Vol 13 (2024): Материалы XX Международного Бурденковского научного конгресса 18-20 апреля 2024 года

The purpose of the study was to research cells of trophoblast in the blood of pregnant
women. Materials and methods: The research was done in maternity hospital of Medical University
Clinic. We took sample venous blood from patients with normal pregnancy and from patients with
preeclampsia. The blood was taken from 20 patients since 31 week till 34 week of pregnancy. 10
women were included in the control group. Native smears were prepared and processed in the
Leishman retainer. After smears were stained according Romanovsky-Giemsa. Light microscopy
was performed with increased 1000. Results: there are 10 patients in blood smears were found cells
of trophoblast. In the smears of control group we didn't find them. Conclusion: the cells of
trophoblast are new marker of preeclampsia. We believe that detection cells of trophoblast in the
blood from pregnant women can be used in the fight against high rate of maternal and child
mortality.

The average age of sexual debut is currently 16 years. Lack of sex education, early age, refusal of adults to talk with children on this topic are the reasons for the negative consequences of unprotected sexual intercourse not only in adolescence, but also in adulthood. Informing the population about risk factors for human reproductive health is an integral part of preventive work in matters of sex education and the formation of sexual culture in society.

Angiomyolipoma is a benign mesenchymal tumor consisting of blood vessels, smooth muscle cells and mature adipose tissue in different proportions [1,2]. The causes of its development are currently not fully clear. There is evidence of a high content of estrogen and progesterone receptors in the tumor [3]. Apparently, this is why angiomyolipoma affects women 2.6–10 times more often, this also explains the rapid growth of the tumor during pregnancy and the high probability of its rupture during this period, and there is no correlation between the size and probability of tumor rupture [3]. We believe that the presence of progesterone receptors in the angiomyolipome is also due to the inability to use progesterone preparations, which are recommended for maintaining pregnancy and are widely prescribed at various gestation periods — the use of these drugs can cause the growth of an undiagnosed tumor.

According to a study of combined oral contraceptives (COCs), when they are used, regardless of the regularity of sexual activity, the level of premenstrual syndrome (PMS) and dysmenorrhea (DM) decreases, and symptoms of high-level anxiety and depressive disorders (DDTS) are less common.

According to the study, analgesics used to relieve premenstrual syndrome (PMS) and dysmenorrhea (DM) against the background of symptoms of anxiety and depressive disorders (DDTS) are most often used metamizole sodium+pitefenone+fepiverinium bromide, drotaverine+caffeine+naproxen+paracetamol+pheniramine, drotaverine, ibuprofen and nimesulide.

The purpose of the study is to analyze the effectiveness of new assisted reproductive technologies necessary to achieve pregnancy in women facing infertility problems.

Materials and methods consist of an analysis of the experience of leading domestic and foreign experts in the field of reproductive technologies. The use of the NGS genetic testing method makes it possible to simultaneously determine aneuploidies and unbalanced chromosomal pathologies of the embryo. The use of preimplantation genetic testing of structural rearrangements (PGT-SP) makes it possible to effectively exclude the presence of chromosomal pathology in embryos of patients with karyotype aberrations.

Conclusions. The effectiveness of therapy methods in preparing patients for assisted reproductive technologies depends on the individual characteristics of the patients.

The study of the relationship between the features of the ridge patterns of fingers and gender has been of interest to scientists for a long time, however, the works found in the available literature are few, and the results presented in them differ. The aim of the study was to study the characteristics of papillary patterns of the palmar surface of the nail phalanges of the hand, depending on gender. In accordance with the purpose of the work, images of papillary patterns of the palmar surface of the distal phalanges of ten fingers of 72 subjects of both sexes aged 18-22 years were obtained. The type of pattern, the delta index, the comb count of each finger of both hands, the total comb count separately for the right and left hands, and the Volotsky index were determined. Statistical processing of the results was carried out using the licensed StstMed program. In this work, some qualitative and quantitative characteristics of the patterns of the ridge skin of the fingers, depending on gender, are established. In the course of the work, no statistically significant differences were found between some quantitative characteristics of the papillary patterns of the palmar surface of the nail phalanges of the fingers of the hand in representatives of different sexes.

Abstract.

Introduction. Ovarian cancer reaches 46% and ranks 7th in terms of prevalence. The high incidence of late detection of ovarian cancer is reflected in the topographic and anatomical features of the grate and, in particular, small pelvic organs.

The goal of this study is to study changes in the topographic anatomy of the abdominal and pelvic cavities in advanced ovarian cancer.

Materials and methods. We conducted a retrospective analysis of medical records of 45 women of different age groups with established advanced forms of ovarian cancer stages III and IV. During the study, we conducted a clinical analysis of the relationship of tumor tissue to neighboring organs and the walls of the pelvis.

Results: The most common anatomical changes were the posterior Douglas pouch, small and large intestine. Often, the process involved the ligaments that provide the fixing apparatus of the uterus and the rectosigmoid part of the large intestine. Less commonly, the diaphragm, mesentery of the small intestine, liver and bladder were involved in the adhesive process.

Conclusion: After a retrospective analysis, it was found that advanced ovarian cancer is a truly serious cause of changes in the topography of the abdominal and pelvic organs. As a result, entry into the abdominal cavity and pelvis is difficult, and surgical teams are faced with serious technical difficulties, which increases the volume of the operation and the time spent on it.

Key words: ovarian cancer; metastasis; germination; pelvic topography

Approximately 50% of deaths are attributed to cardiovascular diseases both in Europe and in the Russian Federation, where over 1 million people die annually, which is 3-4 orders of magnitude higher than in Western countries. For example, at present, about 40 million hypertensive patients have an increased risk of developing cardiovascular complications due to the unattainable effective control of blood pressure, as there is a known correlation between risk groups and the frequency of cardiovascular diseases. It has been found that the lowest level of this risk is observed in the age group from 20 to 29 years, increasing by 20% in the age group from 40 to 49 years and almost 30% in the age group from 50 to 59 years. This same dynamics of cardiovascular diseases is also influenced by smoking among patients and the presence of comorbidity, which includes the presence of atherosclerosis with concomitant hypercholesterolemia, diabetes mellitus, obesity, the aforementioned arterial hypertension, history of strokes and heart attacks, etc. Preventive direction becomes a dominant trend in cardiology and medicine as a whole. Based on these data, there was a need to create a method that could assess the risk of developing cardiovascular diseases.

Introduction. The topic of hygienic assessment of artificial illumination in lecture halls of N.N. Burdenko VSMU is an important part of the educational process. Illumination primarily affects the understanding, reproduction and learning of educational material. The goal. To study the level of artificial illumination of lecture halls and to determine its influence on students' health. Materials and methods. The indices of artificial illumination in lecture halls were measured with the help of luxmeter and compared with the norm indicators. A survey of 100 students of N.N. Burdenko VSMU studying at the medical, pediatric, dental and medical-preventive faculties was carried out. Results of the study. The data on the level of artificial illumination of lecture rooms of the University, on subjective characterization of illumination by students were obtained. The best lecture auditorium was named. Conclusions. The most illuminated is 501 auditorium. The least compliant is 502 auditorium - 108-178 lux with a norm of 300 lux. According to the students, the best lecture room was chosen as the Central Medical Auditorium where the illumination exceeds 300 Lx.

Introduction. An increase in natural focal diseases is observed in the Voronezh region. It is very important to timely monitor tick-borne infections and organize preventive measures to reduce the number of vectors. Target. Study of the prevalence of tick-borne infections and tick infection rates for 2017-2019. Materials and methods. general scientific, hygienic, epidemiological. Results: A total of 3,157 citizens (4.51 per 10,000 population) applied with suspected tick bite. The number of requests increased from 3.13 in 2017 to 6.41 in 2019. Analyzing the appeal rate, adults are in the lead - 65.58%. The largest share belongs to citizens from 25 to 44 years old - 33.54%. The areas with the largest number of requests were identified: Ramonsky, Ostrogozhsky, Ternovsky, Novousmansky and Semiluksky (20.24; 17.71; 13.92; 13.24 and 10.13, respectively). Lyme disease is a priority nosological unit in the structure of natural focal diseases in the region (0.53 per 10 thousand population). Most often, registration of the disease is observed in residents of Ternovsky, Anninsky, Ramonsky, Verkhnekhava and Podgorensky districts (1.3; 1.19; 1.18; 0.6 and 0.61, respectively). Areas with a high level of tick infection include: Novousmansky (31.72%), Semiluksky (25.43%), Ramonsky (25.33%), Ostrogozhsky (24.62%) and Borisoglebsky (23.69%). The area of anti-tick treatments has been increased by 1.4 times. Work is being carried out with the population on individual prevention measures. Conclusions. Having analyzed the results obtained, it was noted that in the Voronezh region there is a constant threat of intensification of epizootics and the epidemic process of natural focal diseases transmitted by ticks.

Introduction. Within the framework of modern medical education, preventive measures and maintaining optimal oral health occupy a key place. This issue remains relevant among medical university students in the context of training qualified medical professionals. The goal of this study is the attitudes of students from various faculties of the Voronezh State Medical University named after N.N. Burdenko towards individual oral hygiene. Materials and Methods. The study included a survey of 225 students from the medical, pediatric, preventive medicine faculties, and students from the Institute of Dentistry of VSMU named after N.N. Burdenko on a range of issues: from the frequency of dental visits to preferences in toothpastes and teeth whitening methods. Results. Most students adhere to the recommendation to brush their teeth twice a day. However, the use of additional means, such as dental floss and mouthwashes, is not as widespread. There are differences among faculties in the frequency of dental visits, with the highest regularity observed among students of the dental faculty. Teeth whitening products are not popular, indicating a preference for natural care. Preferences in toothpaste vary, but most students choose pastes with whitening effects or for sensitive teeth, emphasizing the importance of specialized care. Conclusions. Thus, the study results reflect not only the current state of hygiene habits among medical university students but also their readiness to take responsibility for their own health, which is an important aspect of their future professional activity.

Relevance. Currently, immunoprophylaxis is of great importance for combating the epidemic process associated with vaccine-preventable infectious diseases. Despite the presence of actively used vaccines and the inclusion of most of these infections in the national calendar of preventive vaccinations, measles, as one of them, does not lose its importance.

The goal. To study the manifestations of the measles epidemic process in the Voronezh region for the period 1940 - the first half of 2023.

Materials and methods: general scientific, epidemiological.

Results. After the introduction of mass immunization, the incidence of measles decreased significantly and was predominantly sporadic. However, from 2011 to June 2023, the incidence increased from 0.27 cases (CI 0.06-0.48) to 0.31 cases (CI 0.08-0.54) per 100 thousand population. The highest average annual growth rate was observed in 2014 (658.82%), 2018 (425.00%), 2012 (395.59%) and 2019 (228.57%), while the highest rate of decline was in 2020 (-100 .00%), 2015 (-89.92%), 2013 (-87.22%), 2016 (69.23%). The largest proportion of cases were children and males. During the study period, 61 outbreaks (104 cases) of measles were registered.

Conclusion. The incidence of measles over the last thirteen years had an uneven distribution and was characterized by a pronounced upward trend, which is due to the prevalence in the structure of persons with an unknown vaccination history (45.19%) and unvaccinated (39.42%).

Introduction. Academic stress due to an overabundance of information in the educational environment is a fairly relevant topic among those involved in the field of education. The goal is to study stress, anxiety and depression for the relationship between these conditions. Materials and methods. 987 students participated in the study. The stress level was determined using the Perceived Stress Scale (PSS-10) and the Kessler Scale of psychological distress (K10). The assessment of the level of anxiety and depression was carried out using the scale of depression, anxiety and stress (Depression Anxiety and Stress Scale-21, DASS-21) by S. Lovibond and P. Lovibond. The statistical analysis was carried out using the StatTech v. program. 4.1.0 (developer – Stattech LLC, Russia). Results. Positive correlations between stressful, anxious and depressive states have been revealed. Conclusions. The higher a person's stress level, the higher the degree of progression of anxiety and depression. Therefore, it is necessary to take measures to prevent stress conditions in order to avoid the development of anxiety and depression in students and improve the quality of the educational process.

The study aims to determine the main factors influencing the adaptation processes of personnel in the testing laboratory center of the Federal Budgetary Institution "Center for Hygiene and Epidemiology in the Voronezh Region". Analysis methods include hierarchical cluster analysis to assess the level of employee engagement in hygiene and motivational factors, as well as proposing preventive measures to improve motivation and maintain employee health. The research results indicate that for specialists with a hygiene profile, key factors are interpersonal relationships, working conditions, and safety, while for specialists with an epidemiological profile, reward and interpersonal relationships are important. Additionally, the age structure of employees also influences their priorities and interests, as evidenced by the identification of various factors depending on age category. These results can be used for more effective personnel management and creating conditions conducive to their adaptation and professional development.

Introduction. The study of the relationship between students' lifestyle and their body composition is a significant area of research, as it contributes to a deep understanding of the impact of nutrition on the health and overall well-being of young people. The purpose of this study is to assess the gender-specific lifestyle of first-year students and their impact on some indicators of bioimpedance. Materials and methods. In this study, the results of a survey of 116 first-year students of the Voronezh State Medical University named after N.N. were evaluated. Burdenko in order to identify gender differences in lifestyle and their relationship with bioimpedance indicators. Results. In the women's group, a significant proportion of students (49%) adhere to three main meals, 46% exercise regularly, and 70% consume 1.5 liters of water or more per day. In the male group, the situation did not have statistically significant differences: 48% of students follow three meals a day, 48% exercise, and 67% consume enough water. The analysis of self-assessment and body mass index did not reveal statistically significant differences between the groups. In men, the average percentage of total fat was 27% less than in women, while the percentage of visceral fat in men was 27% higher compared to women. Conclusions. These results highlight the importance of taking gender differences into account when designing healthy lifestyle programs for young people.

Introduction. The article deals with the etiology and prevention of scoliosis. According to various data, about 1% of the population is affected by scoliosis. There are many changes in the body affected by scoliosis, while it is not known whether this is the cause or consequence of this disease. Goal. To analyze the level of knowledge of medical students about the causes and prevention of scoliosis. Materials and methods. A survey of 308 medical students of various courses was conducted in the work. The average age of the respondents was 19.4±0.4 years. The study was a one-time study, the sample size was not calculated beforehand. The paper highlighted the inclusion and exclusion criteria. Results. The study showed that 95% of respondents have an idea about scoliosis, about the factors that increase the risk of its development. About 50% had their spine examined, as a result, 40% of them were diagnosed with scoliosis. Almost 50% of the study participants do not carry out primary prevention of scoliosis. Conclusions. Sufficient awareness of students about risk factors and prevention of scoliosis does not affect the formation of healthy lifestyle principles in them. It is necessary to strengthen measures on the problems of hygienic education of students on scoliosis.

