. Thus, during the study, it was revealed that the problem of drunk driving for the Tver region is still relevant and acutely social, but compared to previous years, it can be seen that the number of accidents has significantly decreased in almost all indicators. This indicates that the applied punitive and preventive measures are effective, and we should continue to develop this area of public activity.

The purpose of the study is to study the prevalence and structure of asthenic disorders in workers of medical and preventive institutions in Simferopol. A survey was conducted on the MFI-20 scale (Multidimensional Fatigue Inventory) of 45 medical workers (30 women and 15 men; average age - 39.4 years). An integral indicator of the overall severity of asthenia on the MFI-20 scale of more than 60 points and more than 12 points of at least one of the subscales, which allows the diagnosis of "asthenic syndrome", was detected in 53.3% of the subjects, among whom female persons aged 40-52 years prevailed. The average value of the total assessment of asthenia was 64.9 points, the level of general asthenia - 15.2 points, decreased activity – 14.3 points, reduced motivation – 12.4 points, physical asthenia – 12.5 points, mental asthenia - 10.9 points. The structure of subjective manifestations of asthenia was dominated by emotional disorders and sleep disorders (70.83%), decreased concentration and memory (41.7%). Among the factors contributing to asthenization, the majority of medical workers indicated stressful and conflict situations (79.17%), night work (70.83%), unfavorable working conditions and physical overstrain (20.83%). Thus, medical personnel are at risk for the formation of asthenic disorders, which requires timely diagnosis and adequate correction with the use of comprehensive preventive measures.

The traditional regimen for the treatment of persistent allergic rhinitis (PAR), regulated in clinical guidelines, does not always allow achieving a stable remission of the atopic process, and therefore patients are forced to regularly take hyposensitizing and corticosteroid drugs, which significantly worsens their quality of life and places a persistent burden on the family budget . One of the possible reasons for the insufficient effectiveness of the basic treatment regimen for the disease is a violation of local immune homeostasis, in which, under the influence of bacterial antigens, a non-IgE-mediated allergic reaction develops, caused by allergen-specific lymphocytes or antibodies of the IgG class with the formation of immune complexes. The pathogenesis of infection-dependent PAR, which differs from the classical one, requires optimization of methods for treating this pathology, which determines the relevance of this study. The author proposed a three-stage scheme for bacterial sanitation of the nasal mucosa, which includes an antibacterial drug selected taking into account the individual sensitivity of the inoculated microorganism, immunomodulatory and elimination drugs, a synbiotic and a bacterial lysate. The proposed scheme made it possible to achieve a stable and long-term remission of chronic eosinophilic inflammation by reducing the bacterial antigenic load on the nasal mucosa and, consequently, the severity of allergic inflammation in PAR patients with a disturbed microbial landscape of the nasal mucosa.

The article examines the feasibility of using machine translation of foreign texts containing medical terminology, based on the scientific accuracy of the translation of individual medical terms. The topic is of research interest because of the increasing need to use foreign, particularly English-language sources in research work. Translation services such as Google Translate, DeepL, Yandex Translator have been used. The services were selected on the basis of the answers received from the questionnaire survey of the students of Tver State Medical University. The authors randomly selected 50 English-language terms as translation material. The results obtained with each individual service were compared with the commonly used Russian-language counterpart, on the basis of which the clarity of the translation for the researcher's understanding was determined. The obtained data was summarised in a table, with the number of accurate and inaccurate translations expressed as a percentage for each individual service. The highest translation accuracy was observed for Google Translate (65%), the lowest for Yandex Translator (45%). The average number of matches is 53.3%. The authors conclude that machine translation currently does not provide the necessary accuracy when dealing with foreign text.

In order to improve the performance of hernioprosthetics for hernias of the anterior abdominal wall, the possibilities of upgrading mesh prostheses are being investigated. One of the promising options for modernization is the use of cellular technologies. The authors of the article investigated the adhesive ability of fibroblasts to the Esfil standard hernioprosthesis (Lintex LLC) without modifications, after treatment with polycaprolactone and after treatment with polycaprolactone and low-temperature plasma. Visualization was provided by scanning electron microscopy. The obtained data suggest that the proposed methods of modification of the mesh prosthesis can improve the cellular adhesion of native fibroblasts to its surface.