Introduction. In modern conditions, both morphological and clinical aspects of the pathomorphosis of second-degree lung sarcoidosis in young people make it difficult to diagnose and detect it in a timely manner. The frequency of detection of this disease increased among the population after humanity suffered the covid-19 epidemic, and therefore this autoimmune disease of unknown etiology needs further in-depth study. The goal of this study is to evaluate the dynamics of second degree lung sarcoidosis in patients of a separate age group in order to analyze the effectiveness of treatment with α-tocopherol drugs and the predisposition of the young body to remission. Materials and methods. The data on the activity of serum angiotensin-converting enzyme were collected, processed and analyzed to establish the presence of an acute degree of the disease, as well as a comparative analysis of the results of computed tomograms of mediastinal organs in sixteen studied patients, in accordance with the accuracy of the experiment according to the method by K. A. Otdelnova. Results. It was revealed that over time, after appropriate treatment, in young patients with lung sarcoidosis, the number of foci of inflammation in the pulmonary parenchyma significantly decreased, and the acute phase of the disease naturally turned into a chronic one. Conclusions. The positive dynamics of the disease has been established in people who do not have pronounced symptomatic manifestations of the disease and have been taking alpha-tocopherol drugs for a long time.

Introduction. Cardiorenal syndrome is a relatively new clinical concept. Research on this syndrome is highly relevant due to its widespread prevalence. The existence of the cardiorenal continuum links the dysfunction of the heart and kidneys. Objective. To identify the presence of cardiorenal syndrome in the studied patients. Materials and Methods. This study analyzed the medical records of inpatients in the cardiology department of the Gomel City Clinical Hospital No. 2. Patients were divided into 3 groups. Indicators of the functional state of the kidneys and the cardiovascular system were analyzed. Statistical analysis of the data was carried out using the "Microsoft Excel 2010" and "STATISTICA 10.0" programs ("StatSoft, Inc"). Results. The appearance of microalbuminuria was noted only in the 3rd group. An assessment of cardiovascular risk was conducted in patients with chronic kidney disease. Statistically significant differences in the studied indicators were found in patients of the 1st and 3rd groups regarding urea (p=0.030), AST (p=0.009), ESR (p=0.011), and CRP (p=0.018). A moderate positive correlation was found between systolic blood pressure and creatine kinase-MB (r=0.50; p=0.05) in patients of the 2nd group, and a high positive correlation between the same indicators (r=0.77; p=0.05) in patients of the 3rd group. Conclusions. Patients with ischemic heart disease and arterial hypertension showed a decrease in glomerular filtration rate, urine density, microalbuminuria, an increase in the concentration of creatinine and urea, indicating the presence of cardiorenal syndrome. According to our data, the greatest severity of this syndrome was observed in patients with arterial hypertension and myocardial infarction.

Abstract.

Introduction. Chronic heart failure (CHF) is the final pathophysiological stage of the cardiovascular continuum. The prevalence of this syndrome both in the Russian Federation and in the world is increasing and leads to an increase in economic losses. This is due to both frequent hospitalization and high patient mortality. Goal. To study the features of the clinical course of CHF in patients with metabolic syndrome (MS). To evaluate the effectiveness of a comprehensive cardiorehabilitation program for patients with CHF and MS on indicators of proinflammatory status (TNF-α, IL-1, IL-6). Materials and methods. The study included 124 people diagnosed with CHF – 60 men (48.4%) and 64 women (51.6%), the average age of patients was 64.50±0.73 years. Subsequently, all patients with CHF were divided into 2 groups based on the presence or absence of signs of MS. The first group consisted of 61 patients with CHF without MS, of whom 29 were men (47.5%) and 32 were women (52.5%), the average age was 64.90±1.01 years. The second group consisted of sixty–three patients with CHF and MS, of whom 31 were men (49.2%) and 32 were women (50.8%), the average age was 64.12±1.05 years. Results. In the group of patients with CHF and MS, against the background of physical training (the first group), OT in men significantly decreased by 6.5 cm, i.e. by 6.3% (F=6.76; p=0.0117), in women – by 6.6 cm, i.e. by 6.2% (F=32.06; p=0.0013). BMI also significantly decreased by 1.6 kg/m2 (by 5%, p<0.001). Against the background of physical rehabilitation, the study showed a positive dynamics of lipid profile indicators with a tendency to be statistically significant in patients of the first group. In the second group of patients, the dynamics of lipid profile indicators after 12 months of follow-up was significantly negative: the level of TG increased by 0.3 mmol/l (F=26.78; p<0.001), the level of HDL cholesterol decreased by 0.21 mmol/l (F=26.27; p<0.001), the level of LDL cholesterol increased by 0.35 mmol/l (F=44.74; p<0.001). The analysis of the TSH data revealed a significant dynamics of the growth of tolerance to FN in the first group of patients with CHF and MS: an increase of 41.0 m (F=7.28; p=0.0090). In the second group of patients, there was a significant negative change in tolerance to FN according to TSH: a decrease of 20.0 m (F=6.73; p=0.0118). In patients with CHF and MS, against the background of physical rehabilitation, a decrease in the level of indicators of the proinflammatory cytokine profile was obtained with a tendency to a statistically significant one. Conclusions. In patients with CHF and MS, compared with patients without MS, there is a lower tolerance to FN, a higher activity of the systemic inflammatory response, which causes more pronounced clinical symptoms of CHF and increased cardiovascular remodeling.

Abstract.

Introduction.  Increasing the level of alertness among students of N.N. Burdenko VSMU in connection with the high level of threat in the Voronezh Region is an urgent issue in our time. Due to the beginning of the military operation in Ukraine, the number of terrorist acts in Russia has increased, which are made public in various news and Internet resources. The level of possible terrorist threat in the Voronezh Region is increasing in comparison with other regions of the country due to its territorial location. This situation certainly affects society, and stress levels among people of different ages, including students, are increasing. Goal. To conduct a survey among students of the Burdenko State State Medical University, to find out their interest in this situation, to identify wariness about terrorism, as well as to find out proposals for improving the level of security at the university. Materials and methods. A survey was conducted among students of the 2nd year medical, dental and pediatric faculties, and conclusions were drawn from the questionnaire. Methods of combating terrorism are proposed, the procedure for actions in case of a threat of a terrorist attack on the university territory is clarified. Conclusions. Students are interested in the issue of terrorism in the Voronezh region, they also noted the relevance of this topic at the moment. The methods of increasing the level of security at the university are proposed.

Introduction. Biological hazards have become most urgent in recent years due to the emergence and spread of a new coronavirus infection, COVID-19. The COVID-19 pandemic has forced to pay special attention to biological and social emergencies associated with other human pathogens. Objective. To analyze the prevalence of biohazard emergencies on the territory of the Central Federal District during 2020-2022. Materials and methods. The materials of the study were the data on biological and social emergencies for 2020-2022 in the Central Federal District and in the Russian Federation, presented on the website of the Ministry of Emergency Situations of Russia. Microsoft Excel program was used for data processing and statistical analysis. Results. On the territory of the Russian Federation in 2020, 60 emergencies of biological and social nature were registered, resulting in 164 people. On the territory of the CFD 12 cases were registered. In 2021 on the territory of the Russian Federation there were 88 emergencies of biologo-social character, with 146 people affected. In 2022, the number of biohazard emergencies on the territory of the CFD was 16% of the total number. Conclusions. The increase in emergencies of biological and social character can lead to the spread of infectious diseases and loss of life. Thus, the determining factors affecting the number of emergencies of biological and social character, as well as their manifestations, are: the prevalence of COVID-19, the presence of restrictive measures, the level of development of the RCHS forces, as well as medical services, the intensity of anti-epidemic and preventive measures.

Introduction. The relevance of first aid on the battlefield is growing every year. A person, finding himself in the center of military operations, acquires risks of injuries of various etiologies. The visual analyzer is not an exception due to low protection. The purpose of the work is to determine the sequence of actions in eye traumatization. The literature on ophthalmology and first aid techniques and federal data were used as materials and methods. Results. A wide variety of etiologic factors are capable of causing both open and closed injuries of various genesis. The risks of subsequent complications associated with the spread of infection are high. Correct actions at different stages of medical and sanitary evacuation can preserve not only color perception and color vision of the victim in the course of further rehabilitation, but also subject vision. First aid includes not only local treatment, but also correct application of binocular dressing. Conclusion. Knowledge of the correct sequence of actions during the first stage of medical evacuation can preserve the correct anatomy and physiology of the eye, reduce the risks of enucleation.

Introduction. Unfortunately, armed conflicts still do not cease to occur in the modern world. There is no doubt that under such conditions not only military personnel directly involved in hostilities, but also the civilian population is injured. The aim of the study was to search for new options to improve the treatment of pelvic organ injuries in gunshot wounds of the civilian population received in the conditions of localized armed conflict. Materials and Methods. The study included 112 wounded and civilian population who received gunshot wounds in the pelvic region. The injured in different periods of armed conflicts were included: on the territory of Grozny (Chechen Republic) in the period from 2000 to 2003 and on the territory of Lugansk People's Republic, Donetsk People's Republic, Zaporizhzhya and Kherson regions during a special military operation. Of the total number of wounded men were 64 (57.1%), women - 48 (42.8%). Methods of descriptive statistics were used for mathematical processing. The criterion used was the criterion of agreement χ2. Results. All pelvic wounds can be conditionally divided into three groups: wounds of external genital organs, wounds of internal pelvic organs, and wounds of external genital organs and internal organs. Complications in case of wounds to this anatomical region occur in 34.8%, and lethality is 18.7%. Conclusions. The conducted analysis showed that the measures aimed at providing first aid to the wounded female patients in the pelvic region were fully rendered by medical teams, and no errors in the performance of these measures were registered, which testifies to the good training of emergency physicians.

Abstract

Introduction

The paper analyzes statistical data on the use of air ambulance in the Voronezh region for the period from 2018 to 2022. The most demanded specialists departing and departing for this period on assignments of the Ministry of Health of the Voronezh region are identified.

Keywords: air ambulance, medical and sanitary support, statistics

Objective: to study the possibilities of using sanitary aviation by the Voronezh Regional Clinical Center for Disaster Medicine.

Materials and methods of research.

In the course of our work we analyzed statistical data and analytical reports of KUZ VO “VOKCMK” for the last five years in order to identify the regularity of the impact of the use of sanitary aviation on them.

Results of the study.

The most demanded in terms of support of air ambulance in the Voronezh region are specialists in the field of anesthesiology and resuscitation and the highest indicator of their work came in 2021. The second place is occupied by surgeons. A separate group of specialists of neurosurgical profile can be singled out, the presence of which is explained by the peculiarity of the structure of sanitary losses with the predominance of those affected as a result of road traffic accidents.

Conclusion.

Summarizing the above, despite the decrease in the number of Covid-19 patients, the number of air ambulance sorties has decreased insignificantly. Consequently, the need to use air ambulance in the process of medical and sanitary support continues to be an urgent task.

Abstract.

Introduction. In emergency situations, the personnel of emergency rescue units are exposed to the damaging factors of disasters. In these conditions, high-quality first aid plays a special role. Thus, to provide first aid, personnel must be provided with appropriate means that are not provided centrally. Target. Formation of the general appearance and configuration of a first aid kit for a rescuer. Materials and methods. An analysis of available medical protective equipment, legislation, literature and methodological recommendations was carried out, and information was collected in emergency rescue units. Results. Based on this, the following problems and tasks related to providing personnel with individual first aid equipment were identified. During the analysis of the AI-4 and KIMGZ first aid kits, their advantages and disadvantages were identified. An option was proposed for completing a first aid kit for a rescuer, which included two conditional blocks: the “fire, radiation, chemistry, bacteria” block and the “trauma and wounds” block. Justification was given for the choice of drugs and medical supplies included in the first aid kit. Conclusions. There is no uniform model of a first aid kit in the units; personnel are engaged in independently completing and purchasing first aid supplies; the kits have disadvantages and limitations; there is no uniformity or centralized supply of units with first aid kits. Existing first aid kits have critical shortcomings. Taking them into account, we have proposed an option for completing a first aid kit for a rescuer, which meets all the requirements.

Introduction. Ankylosing spondylitis is a chronic systemic immunoinflammatory disease characterised by involvement of the sacroiliac joints and/or joints of the spine. The most common extraaxial manifestations include involvement of peripheral small joints, entheses, inflammatory bowel disease, and iridocyclitis. Secondary systemic amyloidosis is considered one of the most severe and prognostically unfavourable complications of ankylosing spondylitis. The relevance of the problem is due to the difficulty of early diagnosis of ankylosing spondylitis and the lack of clear diagnostic criteria for making this diagnosis. Objective. To study the peculiarities of ankylosing spondylitis course against the background of developed secondary amyloidosis of internal organs. Materials and methods. In the course of the work we analysed the current medical literature and retrospective analysis of the patient's medical history of the Voronezh Regional Clinical Hospital No.1. The data were systematised and arranged with the help of MS Office software package. Results. The clinical case of the patient who was on in-patient treatment in the Voronezh Regional Clinical Hospital No.1 was analysed. The progression of multiorgan failure on the background of the conducted pathogenetic and symptomatic therapy was revealed. Conclusions. The described clinical case demonstrates a special complexity of treatment of ankylosing spondylitis with developed secondary amyloidosis of internal organs.

Metabolic syndrome is a combination of several risk factors, such as obesity, hypertension, lipid metabolism disorders and insulin resistance, which increase the risk of developing cardiovascular diseases, type 2 diabetes and other concomitant diseases. The immunological system plays a crucial role in protecting the body from infectious agents and maintaining its homeostasis. However, metabolic syndrome can cause changes in the immune system that can affect its function and the level of immune cells. Therefore, the study of the features of the immune status in patients with metabolic syndrome is important for understanding the mechanisms of development of concomitant diseases and the development of effective treatment methods. The aim of the study is to study the characteristics of the immune status in patients with metabolic syndrome, including the number and function of various types of immune cells. The study was conducted in patients with diagnosed metabolic syndrome after obtaining consent to participate. The patients' blood was taken for immunological examination. Data from healthy patients were used for comparison. The results of the study showed a decrease in the number of T-lymphocytes. An increase in Ig G was also detected in most patients. The study showed that metabolic syndrome causes changes in the immune system, so studying the characteristics of the immune status in patients with metabolic syndrome is important.

Introduction. Juvenile periodontitis is a common dental disease. Complications of the disease have been reported in patients with a medical history of diabetes mellitus, bronchial asthma, and COVID-19.
The objective of this study is to identify and examine the factors contributing to the development of Juvenile periodontitis in children with type 1 diabetes mellitus and moderate to severe COVID-19 after hormone therapy.
Materials and Methods. A literature search was performed to identify relevant studies. The study sample consisted of 42 patients between the ages of 12 and 17 years who were diagnosed with Juvenile periodontitis. A questionnaire and a survey were used to collect data. The data from the CBCT were analyzed.
Results. Eight individuals with a history of type 1 diabetes mellitus and moderate COVID-19 were identified. One patient was diagnosed with severe generalized Juvenile periodontitis, which was confirmed by CBCT. The patient also had a history of hormone therapy. During the interview, it was revealed that the patient has poor oral hygiene and does not visit the dentist for professional cleaning.
Conclusions. The course of Juvenile periodontitis in adolescents can be aggravated by several factors, including a history of type 1 diabetes mellitus, COVID-19, especially after hormonal therapy, poor oral hygiene, and infrequent visits to the dentist's office. It is recommended to conduct further follow-up of these patients in dynamics using CBCT.

Introduction. The primary diagnostic method for cerebral vascular aneurysms is computed tomography with contrast, the use of which is associated with certain risks. The use of native magnetic resonance imaging as primary screening therefore is particular interest. Objective. Exploration of the efficiency of native MRI as a primary screening method in patients with suspected cerebral aneurysm. Materials and Methods. We performed an analyze of MRA, CT and native MRI images of patients with diagnosed brain aneurysms to compare the capabilities of native MRI in visualization of aneurysms, find out its effectiveness as primary screening. Images of 56 patients aged 37 to 62 years old with intracranial aneurysms of different sizes and localizations were compared. Results. Comparison of images showed that native MRI images effectively and accurately visualize the size and localization of aneurysms. Results matched with radiocontrast methods. Conclusions. The use of native magnetic resonance imaging is suitable as a method of primary and presymptomatic screening for the diagnosis of cerebral aneurysms. Further study of images performed using native MRI and confirmation of the validation of their results in the conditions of the Russian health care system is required.

Introduction. The paper discusses the issue of timely diagnosis of scoliosis. In the modern world, idiopathic scoliosis is the most studied disease of the human skeleton. Currently, many of his approaches are used in early diagnosis, using X-rays, MRI, CT, the features of osteogenesis (RND) are also being studied and the functional states of the brain and spinal cord (EEG, EMG) are being investigated. Goal. To carry out a comparative analysis of the incidence of idiopathic scoliosis in athletes and students of a medical university. Materials and methods. The paper analyzes the accounting of athletes during routine medical examinations and analyzes the questionnaire of medical university students. Results. When comparing them, a clear discrepancy in the concept of diagnosis was revealed, given that students are aware of their diseases, they do not seek help from specialists, which can lead to deterioration of their condition. Conclusions. Thus, given the frequency of occurrence, it is important to monitor changes in the spine, even if you are not at risk, and consult a specialist in time.

Introduction. It is known that the clinical manifestation of parvovirus infection B19 often resembles feverish respiratory exanthemic malaise with asthenovegetative or flu-like manifestations. Widespread human infection caused by parvovirus B19, according to many literature data, manifests itself primarily as an exanthemic skin lesion in the form of a "lace" rash. This is the so-called typical form. Taking into account the registration of confirmed cases of parvovirus infection B19 (B19V) in Voronezh in the winter and spring periods 2023-2024, attention was drawn to this infection. The purpose of the study to conduct a clinical and laboratory study of parvovirus infection B19. Materials and methods. There were 7 patients with the diagnosis of "Parvovirus infection B19", aged 23 to 63, who underwent inpatient treatment at the «VOKIB» Medical Center in the "Infectious Diseases Department № 1" (for the period 2023-2024). All those examined were residents of the city of Voronezh. The diagnosis in all cases was laboratory confirmed by PCR testing. Conclusion. According to the conducted study, all cases of the disease had febrile-exanthem manifestations, but, in general, with atypical manifestations of this infectious disease, primarily in the nature of the rash, which was more reminiscent of scarlet fever. Studies indicate the need for a laboratory examination to determine parvovirus infection B19 in each case of febrile exanthem disease, and an in-depth clinical study of the manifestations of this viral disease.

Introduction. The causes of the development of cancer in humans can be biological carcinogens, such as viruses and bacteria. Understanding the mechanisms of carcinogenesis allows us to improve algorithms for managing patients with infectious diseases for the purpose of prevention and early detection of tumors. The purpose of the work is to summarize data on the mechanisms of development of cancer caused by pathogenic viruses and bacteria. Materials and methods. A search and analysis of literature data was performed using materials from foreign and Russian sources. Results. DNA- and RNA-containing viruses, as well as the bacterium H. pylori, can act as biological carcinogens. The pathogenetic mechanisms that are involved in the process of carcinogenesis vary depending on the characteristics of the pathogenic microorganism that causes the tumor. Conclusions. 1. Viruses can cause the development of cancer either through a direct effect on the cells of the macroorganism (human papillomavirus, Epstein-Barr virus, human herpes virus type 8, human T-lymphotropic virus), or indirectly through various pathogenetic mechanisms (hepatitis B virus, hepatitis C virus, AIDS virus). 2. Oncogenesis during Helicobacter pylori infection includes both direct and indirect effects on cells.

Introduction. Pathomorphological specificity and specificity of the study of clinical manifestations, development of methods of treatment and prevention against coronavirus infection 2019 (COronaVIrus Disease 2019 - COVID-19) are limited up-to-date information on structural changes in internal organs affected by the virus. Understanding the structure of the virus, the factors that contribute to its progression and spread, pathological findings, diagnosis and treatment methods are essential for effective control of viral diseases. This not only allows for a better understanding of the disease itself, but also for the development of more accurate diagnostic and treatment methods, thus helping to prevent the further spread of the infection among the population. This is especially important in the case of deadly infections such as COVID-19. Target. Analyze the autopsy material described in a number of literature from COVID-19 coronavirus infection confirmed by PCR. Literary sources are represented by articles written by employees of the Department of Pathological Anatomy of the FSBEI HE DonSMU of MOH of Russia, atlas of pathological anatomy COVID-19, as well as domestic and foreign articles published mainly during the last 5 years. Materials and methods. Microscopic morphological changes in the structure of drugs of lungs, liver, kidneys, skin were evaluated. A pathogenetic chain explaining the severity of the clinical pattern of lesions of the respiratory epithelium in relation to the upper respiratory tract epithelium has been identified; respiratory and non-respiratory clinical manifestations of COVID-19 have been listed. A literature review of the pathomorphological picture of COVID-19 found the presence at the histological level and described diffuse alveolar tissue damage (DAP) of the lung with exudative and proliferative phases of the infection. Findings. COVID-19 affects various organs such as heart (cardiac virus, pericytic and vascular endothelium), kidney (CoV clusters in tubular epithelium and podocytes), gastrointestinal tract organs (endothelial virus infection, vasculitis of the subsylysis base vessels), mainly due to the effects of hypoxemia and cytokine storm.

Introduction. The etiological structure of community-acquired pneumonia in children is associated with age. The change in the epidemiological situation in the region has an impact on the incidence of pneumonia and its etiological structure. The aim is to analyze the etiological structure of community-acquired pneumonia in children in 2018-2023. according to the data of the CSTO Department of Health No.2. Methods and materials. A retrospective analysis of the etiological structure of community-acquired pneumonia in children was carried out on the basis of an electronic database in the pre-pandemic period (2018-2019), the COVID-19 pandemic period (2020-2022) and the post-pandemic period (2023). Results. The number of pneumonia increased from 1,124 in 2018 to 2,905 in 2023. In the precancerous period, pneumonia of unspecified etiology prevailed 83.2%, bacterial clarified ones amounted to 8.9%, mycoplasma 9.7%. During the pandemic, every second child had lung damage caused by SARS-CoV-2, mycoplasma accounted for 1.7%, and in 2023 - 26.3%. Conclusions. There has been a convincing increase in hospitalizations of children with pneumonia: during the pandemic due to pneumonia caused by SARS-CoV-2, in the post-pandemic period due to pneumonia of mycoplasmic etiology.

Introduction. Acute respiratory infections occupy a leading place in the structure of infectious pathology in children. At the same time, in pediatric practice, a special place is occupied by genetically engineered interferon-α2b, the safety and effectiveness of which is similar to endonasal use.

The goal of this study is to study the toxic effects of the drug Rinoferon, dosed nasal spray, 500 IU/dose (Pharmstandard-Leksredstva OJSC, Russia) with repeated intranasal administration in two experimental doses to male and female immature rats for 14 days, followed by a 14-day withdrawal period introduction.

The studies were carried out using visual, instrumental and laboratory monitoring of the condition of animals, modern methods for assessing the effect of drugs in accordance with the “Guidelines for conducting preclinical studies of drugs” under the general editorship of Doctor of Medical Sciences. A.N. Mironov and the rules of good laboratory practice GLP.

It was found that the administration of the study drugs in the studied doses for 14 days did not have a significant effect on the body weight of the animals or their food consumption in comparison with the control group of rats. There was also no change in the general condition, qualitative and quantitative blood parameters and the functional state of the internal organs of rats in the experimental groups compared to the group of control animals receiving placebo. Macro- and microscopic examination of the internal organs and the site of drug administration revealed no signs of toxic manifestations caused by the administration of the study drugs. No pathological changes were observed in animals within 14 days after discontinuation of drug administration.

Abstract. 

Introduction. The problem of using nootropic drugs in the correction of intellectual development disorders in children remains one of the most controversial issues in modern medicine, in particular, due to disputes in the scientific community about the effectiveness of these drugs. This is an important topic that deserves attention and research to improve the quality of life of children with these disorders. The goal of this study is to consider the mechanisms of action and capabilities of some nootropic drugs in the treatment of these disorders in children. Materials and methods. An analysis of literary sources on the mechanisms of action and pharmacological activity of nootropic drugs was carried out. Results. Nootropics improve brain metabolism through various mechanisms of action: increasing oxygen consumption in the brain; increased adenylate kinase activity in the brain; increased synthesis of cytochrome b5; improvement of interhemispheric transmission; increased glucose metabolism in the brain; increasing the plasticity of erythrocytes. In this publication, we would like to pay attention to both the drugs with the longest history of use (Piracetam) and new and possibly promising drugs (Meclofenoxate, Deanol aceglumate and Bacopa Monnieri). Conclusions. Assessing the effectiveness of nootropic drugs from the perspective of evidence-based medicine is difficult due to the high heterogeneity of etiological and pathophysiological factors and significant individual characteristics of intellectual development in children. Research shows that nootropics can improve mental activity, memory, attention, learning ability, and also reduce the oxygen demand of neurons during hypoxia. These drugs also help normalize behavior and correct emotional and behavioral disorders in children. The most common and widely used today is Piracetam. It is a nootropic that promotes intellectual development, improves cognitive function and memory.       

The work raises the question of the synthesis of new drugs that have analgesic and anti-inflammatory activity, high efficiency and safety in their use. The article examines the anti-inflammatory activity of new α-cyanothioacetamide derivatives in the classical pharmacological test of dextran paw edema. The purpose of the study is to evaluate the anti-inflammatory properties of the original α-cyanothioacetamide derivatives in in vivo experiments. New derivatives of α-cyanothioacetamide with laboratory codes d02-128 and d02-122 are the leading samples in the test; their effectiveness is 1.57-10.8 times higher than nimesulide.

Abstract.

Introduction. Slow calcium channel blockers are medications that are widely used in patients with cardiovascular diseases such as hypertension and coronary heart disease. Drugs of this group were created in the early years of the second half of the twentieth century, but despite this, calcium antagonists are quite difficult to find an alternative, and they still occupy a leading position in the pharmaceutical market. Goal. To analyze the consumption structure of calcium channel blockers using the example of the local pharmaceutical market. Materials and methods. An analysis of publicly available statistical data was carried out. In the course of the research work, the structure of the use of calcium channel blockers by visitors to pharmacy organizations in the Kursk, Orel, Kaluga, Bryansk and Smolensk regions for the period 2018-2022 was studied. Calcium antagonists were selected as objects of research. Results. The information obtained is presented in the form of tables in which the level of consumption of medicines has monetary and natural (in packages) expression. Among the drugs that are calcium antagonists, amlodipine occupied a dominant position in terms of consumption in 2022. The second place belonged to lercanidipine. Nifedipine and diltiazem were used infrequently in relation to 2018-2021.

Keywords: pharmacoepidemiology; pharmaceutical market; slow calcium channel blockers; arterial hypertension

Introduction. The irrational use of antibiotics in the treatment of acute phlegmonous appendicitis leads to ineffective therapy and various complications. The purpose of the work. Assessment of the dynamics of the level of resistance of the isolated microflora in children with acute phlegmonous appendicitis with a 14-year interval. Materials and methods. The article analyzes 105 results of microbial seeding and their antibiotic resistance obtained from patients aged 1 to 17 years hospitalized in Regional Children's Clinical Hospital No. 2 with a diagnosis of «Acute phlegmonous appendicitis» in 2007 and 2021. The results of the study. A review of the results on antibiotic resistance showed that Gram-positive bacteria, namely Staph. epidermidis, have a high level of resistance to erythromycin. Most gram-negative bacteria are resistant to ampicillin. E.coli strains (ESBL) also show resistance to amoxiclav, cefotaxime and ceftriaxone. Conclusions. The main bacterium often secreted remains E.coli, the seeding of which has increased from 45% to 52% over the past 14 years. There has been a change in the varieties of microorganisms secreted – Ps. aeruginosa became the cause of acute phlegmonous appendicitis in 2021. A large number of bacteria appeared, which began to produce broad-spectrum β-lactamases. The conducted antibacterial therapy should be prescribed taking into account the expected microflora and corrected in accordance with the results of bacteriological sowing of effusion from the abdominal cavity.

Spinal muscular atrophy (SMA) is a progressive neurodegenerative disease with an autosomal recessive type of inheritance, characterized by increasing degeneration of α–motor neurons of the anterior horns of the spinal cord with the development of flaccid paralysis and muscular atrophy. An analysis of three clinical cases was carried out, during which positive dynamics was revealed in patients taking the Nusinersen - motor functions significantly improved. There were no side effects on the background of long-term administration.

Abstract.

Introduction. The development of the urinary system during embryogenesis is closely related to the development of the reproductive system. In more than 30% of patients with unilateral renal agenesis, an associated abnormality of the reproductive system is detected. In our country, there are no formed and established recommendations for the examination of persons with identified renal agenesis for malformations of the reproductive system. That is why in this group of patients, diagnosis is often postponed until the onset of menarche, when such formidable complications as endometriosis, pelvic inflammatory diseases and infertility occur. Goal. Coverage of the clinical case of a patient with right-sided renal agenesis, vicarious hypertrophy of the single left kidney and doubling of the uterus and vagina with partial aplasia of the right vagina. An overview of the ultrasound examination of this pathology. Materials and methods. A clinical case was considered, a comprehensive examination was conducted: a survey, anamnesis collection, laboratory tests and ultrasound diagnostics. Results. The scientific article describes in detail the data obtained from the results of the patient's survey and examination. Conclusions. The presented clinical case demonstrates the importance of timely ultrasound examination to identify malformations of the reproductive system in patients with diagnosed renal agenesis, as well as the need for dynamic monitoring. Patients with malformations of the genitourinary system need lifelong monitoring of the body's condition, control of the preservation of organ function and the nature of changes in their structure, as well as a specialized approach to pregnancy planning, pregnancy and childbirth itself, and recovery after childbirth.