This paper presents an analysis of the characteristics of the manifestation of type 1 diabetes in children during a pandemic. The analysis was carried out on the basis of children registered with type 1 diabetes mellitus at the State Budgetary Healthcare Institution No. 2 of the city of Tver.

The article is devoted to the current problem of providing drug treatment at home. The treatment of patients with drug addiction has always been a very difficult task, which is primarily due to the very nature of this disease, so the work is interdisciplinary, written at the junction of a certain inextricable link between narcology and psychiatry. We analyzed the situation with drug treatment at home, based on Federal Law No. 323, which prescribes the basics of medical care. As a research part of the article, an attempt was made to assess the attitudes of medical students to the situation with drug treatment at home, to analyze their opinion in relation to such patients. Based on the conducted research, the maximum relevance of this topic is highlighted and justified at the present time. Also, special attention should be paid to the discussion at the state level of the problem of providing drug treatment at home, the revision of laws that will address this topic, the conditions for providing assistance and court decisions. This problem has been little studied and requires further research. The idea that this problem is a big problem of social society is substantiated.

The aim of the study is to determine the incidence and treatment of arterial hypertension (AH) caused by bevacizumab. The medical records of patients treated with bevacizumab for colorectal cancer (CRC), pancreatic cancer (PCa), small cell lung cancer (SCLC), and renal cell cancer (RCC) were analyzed. Hypertension occurred a median of 12 weeks after bevacizumab therapy (range 4-34 weeks). 81.48% of patients had hypertension secondary to bevacizumab therapy. Antiangiogenic therapy-associated hypertension is a manageable toxicity that can be controlled with angiotensin converting enzyme inhibitors (ACE inhibitors).

The integral indicator of the general condition of animals during intoxication is the mass coefficient of the organ. The liver and kidneys are the target organs of cadmium. The dynamics of the mass coefficient of the liver and kidneys of experimental sexually mature male Wistar rats with subchronic cadmium intoxication was studied. For 28 days, experimental animals received cadmium acetate with drinking water (15 ml / day) at a dosage of 1/50 LD50. A large variability of this indicator was revealed for the liver, which may be due to its more pronounced participation in the detoxification of cadmium. A statistically significant decrease in the liver mass coefficient of experimental animals compared with the control group was revealed on the 7th, 14th and 21st days of cadmium intake with drinking water, which may be due to inhibition of cell proliferation and synthetic activity. With further intake of cadmium, there are no differences with the control group, which may be due to the activation of various detoxification mechanisms, in particular, the synthesis of metallothioneins in hepatocytes. The relative weight of the kidneys in relation to the body weight of rats when receiving cadmium with drinking water does not change in comparison with control animals.

Bronchial asthma is a chronic disease that is accompanied by inflammation of the respiratory tract and a constant unproductive cough. Bronchial obstruction in children often occurs with a pronounced allergic reaction. Depending on the severity, mild, moderate and severe asthma are distinguished. According to the nature of the course, bronchial asthma is divided into asthmatic bronchitis, asthmatic asthma and asthmatic status. Bronchial asthma can be allergic and non-allergic. In Russia, about 400 thousand patients have been registered among children with bronchial asthma, however, according to a WHO study, the number of cases of this disease has increased by 10% in recent years. At the same time, there is a progressive obstruction of the bronchi caused by hypersensitivity to certain stimuli. This ailment is most often found in children, but it can also occur in adults. To stop asthma attacks, doctors often prescribe medications such as bronchodilators. Data of medicinal products

Changes in autonomic regulation in the comorbid course of arterial hypertension (AH) and metabolic syndrome (MS) require further study. The aim of the study was to assess the effect of MS on the indicators of autonomic regulation in hypertension. 95 patients with hypertension were examined, 47 of them men, 48 women; the average age was 58.7 ± 6.1 years. Patients were divided into two groups depending on the presence or absence of MS: the 1st group (comparison) included people with hypertension without MS (n = 49), the 2nd (main) - with hypertension and MS (n = 46). The analysis of heart rate variability (HRV) was applied according to a cardiointervalogram recorded over a short (five-minute) period of time. HRV indices were significantly lower in patients with hypertension with MS than in those without MS. In the presence of MS in patients with hypertension, vegetative disorders are aggravated in the direction of relative sympathicotonia, combined with parasympathetic insufficiency against the background of reduced functional capabilities of the heart, which forms unfavorable prognostic sings.