Abstract. The assessment of changes in uric acid levels in an animal model of the orphan disease Lesch-Nyhan allows characterization of the personalized model from the perspective of the principal diagnostic criterion of this syndrome. The objective is to comparatively evaluate the dynamics of uric acid level changes in the blood plasma of mice with a mutation in the Hprt1 gene. Materials and Methods. The study utilized Hprt1^del8Val mice of both genders, categorized into groups corresponding to the zygosity of the mutation on the X-chromosome: Hemi (hemizygous males), Homo (homozygous females), Het (heterozygous females), WT (wild-type animals of both genders). Blood samples were collected from the cheek of animals at various age intervals, starting from 5 weeks of age up to 15 weeks. Uric acid content analysis was conducted using an enzymatic method with spectrophotometric detection at a wavelength of 513 nm. The raw data were statistically processed, employing an appropriate significance criterion. Results. The uric acid level significantly differed in Hemi group males compared to WT group males at 5, 9, and 13 weeks by 21.1%, 21.79%, and 28.84%, respectively (p<0.05). In females, significant differences in uric acid levels were observed in the Homo group at 5, 6, 10, and 15 weeks by 59.78%, 60.45%, 10.33%, and 37.33%, respectively (p<0.05); and in the Het group by 45.01%, 61.68%, 22.05%, and 44.53%, respectively, compared to the control (p<0.05). Conclusion. Hprt1^del8Val mice differ from wild-type mice based on the main diagnostic criterion for Lesch-Nyhan syndrome, directly associated with the impairment of HPRT enzyme function. This personalized mouse model is a crucial component in studying metabolic disturbances occurring in Lesch-Nyhan syndrome.

Abstract. Introduction. Knowledge of the variants of the structure of the branches of the trigeminal nerve is a great practical importance when performing anesthesia in the work of a dentist. Objective. To study of variant anatomy of the branches of the trigeminal nerve. Materials and methods. The study of variant structure of the trigeminal nerve branches was based on the literature review of foreign and domestic sources. Results. On the basis of the studied material the peculiarities of the structure of the trigeminal nerve branches and their influence on anesthesia during manipulations by a dentist were studied. Conclusion. Understanding the variant anatomy of the trigeminal nerve branches is extremely important, especially in the practice of a dentist, as it will allow to achieve better anesthesia.

Introduction. Pathogenesis of most respiratory diseases is a consequence of dysfunctions and defects of the epithelial barrier in the respiratory tract. Consequently, the study of epithelial conditions and mechanisms of their damage in a pandemic coronavirus infection is very relevant. The goal of this study is to explore the role of epithelial permeability syndrome in coronavirus infection (COVID-19), identify relevant pathomorphological changes of the bronchopulmonary system, assume possible targets of pharmacotherapy. Materials and methods. The scientific literature was searched in the following databases: syndrome of increased epithelial permeability, pathological anatomy COVID-19. Results. The article considers and generalizes current information about the development and role of the syndrome of increased epithelial permeability (SIEP) in pathogenesis COVID-19, studies molecular and pathomorphological features of the bronchopulmonary system in coronavirus infection, describes processes and targets, that are potentially medicated. Conclusions. Further study of molecular and pathomorphological features of epithelial barrier dysfunction is helping to improve the quality of diagnosis and treatment of new coronavirus infection, which will help prevent development and reduce the severity of complications.

Introduction. Multiple sclerosis is a chronic demyelinating disease of the central nervous system, which is based on autoimmune and neurodegenerative changes that lead to early disability of people of working age. It is known that in the structure of MS symptoms, about half of the manifestations are due to damage to various pairs of cranial nerves, of which bulbar and pseudobulbar disorders are of interest due to their relevance. Goal. To analyze the prevalence of bulbar and pseudobulbar manifestations among patients suffering from multiple sclerosis. Materials and methods. A study of the functions of IX-XII pairs of cranial nerves was conducted in 19 patients with a reliable diagnosis of MS and who are currently being treated at the neurological department of the BUZ VOKB No. 1. Among the surveyed there were 9 men (47%) and 10 women (53%) in the age range from 23 to 56 years. Results. It was found that among the 19 examined patients with  confirmed diagnosis of MS in the age range from 23 to 56 years, 74%  suffer from bulbar and pseudobulbar disorders. Conclusions. Bulbar and pseudobulbar manifestations were detected in more than half of the studied patients with a confirmed diagnosis of MS.

Introduction. Lafora's disease is a rare autosomal recessive hereditary disease from the group of progressive forms of epilepsy with myoclonus, characterized by partial and generalized epileptic seizures, extrapyramidal disorders, cognitive disorders and dementia. Caused by mutations in the EPM2A and EPM2B genes, which are responsible for the synthesis of the proteins laforin and raspberry. The onset of the disease is at the age of 8-18 years, which rapidly progresses, leading to death after 4-10 years. Target. Using a clinical case as an example, to highlight a rare form of hereditary myoclonus epilepsy. Clinical case. Patient E. Born from consanguineous marriage. He grew and developed in accordance with his age. The onset of seizures at the age of 8 years was generalized tonic-clonic convulsions; valproic acid was started. He was repeatedly treated in the psychoneurological department with a diagnosis of idiopathic generalized epilepsy in the form of tonic-clonic seizures. The following drugs were introduced into the treatment regimen: lacosamide, lamotrigine, topiramate, a course of corticosteroids - without effect. Consulted by a geneticist. A diagnosis of Lafora's progressive myoclonic epilepsy (homozygous mutation in the NHLRC1 gene) was made. Treatment was carried out: valproic acid 1000 mg/day, levetiracetam 2000 mg/day, perampanel 8 mg/day, sibazon 2.0 IV No. 2. The patient has now been transferred to the adult service and his condition is progressively deteriorating. Conclusion. This disease is quite rare, but it should cause vigilance among neurologists in cases of rapidly progressing forms of myoclonic epilepsy that cannot be treated.

This study describes the results of neurological testing and a description of the outcomes of childbirth among patients of the GUZ "Clinical Maternity Hospital No. 2" in Volgograd. The importance of neuropsychiatric stress during childbirth and its effect on the traumatization of pregnancy has been statistically proven.

Introduction. According to epidemiological data, acute cerebrovascular accident (ONMC) is diagnosed in 3 people per 1000 population, which is a fairly high indicator. It is also impossible not to mention the incidence of post-stroke depression of 24-59% (foreign data) and more than 42% (domestic data). Previously, it was believed that stroke is an exclusively older people's problem, however, as practice and time show, the disease is rapidly "getting younger", people aged 20-35 years (5-19%), and in some cases even teenagers (3-7%) are becoming more susceptible to it. Goal. To compare the pathogenetic mechanisms of hemorrhagic and ischemic stroke with the help of current scientific data. Materials and methods. We have analyzed foreign and domestic publications over the past 5 years. Results. The immediate cause of hemorrhagic stroke is hemorrhage in the medulla. The pathogenetic mechanism of ischemic stroke is the interruption of blood supply in

Strabismus is a form of oculomotor disorders, which is characterized by a deviation of the eye from the general point of fixation and is an external manifestation of a violation of binocular vision. At the same time, the pathogenesis of this pathology is still being debated. This study is devoted to the analysis of children with perinatal CNS damage and strabismus.

Goal. Identification of the features of strabismus in this group of patients and identification of patterns of localization of focal lesion according to neuroimaging data.

Materials and methods. A neurological examination and analysis of medical documentation of 26 children with perinatal CNS lesion and strabismus, who are being treated in the neuropsychiatric department No. 3 of the Voronezh Regional Children's Clinical Hospital No. 1, was carried out.

Results. It was concluded that among patients with perinatal CNS lesion, strabismus is most often detected in boys (73%), and the most common type of strabismus is convergent alternating (77%). According to MRI data, the leading position is occupied by atrophic changes in the large hemispheres (58%) with a predominance of lesions of the temporal (33%) and occipital (26%) lobes; changes in the corpus callosum (39%); periventricular leukomalacia (23%) and multicystic encephalomalacia (12%) in the occipital lobes (66.6%) combined with frontal (33.3%) and parietal (33.3%) lobes.

Conclusion. The results of the study suggest that atrophic changes in the brain may be a factor in the occurrence of strabismus.

Introduction. To date, there is no uniform approach to diagnosing developmental dysplasia of the hip (DDH) in children in the first year of life. In order to reduce the number of instrumental studies performed, it is necessary to expand knowledge about the most pathognomonic symptoms that occur with DDH in children of the first year of life, which include abduction limitation of the hip joint (ALH). The goal of this study is to inform opportunity of using ALH symptom in diagnosis DDH. Materials and methods. Using the R. Graf classification (1984), ultrasonograms of 1052 hip joints (HJ) of 526 children in the first year of life were analyzed, and anamnestic data were studied. ALH was observed in 48.48% of observations (58.43% of boys and 41.57% of girls). In the structure of children with ALH, full-term children (69.41%) predominate over premature children (30.59%). 85.89% of children were born with a cephalic presentation of the fetus, 14.11% - with a pelvic presentation Results. Variants of the structure of the HJ of children of the first year of life with a ALH in anamnesis were studied. The sensitivity and specificity of the symptom, the predictive value of positive and negative results was determined. Conclusions. ALH is not a reliable symptom indicating DDH in children of the first year of life, however, in it is absence, the absence of the disease can be assumed.

Abstract.

Introduction. Neuroendocrine tumors (NEO) are a heterogeneous group of neoplasms that originate from neuroendocrine cells of the embryonic intestine that have biologically active properties. Neuroendocrine cells have certain secretory characteristics that cause the development of syndromes of hyperproduction of regulatory peptides, which can lead to the development of corresponding clinical syndromes. NEOS can occur in all organs with neuroendocrine cells. Goal. Conducting an analysis of an atypical clinical case. Materials and methods of research. examination, medical history, laboratory and instrumental studies, surgical, radiation, chemotherapeutic and immunotherapy treatment. The results of the study. A 59-year-old man turned to the VOCODE on 04.09.23 with complaints of shortness of breath during physical exertion, weakness. He considers himself sick since 10.19. During the examination, a brain tumor and a peripheral tumor of the upper right lung were revealed. In the NHO OKB22.11.19, removal of a brain tumor with TMO plastic surgery, according to the results of histological examination, fibrous meningioma. 12/30/19 lumboperitoneal bypass surgery on the left. Conclusions. Carcinoid lung tumors are formed from Kulchitsky neuroendocrine cells located in the mucous membrane of the bronchial tree, and account for 2 to 5% of all primary malignant lung diseases, ectopic ACTH hypersecretion occurs only in 0.5–2% of these neoplasms.

The main method of treatment of localized forms of carcinoid tumors of bronchopulmonary localization is surgical, organ-preserving operations such as segmentectomy, bisegmentectomy, lobectomy, lung resection with bronchoplastic stages are preferred.

Rehabilitation of cancer patients is a complex process that includes not only physical recovery after treatment, but also psychological support. Psychological aspects play an important role in this process, as cancer and its treatment can have a significant impact on the psychological state of the patient. Seriously ill people are characterized by fear of death, shame, self-isolation, impotence, refusal of treatment, revision of life values and lifestyle, hard-to-tolerate treatment, possible pain reactions, fear of recurrence of the disease, suicidal ideas. Attention to the psychological problems of an oncological patient is dictated by the fact that a malignant disease can carry a threat of mental trauma. Psychoncology and oncopsychology are actively developing all over the world and in our country, within the framework of which psychological studies of cancer patients and their families are conducted. For many people, nature is a calming and relaxing remedy, there are also different lists of exercises that are suitable for people with a certain type of cancer, but their performance again depends on the patient's condition, as well as the opinion of the attending physician about them.

Introduction. In view of the high mortality rate from laryngeal cancer, it is important to consider that timely detection and correctly selected treatment tactics can significantly affect the patient’s life expectancy, as well as the development of multiple primary tumors and metastases. Target. To assess the relationship between the life expectancy of patients with cancer in various parts of the larynx, after surgical treatment, and the development of multiple primary tumors. Materials and methods. The study included 149 patients with a histologically confirmed diagnosis of laryngeal cancer of various stages who underwent surgical treatment between 2010 and 2023. The patients were divided into three groups depending on the location of the tumor: group 1 (vestibular larynx), group 2 (middle larynx), group 3 (vestibular and middle larynx). Results. In group 1, life expectancy after treatment ranged from 10 to 50 months. In 27.3% of patients, PME was identified, the development of which occurred 11-66 months after surgery. Also, 18.8% of patients developed metastases 18-29 months after treatment. In group 2, the average life expectancy of patients after surgery was 58.2 months. Progression of PME was found in 16.2% of patients from 9 to 148 months, and metastases developed in 9.4% of patients 8 to 163 months after surgery. For group 3, life expectancy ranged from 2 to 70 months. Progression of PME was detected after 84 months, and metastases developed after 30 months. Conclusions. A favorable course is observed with pathology of the middle part of the larynx, while an unfavorable outcome is more common with tumors of the vestibular part. However, the prognosis still depends on many factors, such as the stage of the disease, the type of tumor, the general condition of the patient and the presence of metastases.

Relevance. Inflammatory diseases of the pharynx are currently leading among the pathologies of the ENT organs. At the same time, diabetes mellitus occupies a huge niche in the global incidence of the endocrine system. The immune status of patients with these two pathologies has been significantly changed. This proves the relevance of the problem of chronic tonsillitis and diabetes mellitus as combined diseases. Goal. Investigation of the effect of the immune status of patients with diabetes mellitus on the development of chronic tonsillitis. Tasks. The study of the immune status in patients with diabetes mellitus, both those complaining of diseases of the ENT organs, and patients without these complaints, as well as a subsequent assessment of the effect of the immune status. Materials and methods. 26 patients with type I and II diabetes mellitus who were treated in both the otorhinolaryngological and endocrinological departments of the Voronezh Regional Clinical Hospital No. 1 were examined. anamnesis was collected and an immunological study was conducted. Results. The evaluation of immunograms revealed leukocytosis, lymphocytopenia, lymphocytosis, decrease and increase in B lymphocytes (CD19), increased IgM levels, decreased IgG levels, CEC was also determined, and an increase in phagocytic number was noted in patients. Conclusion. Endocrine disorders in diabetes mellitus lead to changes in the immune status of patients, which serves as a favorable factor for the development of chronic tonsillitis.

Introduction. There are few data in the literature on the prevalence of various hemostasis disorders in the population. Goal. To determine the propensities to hemostasis disorders among medical university students. Materials and methods. Questionnaire and subsequent analysis of capillary blood on a coagulometer. Statistical processing was carried out using Microsoft Exel 2016 software. 111 people aged 18 to 22 years (24 men and 87 women) took part in the survey.  Results. It was revealed that among the surveyed students, 90% (n=100) have some degree of risk for hypocoagulation and 10% (n=11) have a tendency to hypercoagulation. Women were more likely to have a predisposition to hypocoagulation (%n), and men were more likely to have hypercoagulation (%n). A positive correlation was found between the presence of disorders in the hemostasis system and diseases of the cardiovascular system in relatives (r=0.997, p<0.05) and chronic inflammatory diseases in the respondents (r=0.985, p<0.05). The most common symptoms of hypocoagulation were nasal and gingival bleeding (45%, n=50). Low levels of INR (12%, n=1) and prothrombin time (25%, n=2) were found in individuals with a tendency to hypercoagulation. Conclusions. Identification of the most common symptoms of hemostasis disorders, the presence in the anamnesis of diseases of the cardiovascular system in relatives and chronic inflammatory diseases in the respondents, changes in the coagulogram will allow to establish a tendency to hemostasis disorders.

The presented article analyzes the level of predisposition of people to hypertension, as one of the most common diseases or, as they say now, the "scourge" of the XXI century. A parallel is also drawn between different age categories to find out how globally widespread this pathology is. The paper touches on the topic of risk factors for hypertension: obesity, poor lifestyle, stress and hereditary predisposition. Goal. To substantiate the most common causes contributing to the development of arterial hypertension, to track the features of the course and frequency of pathology among people of different ages. The survey, based on the work entitled "Development of an outpatient questionnaire for patients with high blood pressure," involved 102 people aged 20-44, 45-59 and 60-74, 60 of whom were men and 42 women. As a result of the survey and its careful analysis, the following was determined: arterial hypertension affects not only middle-aged and elderly people, but also the younger generation. In all cases, the development of the pathology under study is associated with maintaining an improper lifestyle, being overweight, low stress resistance and the detection of the disease under study in loved ones.

Introduction. Modern world is full of new information, and it is difficult for the younger generation to concentrate on one of the most important processes – learning. In order to facilitate the assimilation of new knowledge, it is necessary to know your cognitive style, which is an individual feature of a person's intellectual abilities. That is why it is necessary to study the strengths of your thinking in order to memorize and assimilate new information as effectively as possible. Goal. To study the cognitive characteristics of various population groups, identify patterns, give brief recommendations on the organization of the educational process. Materials and methods. Information was collected and data analysis was carried out on the topic "Cognitive abilities". Based on the data obtained, a questionnaire was compiled using basic techniques, and respondents with an average age of 21 ± 1 year were surveyed. Results. The analysis of the answers was carried out, on its basis, patterns of distribution of cognitive styles among students of various faculties, groups with distribution by gender and age were revealed. Recommendations for improving the educational process were proposed for them. Conclusions. The respondents identified their strengths and received useful recommendations that they will use in practice.

The need to use personal respiratory protection equipment, as well as an increase in the number of patients with airway obstruction, makes the study of the effect of additional respiratory resistance (АRS) on the body one of the key problems. To study the adaptation processes formed in the body under the influence of airflow restriction, it is necessary to use experimental models that make it possible to study various adaptive and pathological processes, including in the blood system. Complete blood count (СВС) data make it possible to determine the risk of anemia during operational modeling of АRS. Goal. To determine the effect of the development of АRS on the development of anemia. Materials and methods. The study involved 20 animals. They were randomly divided into 4 groups of 5 rats each. All animals except the control group underwent tracheal ligation surgery with restricted airflow. The frequency of respiratory movements, weight were determined in animals, and blood was taken for general analysis. Results. Against the background of the tracheal ligation operation in animals, there are no violations of the parameters of red blood, except for the indicator of erythrocyte anisocytosis, which returns to normal by 12 days after ligation, which may indicate minor blood loss during surgery.  Conclusions. The indicators of red blood change slightly, the ligation operation does not lead to blood loss in animals, there are no signs of anemia on days 6 and 12.

Ichthyosis is a group of rare genetic diseases with a wide phenotypic spectrum, characterized most often by generalized hyperkeratosis and peeling with variable erythema. The pathogenesis of congenital ichthyosis is based on a change in the structure of keratin and its hyperproduction. The phenotypic heterogeneity of ichthyosis is the result of numerous variants of gene mutations that lead to a violation of the homeostasis of the granular and horny layers, causing structural and functional disorders of the skin barrier. In most cases, the diagnosis is established immediately after birth based on clinical data. The basis of treatment is proper skin care, regular moisturizing, prevention of infection. Goal. To describe the features of the clinical course, diagnosis and therapy of familial cases of congenital ichthyosis. Materials. Medical records of patients with congenital ichthyosis. Results. The article describes clinical cases of congenital ichthyosis in two boys from the same family born 8 years apart. At the time of birth, both children had similar clinical signs and the nature of the course of the disease. Conclusion. The children in this family showed a genetically similar form of congenital ichthyosis. Due to timely initiation of complex therapy and proper care, significant positive dynamics were noted.

Abstract.

Introduction. ANCA-associated vasculitis is a group of immuno-mediated diseases of unclear etiology characterized by chronic inflammation of predominantly small-caliber vessels, frequent involvement in the pathological process of the lungs and kidneys, and the presence of circulating autoantibodies to the cytoplasm of neutrophils. They are rare in children, they are diagnosed late, which leads to early disability and high mortality due to damage to the respiratory system and the development of renal failure. The aim of the work is to demonstrate the difficulties of diagnosis and treatment of a 16-year-old teenager with systemic ANCA-associated vasculitis. The analysis of the medical documentation of a patient who was undergoing examination and treatment in the cardiorheumatology department of the Medical School "VODKB No. 1" in Voronezh was carried out. The results of the study: the girl was admitted to the department of the VODKB No. 1 medical school from an infectious diseases hospital, where she was with acute pneumonia. Antibacterial therapy without effect. Complaints of fever, chills, difficulty in nasal breathing, cough, hearing loss. During the year, episodes of nasal congestion. She was observed at the place of residence with a diagnosis of rhinosinusitis. Radiography of the paranasal sinuses: violations of the airiness of the left maxillary sinus, changes in the density of the nasal concha. Chest X-ray: signs of bilateral multiple globular lung lesion with signs of disintegration. Titers of cANCA 68.8 (N-20); pANCA < 2.0 (N-20) confirmed the diagnosis: Systemic ANCA-associated vasculitis - granulomatosis with polyangiitis. The course of the disease was complicated by perforation of the nasal septum and pulmonary bleeding. Immunosuppressive therapy improved the child's condition. Taking into account the high degree of activity of the disease, it is recommended to connect GIBP – rituximab to therapy. Conclusion: Analysis of the clinical picture in combination with instrumental and immunological data is the basis for timely diagnosis. The course of the disease was complicated by perforation of the nasal septum and pulmonary bleeding. Standard immunosuppressive therapy improved the patient's condition.

Introduction. Adrenal insufficiency, or hypocortisolism, is a syndrome caused by a deficiency in the synthesis and secretion of cortisol in the adrenal nucleus. Depending on the level of damage in the hypothalamus-pituitary-adrenal system, adrenal insufficiency can be primary, secondary or tertiary. The most common is primary adrenal insufficiency. Hypocortisol may be congenital or congenital. Clinical symptoms of chronic adrenal insufficiency today affect 95% of the tissues of the adrenal cortex. In almost 60% of patients, adrenal insufficiency occurs as a result of idiopathic adrenal atrophy.

Chronic adrenal insufficiency (CAI) is a fairly rare pathology, the annual incidence ranges from 100 to 144 cases per million population. The age of diagnosis is most often 20-40 years. Men (and therefore boys) have chronic adrenal insufficiency more often than women (girls).

Target. To present a clinical case of the manifestation of CAI in a teenage girl in the post-pubertal period.

Materials and methods. Clinical study of a patient with anamnesis collection during hospitalization in the endocrinology department of the BUZ VO VODKB № 1. Analysis of clinical case histories with study of the results of laboratory and instrumental examinations, as well as consultations with specialists.

Results. A 17-year-old patient had the onset of the disease in adolescence, with symptoms that imitated vegetative-vascular dysregulation and led to hospitalization in the psychoneurological department of the BUZ VO VODKB №1 with complaints of headaches, dizziness and fainting. An examination was carried out, during which electrolyte disturbances were discovered in the biochemical blood test, which made it possible to suspect CAI. The patient was transferred to the endocrinology department, where the diagnosis was confirmed.

Conclusions. CAI is an endocrine disease that requires lifelong hormone replacement therapy with constant clinical and laboratory monitoring. With proper follow-up and management of the patient, the prognosis for CAI is favorable. Delayed diagnosis and/or inadequate treatment not only aggravates the prognosis, but can also lead to death.

Relevance. Mediterranean fever is a disease with an autosomal recessive type of inheritance, common among certain ethnic groups. Goal. a clinical case of a 12-year-old child with Mediterranean familial fever. Materials and methods. The analysis of the child's medical documentation was carried out.
Results. A 12-year-old patient M. was admitted to the VODKB No. 1 Medical Center in Voronezh with complaints of periodic abdominal pain, extremities, headaches, redness and eye irritation (uveit). From the age of 2, the girl has a skin lesion. From the age of 5-6, headaches appeared, and periodically the pain became intense. Pain syndrome also appeared from this age Diagnosis: I degree obesity (SDS +2.45), exogenous - constitutional, complicated. Autoimmune thyroiditis. Urinary tract infection. Uveitis is in remission. Arachnoid cyst of the hypocompal region. In the MGC in Moscow, a mutation of the MEFV gene in exon 10 was detected in a heterozygous state - pathogenic variant c.2177T (p. Va1726A1a$ p.V726A).
Conclusion. The disease in a child has an atypical course. Further tactics for managing the patient depend on determining the mechanism of the relationship between the underlying disease and concomitant diseases.

Introduction. One of the important conditions for the harmonious development of children and adolescents is the correct formation of the musculoskeletal system, corresponding to age-related anatomical and physiological norms. The conditions of the school environment contribute to the formation of a sedentary lifestyle, which in turn is a predisposing factor for the formation of orthopedic pathology. The purpose of this work is to study the chronic pathology of the musculoskeletal system in school-age children. Materials and methods of research. Using statistical analysis, data from 43 medical records of patients of the school age group who were in the rehabilitation department from 2022 to 2023 were considered. Based on the study, the most common pathologies characteristic of the group under consideration were identified. The results of such research methods as computed tomography, magnetic resonance imaging, radiography, and densitometry were used. The results of the study. In the course of the work, the structure of orthopedic pathology in schoolchildren was studied. Such pathologies as scoliosis, chest deformities, hyperkyphosis and flat feet took the leading positions. With regard to physical development disorders, protein and energy deficiency was more common than overweight and obesity. Conclusion. As a result of the study, it was found that impaired physical development in the form of protein and energy deficiency is more often accompanied by chest deformities. There is a direct correlation between the degree of protein-energy deficiency and osteopenic syndrome, which predisposes to the formation of Z-shaped scoliosis. Overweight and obese children are more likely to be diagnosed with hyperkyphosis.

Introduction. Neuroblastoma (NB) is a malignant extracranial solid tumor of the pediatric population. It can be localized in sympathetic parts of the nervous system and adrenal glands. It occurs sporadically but may be associated with a family history. Treatment tactics of this disease are different, depending on localization, stage and severity. Objective. To describe a patient with accidentally detected NB of the left adrenal gland. Materials and methods. Analysis of the patient's medical history, domestic and foreign literature on the subject of the article. Results. We present a clinical case of accidental detection of adrenal NB in a child of the first year of life who was taken to the hospital with anemia and suspected urinary tract infection. Complex diagnostics made it possible to establish the diagnosis. The child needs thorough examination, specialist consultations, selection of therapy and determination of further management tactics. Conclusion. Risk determination based on a combination of instrumental and laboratory diagnostic methods is no less important than early diagnosis of NB. To date, the search for new methods and schemes of treatment remains relevant due to its high share in the structure of pediatric mortality from oncologic diseases.

This article provides an analysis depending on the type of feeding of a child at an early age and the course of bronchial asthma, as well as its consequences. The study is based on a study of severe causes of the disease in patients of the pulmonology department of the Voronezh Regional Children's Clinical Ward No. 1. The authors point out the role of breastfeeding in the treatment of primary diseases caused by atopic disease in children. The results of the study also include graphs, diagrams and a summary table that display the severity of bronchial asthma and the duration of the child's breastfeeding, taking into account the time of introduction of complementary foods. The benefits of breastfeeding in mild mild forms of bronchial asthma are reflected. The article also discusses the mechanisms of effective breastfeeding in diseases. Symptoms of changes in each form of the disease in children are given. The indicated average age diagnosed bronchial asthma in breastfed and bottle-fed children. The influence of breastfeeding time on the further development of the disease was assessed. In conclusion, the authors highlight the impact of breastfeeding on asthma in children and recommend it as a consistent feeding method in early childhood.

The article presents the data of the study on screening assessment of nutritional risk in children hospitalized in the infectious disease hospital of Voronezh using the STRONGKids questionnaire. Voronezh. Nutritional status is a complex of clinical, anthropometric and laboratory indicators characterizing the quantitative ratio of muscle and fat mass of a person. After all, any nutritional disorders lead to changes in metabolism and violation of adaptive capabilities of organisms due to the peculiarities of the child's body is formed quickly enough protein-energy insufficiency. Nutritional deficiency is a condition caused by a discrepancy between the intake of nutrients into the body and their consumption, which leads to a decrease in body weight and changes in the component composition of the body. Early screening and correction of nutritional deficiency will increase the effectiveness of therapeutic treatment, disease outcomes, reduce the risk of complications and reduce the number of bed days in hospital.

Abstract.

Introduction. Pneumonia is an acute infectious disease, different in etiology, characterized by intoxication, respiratory disorders, changes in the lungs. Early diagnosis and rational therapy of community-acquired pneumonia in outpatient practice is an important part of the course of the disease and recovery time of children. The goal of the work is to analyze the timing of diagnosis and course of community-acquired pneumonia at the pediatric site. Materials and methods. 58 electronic medical records of children from 0 to 18 years with pneumonia were analyzed in the children's polyclinic in Voronezh. Statistical, descriptive methods and analysis were used. Results. More than 95% of children with community-acquired pneumonia had fever, and 86% had cough. During auscultation of lungs dry wheezes were heard in more than half of patients. The right-sided localization of the process was observed. Pneumonia was equally of viral and bacterial (caused by Mycoplasma pneumoniae) etiology (37% each). All children received antibacterial (macrolides were the drugs of choice in 86.2%) and symptomatic therapy. Inhalations were received in 70.7%. Conclusions. Pneumonia has equally viral and atypical etiologies. The right-sided localization of the process was more frequent. Macrolides were used in most cases.

The Russian Federation is represented by many regions that have peculiarities of nutrition by seasons and regions. The Republic of Tatarstan is a multinational subject, the traditions of which influence the formation of children's nutritional habits. At the same time, the rhythm of large cities, employment in everyday life leads to an increase in the energy expended in a short period of time, which contributes to the popularization of "streetfood" and "fastfood". In this paper, we examine the influence of traditions and popularization of junk food relevant to adolescent's nutritional habits. The purpose of the study was to analyze the diet and food system, to determine the influence of ethnic traditions and junk food on food habits. In this article we present two studies conducted, in which parents and adolescents of the Republic of Tatarstan were questioned and children's diet was analyzed. As a result of these studies, a distortion of eating behavior was revealed, due to the influence of both the traditions of the region and the popularization of high-calorie food. Distortion of nutritional habits through the consumption of high-calorie and unbalanced food affects the disruption of the body system and internal organs of adolescents and leads to serious diseases of the cardiovascular system and gastrointestinal tract.

Introduction. The combination of two metabolic pathologies: glycogenosis type 2 known as Pompe disease and β -oxidation of fatty acids is extremely rare in practice, as far as the authors know, there is no scientific literature describing such a combination of the two diseases. Often, the infant form of Pompe disease causes the death of a child, due to progressive myopathy, in some cases even resuscitation measures have a low effect. Defective disorders of fatty acid oxidation are also highly lethal and can manifest themselves as a lag in neuropsychiatric development and damage to the muscular link. Goal. To study the features of the course of two rare metabolic diseases in a child with additional pathologies of a non-exchangeable nature. Materials and methods. A search for literary works on the chosen topic was performed, the medical history and discharge epicrisis, laboratory and instrumental results and patient genetics were studied. Statistical data on the occurrence of these pathologies among the child population have been processed. Results. A general description of the clinical case is given. The features of Pompe disease and congenital changes in the oxidation of fatty acids are revealed, assumptions are made about the dynamics of diseases and possible deviations in the development of the child in the future. The risks of the development and progression of certain disorders have been identified. Conclusions. The diseases have a number of similar symptoms, which contributes to an increased negative impact on the main life support systems of the child, which requires new approaches to the management of such children, if possible. The rarity of the disease precludes sufficient awareness of these diseases.

Hemorrhagic vasculitis in children over a five-year period from 2019 to 2023, taking into account the new coronavirus infection

Yurchenko A.S., Streltsova V.V.

Voronezh State Medical University named after N. N. Burdenko

Scientific supervisor – Doctor of Medical Sciences, Professor Nastausheva T.L.

Abstract.

Introduction. Hemorrhagic vasculitis is the most common pathology among systemic vasculitis in children. During hemorrhagic vasculitis (HV), small vessels of the skin are always affected, clinically manifested by pinpoint rashes. According to the literature, the new coronavirus infection leads to increasing of autoimmune diseases and changing of their course. . Purpose of study. Analysis of the frequency of hospitalizations of children with HV for the period of 2019-2023y. and assessment of the course of the disease. Materials and methods. A retrospective and prospective analysis of the medical records of children with HV who were hospitalized in Voronezh regional children”s hospital № 1 from 01.01.2019 to 12.31.2023y. was carried out. Results. Over the past 5 years, 92 patients with HV (49 boys and 43 girls) were hospitalized. The age of the patients ranged from 3 to 17 years. Dynamics of hospitalizations of children with HV: in 2019 18 patients were hospitalized, in 2020 – 21 patients, in 2021 – 6 patients, for 2022 - 18 patients, in 2023 – 29 children. There were 22 patients who needed repeated hospitalizations because exacerbations of disease and/or kidney damage. Conclusion. YV is a common pathology among children. During the COVID-19 pandemic, the number of hospitalized children with HV has decreased significantly. These children could have been in an infectious diseases hospital. In 2023, there will be an increase in hospitalized children. Because of exacerbations of disease and/or kidney damage 23,9% patients needed repeated hospitalizations.

Introduction. Heart rhythm disturbances can occur at any stage of pregnancy, their spectrum is wide, both benign and high-grade arrhythmias can be observed, which have a negative effect on the mother and the fetus, leading to a complicated course of pregnancy.The goal of study is determine the frequency, nature, possible causes of heart rhythm disturbances and the possibility of treatment during pregnancy. Materials and methods. The work was carried out in an antenatal clinic. A group of pregnant women (125 women) in the I-III trimester, aged 18 to 34 years, was selected. To diagnose arrhythmias and their possible causes, all pregnant women underwent a comprehensive examination.Result. The majority of pregnant women (68%) were diagnosed with various rhythm disturbances, which more often occurred against the background of various pathologies, their number increased with increasing gestational age. The most common types were sinus tachycardia, ventricular and atrial extrasystole. Supraventricular paroxysmal tachycardia has been rarely observed.There were no severe arrhythmias in the pregnant women we observed. Treatment was carried out for poor tolerance of arrhythmias, clinically significant rhythm disturbances, taking into account existing somatic pathology.Conclusions. Most pregnant women experience various heart rhythm disturbances, the frequency of which increases with the duration of pregnancy. They occur most often against the background of somatic pathology. Drug correction of arrhythmias should be carried out after lifestyle modification and treatment of existing pathology with drugs approved for use in pregnant women.

Abstract.Introduction.Every year there is an increase in the number of elderly and senile people, and along with this there is an increase in the prevalence of cognitive impairment (CI). Target. To assess the prevalence and nature of CI, taking into account pharmacotherapy and adherence to treatment in elderly and senile people with comorbid pathology. Materials and methods. The clinical study was conducted on the basis of the VGKP №4. A group of patients was formed - 116 people 60 years of age and older with chronic non-communicable diseases. To diagnose senile asthenia, the “Age is not a hindrance” questionnaire was used; cognitive and psycho-emotional disorders, - clock drawing tests, Mini-Cog, MMSE, Geriatric Depression Scale. Pharmacotherapy in patients 60 years of age and older was assessed using the STOPP/START criteria. Results. 101 (87.1%)patients with hypertension, 87(75%) patients with dyslipidemia, and 99 (85.3%) patients with senile asthenia had irrational pharmacotherapy. Non-dementia cognitive disorders were found in 83 (71.6%) patients with chronic NCDs according to the Mini-Cog data and 36 (31%) according to the MMSE data. Probable dementia was verified in every fifth (Mini-Cog) and every second (MMSE) patient. Probable depression was detected in 77(66.4%)geriatric patients. Conclusion. This study showed an underestimation of the high prevalence of cognitive disorders in people over 60 years of age.

Introduction. Introduction. Currently, the study of the spread of bad habits among young people occupies one of the leading positions in the prevention of diseases. Dependence on mobile devices occupies one of the leading positions among people of all age groups. Adults and children spend hours in front of the screen of their smartphones, playing games and diving into social networks, which can negatively affect not only their learning process and sociality of activity, but also their health. Young people are more susceptible to this addiction than others, as they use their phones for study, communication and entertainment. Goal. To find out the key factors influencing the emergence of dependence on mobile devices, to develop and propose solutions to this problem. Materials and methods. To compile and analyze an anonymous questionnaire for a sociological study of addiction among medical university students. In addition, qualitative methods of information collection were used in the course of the study. Group discussions were held with students to identify their opinions and views on mobile phone addiction. Results. 49 people took part in the survey, the female gender prevailed. 28.6% of students are annoyed when they cannot use a mobile phone, and 49% are nervous when the phone battery is almost empty. Most people feel anxious when they forget their phone at home. Some respondents had problems with health, physical activity and learning process due to excessive use of mobile devices. According to the results of the survey, 75.5% of the respondents are stressed. 36.7% of students believe that it is necessary to reduce their phone usage time. According to the respondents, myopia and headaches were considered the main adverse consequences of excessive use of mobile phones. Students believe that in order to get rid of phone addiction, it is necessary, first of all, to assess their attitude to the phone and make it a rule to remove the phone from the bedroom in the evenings. Conclusions. The study of the formation of dependence on mobile phones is an urgent and important topic, especially among students. In the medical sense, addiction is defined as "a systemic change in the mental processes and behaviors of a person, characterized by a strong desire or persistent craving for a particular substance, object, or activity (an "addictive agent"), which may cause pleasure, euphoria, relief from stress, or a pleasant altered state of consciousness. Only through an integrated approach can effective strategies be developed to manage this problem and create healthy digital habits among students.

Introduction. At the present moment of time in the system of higher education there is a tendency to intensification of educational process. Taking into account the requirements set by the Federal State Educational Standard, the training program in higher education institution includes the discipline "Physical Culture", however, the focus on reducing the number of training hours on this subject and their uneven distribution leads to an increase in the number of students falling into the risk group by the level of physical health. Objective. To determine and compare the level of physical development of students of N.N. Burdenko VSMU and VGTU.  Materials and methods. The questionnaire survey was conducted among the students of N.N. Burdenko VSMU and VSTU aged 18-23 years, the analysis and generalization of the obtained data were performed. The questionnaire was conducted using a questionnaire based on universal questionnaires for assessing the level of physical education. The questioning demonstrated similar level of physical activity in students of different universities at different multiplicity of loads, high frequency of chronic diseases. Justification of the obtained results was given.  Conclusions. The unfavorable influence of the current epidemiological situation on the level of physical development of students, the need to create systems for monitoring the state of physical health, the importance of formation and maintenance of motivation to a healthy lifestyle are noted.

Abstract.Introduction. Nutrition is an important part of a healthy lifestyle. Currently, in Russia, according to Rosstat, 73.2% of men and 84.9% of women have diseases, the etiological factor of which is non-compliance with the diet. Cholelithiasis is no exception, its second name is "The Disease of civilization". The incidence of cholelithiasis increases significantly every year. Goal. To assess whether gallstone disease is the "norm" in the realities of the present time or not. Materials and methods. The object of the study were respondents from different courses of all faculties of TvSMU, patients in the surgical hospital of the GBUZ GKB No. 7 in Tver, as well as respondents with cholelithiasis. Results. The statistical data of the conducted study showed that in respondents with a confirmed diagnosis of gallstone disease and in respondents who did not have this diagnosis, the nature of nutrition and lifestyle practically did not differ from each other. Conclusion. Based on this study, it can be assumed that the entire population is susceptible to cholelithiasis, and therefore a special place should be given to the prevention of cholelithiasis.

Introduction. Infectious diseases in general and sexually transmitted infections (STIs) in particular are a pressing public health problem [1]. Every year, 500 million people acquire one of the four main forms of sexually transmitted diseases (STDs): chlamydia, gonorrhea, syphilis or trichomoniasis. In particular, among modern youth, where free sexual relations are increasingly spreading. Target. To study the knowledge and awareness of students in the field of sexually transmitted diseases. Materials and methods. Conducting a sociological study on the basis of the Federal State Budgetary Educational Institution of Higher Education “VSMU named after. N.N. Burdenko" Voronezh, Studencheskaya street 10. Questioning. Results. 124 people took part in the survey, of which only 75% of respondents know what an STD is, the remaining 25% have no idea what they are talking about; 31.5% of students began to be sexually active at the age of 14-17, more than half of students 52.4% believe that 2-3 partners or more per year is acceptable for our time, the main thing is to protect yourself, only 75.8% of students know If you become infected with an STI, you must treat the disease by consulting a doctor. Conclusions. A sociological study has shown that information messages occupy a large niche in the prevention of STDs. Reminders about the risk of contracting sexually transmitted diseases and other sexually transmitted diseases force students to think about their sex lives.

Introduction. The Irkutsk region is among the top ten most environmentally disadvantaged regions of Russia, ranking 79th in the national environmental rating. This environmental condition negatively affects the living standards and health of citizens. The aim of the work was to analyze the existing system of solid municipal waste collection and storage in the Irkutsk region, as well as the prospects for its development according to the data of official sources and a survey of residents. The following methods were used in the work: analytical, sociological, statistical (calculation of 95 % confidence interval (CI) and structural analysis). During the analysis of documents it was established that the priority method of waste management in the region is burial; the infrastructure for garbage processing is developing slowly, measures to reduce the volume of its formation and burial are not taken. The results of the questionnaire revealed that 85,2 % of the population support nature protection measures, 88,0 % of Irkutsk citizens are aware of the negative consequences of open disposal of garbage in landfills and 90,3 % agree with the need to modernize waste storage methods. Statistically significant differences are determined for two groups of respondents, one of which is in favor of the construction of a waste processing plant – 90,3 %, and the other is against – 1,7 %, which indicates a high level of acceptance of innovations in waste processing by the population of the Irkutsk region.

Introduction. For many years Russia has been one of the leading countries in the number of abortions. Any artificial termination of pregnancy is always a stress for the organism, which can then affect the health of the woman and the future generation. In this regard, prevention and prophylaxis of abortions and their complications is one of the main tasks in preserving women's reproductive health and a guarantee of giving birth to healthy offspring. Objective. To study and quantify the opinions of the young generation regarding sexual intercourse before marriage, the consequences of abortion and its prevention. Materials and Methods. A sociological study among the students of the N.N. Burdenko Voronezh State Medical University was conducted using a questionnaire in Google form. Results. 17.2% of students have a negative attitude to abortion, considering it a murder. Abortion prevention should include, according to respondents, the following:

- Medical literacy (82.8%);

- accessibility and promotion of contraceptives (81.9%);

- Improving the quality of information, education and awareness (81%)

Conclusions. The issue of sex education, awareness about types of contraception, harmful effects of abortion is especially important for such category of people as students. Having conducted the study, the data can be used for educational work to inform the young generation about the culture of reproductive health and behavior.

Introduction. Health is a set of multifaceted processes, the result of our actions. The ideal state of the body is what every person should strive for. Materials and methods: 84 students were examined using a questionnaire on a google form. Results: - do not go in for sports – 52.4%;are in a state of stress – 86.9%; do not do exercises in the morning – 78.6%; do not have breakfast every day – 46.4%; do not have lunch – 28.6%; do not eat dinner – 63.1%; do not get enough sleep – 59.5%. Conclusions: thus, lack of control over one’s health, rare visits to medical organizations, ignorance of basic blood parameters and pressure are risk factors for the occurrence of chronic NCDs among students of the Federal State Budgetary Educational Institution of Higher Education VSMU named after. Burdenko of the city of Voronezh.

Studying the influence of daytime sleepiness on the diet of medical students is of interest, with the aim of developing a commitment to the principles of healthy eating and sleep hygiene among future doctors.

The subject of the study was to study the manifestations of daytime sleepiness and eating habits among medical students.

Materials and methods. The study included data from 174 female second, third and fourth year students who completed a survey using the Epworth Daytime Sleepiness Scale and the ESSE-RF questionnaire (information about the respondents, body mass index, information about foods).

Results and conclusion. Girls with symptoms of daytime sleepiness more often noted the absence of fish and/or seafood in their weekly diet (p=0.03). Girls without significant manifestations of daytime sleepiness were less likely to add additional salt to their food (p=0.02), and also somewhat less likely to drink sugar-containing drinks (p=0.09). Most students, regardless of Epworth score, did not include the recommended amount of fruits and vegetables in their daily diet. There were no significant differences in body weight among girls.

Resume. Introduction. Drug addiction is a significant problem in the modern world. Federal legislation on health protection defines prevention as the sphere of competence of regional authorities, and in the regions of the Chernozem region, legal acts and targeted programs have been adopted that are different in content, but conceptually similar: they are all based on the priority of anti-drug education of young people, but different bodies and institutions are empowered to provide methodological support and practical implementation of thematic events. In this regard, there is a need for comparative monitoring of the indicators of various forms of anti-drug education in neighboring territories. The purpose of the work. To study the differences in the implementation and information content of work on the prevention of drug-related diseases among students of the natural science profile of the Kursk and Voronezh regions.  Materials and methods. In the Kursk region, within the framework of the project supported by the RSF grant №23-28-10301, a survey of 423 students studying in medical and biological specialties was conducted. The volume of a similar study conducted by Voronezh State Medical University named after N.N. Burdenko in its region amounted to 718 observations. In data processing, the calculation and comparison of the proportions of respondents for each position were used, with the calculation of confidence intervals at p≤0.05 and the assessment of the reliability of the data difference for the Kursk and Voronezh regions according to the Student's criterion. Results. The events most widely held in the Voronezh Region, which covered more than 30% of the surveyed students, are organized video screenings, including educational films, self–access to medical Internet resources, and face-to-face lectures by doctors. In the Kursk region, coverage rates of 30% or more were obtained for videos and speeches by medical workers directly in front of student groups. The approach itself in Kursk can be assessed as less centralized, since there is no such obvious group of leading events as in Voronezh. Conclusion. The data obtained indicate a more centralized nature of anti-drug work with natural science students in Voronezh and a greater variety of approaches to prevention in Kursk. Among students of medical and biological specialties of the Voronezh Region, involvement in research and journalistic work with independent study and analysis of professional information is much more common.

 Introduction. Oncology presents a serious challenge to modern medicine in Russia, reducing quality and life expectancy, while early cancer diagnosis is critically important for treatment success. Primary care physicians play a key role in the early diagnosis of cancer, making the enhancement of their cancer awareness particularly relevant. The implementation of digital technologies can significantly improve the process of detecting oncological diseases, increasing the chances of successful patient treatment.

Objective. To assess the need for automated software among primary care physicians to increase cancer awareness during consultations.

Materials and Methods. Anonymous survey of physicians in the Voronezh region, involving 150 participants.

Results. It was found that 88% of physicians see the need for the development of specialized software solutions to increase cancer awareness. Additionally, 71% believe that such an addition will help expedite and simplify their work during consultations. 10% of physicians were against this, mainly due to fears of increased workload as a result of adding a new component to their work, and 22% of respondents believe that the introduction of additional digital components may complicate the work of "older medical workers."

Conclusions. The introduction of additional software can not only contribute to more effective and timely detection of oncological diseases but also simplify the work of medical specialists.

Summary. Introduction. During their studies, students often encounter multiple stressors that cause anxiety symptoms. However, not everyone is able to adaptively tolerate even minor changes in their usual way of life, especially if we are talking about an anxious-suspicious psychotype (anancastic personality). The purpose of the work was to evaluate the effectiveness of training groups for personal growth among students of VSMU named after. N.N. Burdenko. Materials and methods. The emotional state of students, their impressions of the psychological group, as well as the dynamics of the well-being of group participants “before” and “after” 10 training sessions were studied using the testing and survey method. Conclusions. The group participants rated the experience of passing the training sessions as very useful for themselves. The group process and psychological support helped students reduce the level of intrapersonal tension and stress.

The topic of risk factors and medical rehabilitation of drug addicts remains unexplored. Target. Conduct an analysis of risk factors for drug addiction and rehabilitation methods. Materials and methods. A survey of patients was carried out to identify risk factors for drug addiction. Results. It was revealed that the presence of a drug addict among relatives occurred in 20% of people; environmental influence – 80% of respondents; low family standard of living in 95% of cases; self-doubt was recorded among all respondents, problems of interpersonal relationships among 70% of respondents; early sexual activity in 50% of respondents; high crime rate in the area – 5% of respondents. Conclusions. Drug use has a negative impact on many areas of life, including family relationships, housing conditions, education and employment, and social and economic isolation of the drug user occurs. It is necessary to create rehabilitation centers for such patients, which will facilitate their return to society.

Introduction. Non-psychotic disorders is widespread among the population. Students can be considered the most affected by this problem. More relevant than ever is the study of the mental health of students in connection with their high exposure to neurotic disorders, arising against the educational stress. Early identification of changes in the mental health of students will allow to develop methods of prevention of mental disorders. Purpose. Studying the prevalence of symptoms of the non-psychotic disorders among students of medical university. Materials and methods. A study was conducted in students using psychometric methods in the form of electronic testing. Results. Symptoms of non-psychotic disorders were identified in 58% of the surveyed students. Among them, symptoms of anxiety were detected in 46% of the subjects, depression in 26%, bipolar-affective disorder in 52%, obsessive-compulsive disorder in 35% and borderline personality disorder (BPD) in 3%. Conclusions. The study revealed a high prevalence of symptoms of non-psychotic disorders among medical university students. Our electronic questionnaire developed can be used as a screening method for studying the mental health status of medical students.
Keywords: prevalence, students, non-psychotic disorders, screening.

Introduction. The problem of low compliance includes all the factors of the treatment process: prevention, positive outcome and maintenance of public health of the population as a whole. The incompetent behavior of patients leads to an increase in the medical and social burden of diseases and an increase in government spending on healthcare [6]. Goal. To study the level of respondents' awareness of compliance and determine the degree of compliance of the respondents in correlation with the profile of education. Materials and methods.The sample population is 723 respondents. Inclusion criteria: students ofRostov-on-Don. The study was conducted using a questionnaire

The results of the study. The concept of "compliance" is correctly understood – 89.6% of the 1st group and 78% of the participants of the 2nd group. 76% of the 1st group. 54% of the 2nd group believe that compliance increases the effectiveness of treatment. Assessing the importance of compliance in the treatment process on a 3-point scale, 88%-1g and 76%-2 gy gave the maximum assessment of the importance of compliance. According to the majority of respondents in both groups, effective measures to increase compliance are to increase public awareness of the importance of following doctor's recommendations. Conclusion. The education profile has little impact on the level of respondents' awareness of compliance. The majority of respondents of 1 gr. have insufficient adherence to treatment, the predominant part of 2 gr. showed non-adherence according to the results of the analysis on the Morisky-Green –Levine scale.

Summary

External cleanliness of the teeth and oral cavity is a necessary condition for the integrity of the dentition, the general health of the individual and his effective communication. Beautiful and healthy teeth are considered an element of beauty and charm for their owner. Achievements in dentistry, the number of dental clinics, and the variety of dental care products produced by industry are indicators of the demand and relevance of issues related to dental and oral health. Regular brushing of teeth at any age, under any conditions, is a healthy habit and a vital need for a modern person. Target. To get acquainted with the existing options for caring for the oral cavity and teeth of a modern person. Materials and methods. Printed and electronic sources, online questionnaire. Search, analytical, descriptive, survey methods. Results. Oral care is an important component of the hygiene measures of a modern person: both healthy and sick. It is important to rinse your mouth after every meal and brush your teeth twice a day using a brush, paste, and dental floss. Alternative ways to care for teeth are the use of an irrigator, a freshener, an ultrasonic polishing device, mousse, foam, oral deodorant, a pencil, a strip, or a teeth whitening stick. Conclusions. Constant hygienic oral care is an important component of health preservation for every person. You should adhere to the timing of preventive examinations at the dentist recommended by specialists at least twice a year. In patients with a lack of self-care, assistance in caring for teeth and the oral cavity is called upon to be provided by nursing staff. Modern young people strive to have healthy and beautiful teeth by taking proper hygiene measures.

The purpose of the work was to study the level of knowledge of students about reproductive health, measures to preserve and strengthen it, family planning, prevention of unwanted pregnancy. Materials and research methods. The study was conducted using a survey method in 2023 on the basis of medical organizations in Voronezh, Voronezh State Medical University. N.N. Burdenko, as well as through social networks. 98 people took part in the survey. The questionnaire was developed taking into account the age of the respondents and consisted of 20 questions. Research results. Protecting and improving the reproductive health of the population of our country has been one of the key health tasks of our state over the past decades. Considering the steady trend towards a decrease in the birth rate, an increase in mortality and, as a consequence, a decrease in the country's population, the issue of preserving the reproductive health of young people is especially acute. As part of a study conducted among students at Voronezh State Medical University, the level of students' awareness of reproductive health issues was studied. An anonymous survey was conducted among students aged 17 to 25 years, among them 74.5% were girls, 25.5% were young people. The vast majority of students surveyed (97.2%) believe that they have the necessary knowledge in the field of reproductive health , 1.5% of respondents note an insufficient level of their knowledge, 1.3% of students are not interested in this topic at all. At the same time, all 100% of respondents studied issues related to contraception and prevention of STDs. According to the survey results, the majority of respondents prefer condoms (76.5%), some indicated COCs (10.2%), the rest have no preference, but believe that chemical contraceptives are more convenient. Of those who consider their knowledge sufficient, 38.8% still doubt the correct choice of contraception and plan to consult a doctor on this issue in the future. When asked about the effectiveness of various types of contraception, taking into account the prevention of STDs and unwanted pregnancy, many indicated: barrier methods - 89.7%, chemical methods - 5.1%, the rest doubted the correctness of their knowledge. Part of the questionnaire was devoted to the problems of abortion. Unfortunately, not everyone knows that abortion always has some consequences, so they admit that it can be carried out not only for medical reasons, but also at one’s own request (12.2%). When asked what consequences an abortion can have, the following answers were received: infertility - 51%, inflammatory processes - 20.4%, depression/psychological problems - 15.3%, massive bleeding - 5.1%, menstrual irregularities - 18, 4%, do not know about the negative consequences - 14.3%. Of interest are the sources of student knowledge on the topic of reproductive health. The result was as follows: 20.4% of respondents received the first necessary knowledge from their parents, at school during special classes - 17.1%, from friends - 10.2%, from a doctor - 11.3%, pointed to the media (media ), including the Internet - 28.6%, from popular science literature - 9.8%, 2.6% of respondents indicated other sources. At the same time, 64.5% of students consider it appropriate to study these issues in the university curriculum . The most convenient forms for them to obtain this knowledge at a university were the introduction of an elective (optional) course on reproductive health issues - 66.3%, consultations and lectures by a practicing doctor/teacher 39.4%. Some of the questions in the questionnaire were devoted to the topic of family planning. According to the survey results, it turned out that the majority believe that it is necessary to start a family after 25 years - 76.5%, before 25 years - 15.3%, age does not matter - 8.2%. The optimal number of children in a family was indicated: one child – 30.6%, two children – 53.0%, three children – 8.2%, the more the better – 8.2%. To the question: is it necessary to plan a pregnancy, all 100% answered positively, but what specific measures need to be taken before the desired pregnancy, more than 50% of students expressed doubts about their knowledge. Upon further study of this aspect, it turned out that the majority do not know about the need to get tested for STDs, HIV and other tests. Only a third (30.6%) know about recommendations for a healthy lifestyle, taking courses of vitamin therapy and organizing proper nutrition “before an upcoming event.” The majority of guys (more than 70%) do not consider it necessary to quit smoking before planning conception, and girls believe that it is possible to stop smoking/reduce nicotine consumption only during pregnancy and breastfeeding. Unfortunately, 100% of the survey participants are aware of the negative impact of smoking on the body, but smokers do not plan to give up their addiction in the near future. The attitude of young people towards alcoholic beverages is of concern.The majority (81.6%) of respondents believe that alcohol has a negative effect not only on the central nervous system, but also on the reproductive system, but the majority think that the consequences are reversible. Also, 8.2% of respondents indicated that drinking alcohol during pregnancy in minimal quantities does not have a negative effect on the development of the fetus. Conclusion. This paper presented the results of a survey of students in order to study knowledge about reproductive health and identify factors influencing it. The survey generally showed that students are well informed on the issues of contraception and pregnancy planning, but they would like to improve their knowledge. In addition, the identified problem of a lack of knowledge about preparing for pregnancy and a frivolous attitude towards smoking/alcohol is alarming and requires the development of measures to address this issue. The results obtained can be used to develop programs and activities that will help improve the reproductive health of students and improve their awareness. This is an important step in maintaining optimal health in youth and preventing future reproductive problems.

Introduction. The problem of rickets has always been relevant. Rickets is one of the most common diseases among children in the first years of life. The main cause of rickets is a lack of calcium salts in bone tissue due to a lack of vitamin D in the child’s body. The nurse plays a key role in the prevention of rickets. Target. To study the awareness of students at the Institute of Nursing Education of VSMU named after. N.N. Burdenko on issues of rickets and its prevention. Materials and methods. A search of literary sources was carried out in order to identify the relevance, causes and risk factors for the development of rickets in children, as well as highlight the issues of prevention and treatment of this pathology. A survey was also conducted among students of the Institute of Nursing Education at VSMU named after. N.N. Burdenko on issues of student awareness in the identification and prevention of rickets. For this purpose, an original questionnaire was developed, consisting of 10 questions related to the problems of rickets. Conclusions. Based on the survey results, we concluded that students at the Institute of Nursing Education are sufficiently knowledgeable about the causes of development, signs of rickets, as well as issues of prevention and detection of this pathology.

Introduction. Patient-oriented medicine is a mechanism that can improve the quality of medical care. A personalized approach, early detection of comorbid pathology helps to increase patients' adherence to therapy and improve their quality of life. Goal. The introduction of a patient-oriented model into the practice of nurses working with patients suffering from autoimmune diseases. Materials and methods. The study included 29 patients suffering from autoimmune thyroiditis. The Beck test was used to study and identify depressive tendencies. Results. Autoimmune thyroiditis is most often affected by women over the age of 60, and the age of onset and heredity are predictors of adverse outcomes of the disease. Comorbid pathology is depression. The maximum values of depressive disorders were found in patients who had passed from 6 months to 1 year from the moment of diagnosis. Conclusions. The inclusion of elements of cognitive behavioral therapy in the care of patients with autoimmune thyroiditis will lead to the correction of depressive disorders. This will increase patients' commitment to therapy and provides justification for the introduction of a patient-oriented model into the practice of nurses working with patients suffering from autoimmune diseases.

Keywords: autoimmune thyroiditis; depression; patient-oriented care

The professional activity of a dentist is accompanied by exposure to harmful production factors on the body. The dentist is constantly exposed to vibration, noise and infectious agents. A significant load falls on the doctor’s musculoskeletal system. A set of developed preventive measures is necessary to preserve the working and social health of a dentist.

Abstract. The oral cavity is the entrance gate and the location of many pathological processes of various origins. Toxins, microorganisms and breakdown products of tissues and cells can be disseminated in the body and have a negative effect on the ripening fruit. Prevention of dental diseases in pregnant women can help prevent the occurrence of various pathologies of the child's oral cavity. Moreover, pathogenic and opportunistic pathogens that spread through the mother's body can enter the fetus, which will lead to more serious disorders such as congenital heart disease, deformities or miscarriage. A decrease in the immune status during pregnancy contributes to the occurrence of the above pathologies. The conducted sociological research in the form of a survey showed that pregnant women in most cases are poorly or unaware of the rules of oral hygiene and the risks that non-compliance entails. Almost half of the respondents identified the second the trimester of pregnancy as the period of the most frequent occurrence of inflammatory diseases of the oral cavity. It is necessary to conduct preventive and educational activities to prevent the occurrence of stomatitis, gingivitis and other pathologies, and therefore reduce the likelihood of pregnancy disorders.

Introduction. Carbon nanotubes have many unique properties such as physical strength, chemical stability, inertness, biocompatibility, which makes them attractive for use in various medical applications and dentistry is no exception.  The aim of this study is to investigate the possibility of using homogeneously distributed dispersed dispersed graphene nanotubes for the development of innovative dental materials and technologies to improve the effectiveness of treatment and prevention of dental diseases, improve biocompatibility and wear resistance of dental structures. Materials and Methods. The existing scientific literature on the subject of the study was reviewed, including works devoted to the study of the use of single-walled graphene nanotubes in dentistry, as well as studies examining the dispersion and homogeneous distribution of graphene nanotubes in various materials. Homogeneously distributed dispersed single-walled graphene nanotubes obtained using standard synthesis methods are used for the study. The samples are characterized using scanning electron microscopy, transmission electron microscopy and X-ray diffraction. The effect of graphene nanotubes on the properties of various dental materials has been investigated. Results. The study revealed an improvement in the physical strength of toothbrush bristle fibers due to the use of graphene nanotubes embedded in the polyester matrix, biocompatibility of the material and its antibacterial activity were noted. Conclusion. The use of homogeneously distributed dispersed dispersed graphene nanotubes in dentistry is promising and relevant. Single-walled graphene nanotubes have unique properties that make them promising for dental applications.

Abstract.

Introduction. The topic of changes in the oral cavity of patients with functional dyspepsia remains understudied. Dyspeptic symptoms include belching, postprandial fullness, early satiety, epigastric pain, and burning sensation. Functional dyspepsia is diagnosed when no organic etiology of the symptoms is identified. Objective. To analyze changes in the oral cavity of patients with functional dyspepsia. Materials and methods. Patients were surveyed using Coogl forms, and dental examinations were conducted on patients with an average age of 21 years. The collected surveys were analyzed to identify common manifestations in the oral cavity. Results. Changes in the oral cavity characteristic of patients with functional dyspepsia were identified. A higher percentage of patients had a yellowish tint to their teeth, paleness of the oral mucosa, and stomatitis. Conclusions. The most significant findings from the analysis of changes in the oral cavity of patients with functional dyspepsia include the frequent occurrence of stomatitis, paleness of the oral mucosa, and changes in tooth enamel color. In the management of gastroenterological patients with dental issues, the involvement of a dentist is necessary. Further research on the microbiological status of saliva and the oral mucosa is needed. Only through collaborative efforts between gastroenterologists and dentists can the quality of life of patients be improved.

Introduction. In orthopedic dentistry, one of the most pressing problems is the restoration of dentition One of the modern methods of orthopedic treatment of complete and partial absence of teeth is dental prosthetics using dental implants. However, the presence of somatic pathology in the patient’s medical history is one of the contraindications to implantation. In thyrotoxicosis, as a result of an increase in thyroid hormones, bone resorption prevails over bone formation, which leads to a decrease in bone mass (Masalova, R.V. Zakharenko; 2009) and calls into question the successful osseointegration of implants and calls into question the successful osseointegration of implants. The main approach to increasing the osseointegrative properties of implants is to actively modify their surface, resulting in a maximum area of ​​contact with the adjacent bone tissue and, at the same time, stimulating the process of remodeling of this bone [Alekhin et al 2000; Novochadov et al. 2013;]. The above data substantiated the relevance and prompted us to study the dynamics of stability indicators for the objective diagnosis of osseointegration processes when using implants with a hydrophilic surface in patients with thyroid pathology.

Introduction. The shortage of physicians in healthcare is a serious and ongoing problem. It is becoming obvious that due to the shortage of doctors, the opportunity to obtain quality medical care is becoming less accessible. The purpose of the study is to study the causes of the shortage of medical personnel, identify the consequences associated with this, and also propose ways to solve this problem. Research methods. The study was conducted on the basis of the Federal State Budgetary Educational Institution of Higher Education KSMU of the Ministry of Health of Russia among 2nd and 3rd year students of the medical, pediatric and preventive medical faculties using YandexForms. 376 respondents took part in the survey, of which 256 were women and 120 men. The obtained data are presented in text form. Results. When asked about the reason for the shortage of medical personnel, 88.3% of respondents answered “low wages compared to other industries. The most significant question was “What, in your opinion, are the main ways to reduce the shortage of medical personnel?” 290 people (77.1%) responded that it is necessary to improve the remuneration system, as this is one of the main problems of the shortage of medical personnel. Conclusions. As a result of the study, the following conclusions can be drawn. Currently, there are various reasons why there is a shortage of doctors. It is necessary to solve this problem at the state level and promptly identify the local shortage of medical personnel. As a result of solving the problem, the quality of medical services provided and their accessibility will increase.

Introduction. This article includes a retrospective analysis of indicators incidence of tuberculosis in the Voronezh region, as well as a comparative analysis of risk factors for tuberculosis in groups of different age categories. Target. Studying tuberculosis incidence rates in the Voronezh region, as well as conducting a comparative analysis of risk factors for tuberculosis. Materials and methods of research. To conduct the study, data on the incidence of tuberculosis in the Voronezh region for two three-year periods was used: 2012-2014 and 2020-2022. Results. Thus, the incidence rate in the region for the period from 2012 to 2014 decreased by 15.0%, and for the period from 2020 to 2022 by 34.1%. In addition, it was noted that risk factors for the development of tuberculosis are epidemiological, medical, social and professional factors. Conclusion. In a comparative analysis of factors, a greater influence is exerted by social factors that characterize the lifestyle of the population - their addiction to bad habits, unsatisfactory conditions and financial condition, lack of examinations in medical organizations.

Introduction. Sleep is a complex physiological process that ensures the body's recovery. Sleep disturbance can lead to increased stress levels, anxiety, and decreased academic performance. Prevention of sleep disorders is an important aspect of public health. Objective. To assess the duration and quality of sleep of medical students. Materials and methods. The PSQI sleep quality test was administered to 1st-4th year medical students at the beginning of autumn and spring semesters. Components 1-7 were assessed and a summative index was calculated. Results. Sleep quality was found to be impaired in 73.9% and 68.6% of the first and second group respondents, respectively. Sleep disorders were more frequent in female respondents 70.6% (p=0.488) and 87.5% (p=0.352). Most of the students in both groups slept less than 8 hours. Sleep disorders occurred more frequently in the spring semester than in the autumn semester (p=0.020). Conclusions. Regardless of the period of the academic year, medical students were found to have sleep quality disturbance as well as reduced sleep duration, indicating labour and rest disturbance.

Abstract.Introduction. Smoking remains one of the most common harmful habits of mankind. In recent years, the list of nicotine delivery vehicles has changed significantly. And in order to prevent smoking-related diseases, it is necessary to assess the age-related aspects of the prevalence of various types of nicotine addiction. Goal. Compare the prevalence and characteristics of smoking in different age groups. Materials and methods. The material was collected during a survey of students of various universities in the Voronezh region and patients of the polyclinic of the BUZ VO "VGKP No. 7" City polyclinic No. 21. A total of 100 people were interviewed, who were divided into the following groups according to age: 1 group - 18-35 years old - 40 people (23 men and 17 women); 2 group 36-60 years old - 30 people (17 women and 13 men); 3 group - over 60 – 30 people (19 women and 11 men). Results. According to the survey conducted, it can be stated that people aged 18-60 suffer more from nicotine addiction than representatives of the older age group. It is also worth noting that the prevalence of vapes and electronic tobacco heating systems is most widespread among young people (up to 35 years old), and significantly exceeds the popularity of cigarettes in this age group. Conclusions. This information, coupled with the low interest of young people in quitting nicotine addiction, shows the need for active primary prevention of smoking among young people, with special attention to electronic nicotine delivery devices.

Introduction. Legal regulation of Informed voluntary consent is regulated by Federal Law 323 “On the fundamentals of protecting the health of citizens in the Russian Federation”, article 19, paragraph 9, which states that the patient has the right to compensation for harm caused to health during the provision of medical care. Order of the Ministry of Health of the Russian Federation No. 785 “On approval of requirements for the organization and conduct of internal control of the quality and safety of medical activities” task: ensuring and assessing compliance with the rights of citizens in the field of health protection when carrying out medical activities.

Objective: To communicate to physicians and patients the importance of signing informed voluntary consent.

Materials and methods: The study was conducted through medical record analysis, historical analysis, content analysis of medical records and official information sources.

Results of the study: Often patients after surgery (including dental) do not remember that they are warned about possible complications if the intervention is refused, and there are no records of such warnings in their documentation.

Conclusions: Obtaining informed voluntary consent is both the observance of the fundamental rights of the patient and ensuring the safety of the attending physician and the medical organization providing the medical service.

Introduction. With the growth of potential international medical tourism and the desire of medical institutions to expand their client base, developing an effective marketing strategy has become a key aspect of successfully attracting and retaining international patients. Factors such as quality of healthcare services, level of service, communication, and trust play an important role in this process. With increasing competition in this field, updating marketing strategies helps meet the needs of international patients and improve the image of healthcare institutions at the global level. Goal. Develop a marketing strategy to attract foreign patients that will be practically applicable for many medical institutions in Kazakhstan interested in increasing the number of foreign patients. Materials and methods. Theoretical sources of information from many authors on the topic of developing a marketing strategy for medical institutions in the Republic of Kazakhstan and countries where medical tourism is well developed (Israel and Turkey) have been studied. Results. Clearly defined features of factors that influence the correct development of a marketing strategy for a clinic that intends to attract and increase the number of foreign patients have been identified. Conclusions. A marketing strategy will be developed for medical institutions of the Republic of Kazakhstan, which takes into account the characteristics of the country, legislative norms and acts, and transport accessibility of each clinic.

Resume. In the Russian population, there have been practically no studies on the effect of vitamin B12 deficiency on cognitive functions. The relevance of the study is due to the increasing number of cognitive impairments and the tendency to rejuvenate diseases. One of the factors of cognitive decline is vitamin B12 deficiency. The purpose of this study is to find modern and timely opportunities to correct cognitive impairments that occur against the background of cyanocobalamin and folic acid deficiency by sharing these missing vitamins during treatment. Materials and methods. A search of literature sources was carried out in order to identify the possibility of correcting cognitive impairment with vitamin B12, as well as to identify the relationship between the level of cognitive impairment and vitamin B12 intake in respondents. Results. Three groups of respondents were identified, among which cognitive functions were assessed. The relationship of vitamin B12 and B9 deficiency with the level of cognitive impairment and lifestyle has been determined. Conclusions. The model of interaction of the metabolism of vitamins B12 and B9 in the human body, occurring in the folate cycle, has a complex effect on many processes in the body, including brain activity manifested by higher nervous activity (memory, attention, etc.). A relationship has been found about the effect of cyanocobalamin and folic acid on cognitive activity of the brain and psychogenic manifestation deficiency conditions of these vitamins, as well as the effect of bad habits, such as smoking, on the absorption of these vitamins and the depletion of their internal reserves in the body. The relationship between homocysteinemia and the metabolic processes of vitamin B12 and folic acid has been established through their joint interaction in the folate cycle, during which methionine is synthesized from homocysteine. Along with the development of the popularization of complex vitamin therapy in medical practice, this work proposes to place not only a significant emphasis on preventive and timely treatment with vitamin preparations, but also to highlight the problem of vitamin deficiencies among the population.

Introduction. Depressive disorders, characterized by a low mood and other symptoms, are becoming increasingly common, especially among young people. Therefore, it is important to find new, more effective methods of treating depression. Objective. To explore scientific research on new perspectives in the treatment of depressive disorders using psychedelics. Materials and Methods. Literature was reviewed to study modern methods of treating depressive disorders, as well as to analyze the frequency of ineffective modern treatment in such cases. Based on foreign studies, we also examined proposed methods of treating depressive disorders with LSD and psilocybin. Results. Research shows that psychedelic substances, such as LSD and psilocybin, can be used as fast-acting antidepressants with a long-lasting therapeutic effect comparable to existing medications. Scientists have hypothesized that the hallucinogenic effects of psychedelics can be separated, leaving only their antidepressant and stimulating properties associated with increased neuroplasticity  the brain's ability to change and form new connections between neurons under the influence of new experiences. Research also shows that psychedelics affect brain-derived neurotrophic factor and its receptor TrkB, which contributes to enhanced neuroplasticity. Conclusions. Thus, there is a possibility of developing compounds or their combinations that retain the antidepressant properties of psychedelics without the hallucinogenic effect. Understanding the mechanisms of action of psychedelics opens up new perspectives for more effective and safe use of these drugs in medical practice.

Introduction. Therapy of bronchial asthma with genetically engineered biological drugs is promising, but issues of effectiveness and safety are relevant.

Aim of the work. Describe the effectiveness and safety of genetically engineered biological drugs.

Materials and methods. Analysis of the literature over the past 10 years.

Results. The article provides information regarding the effectiveness and safety of the following genetically engineered biological drugs: omalizumab, reslizumab, dupilumab, mepolizumab, benralizumab.

Conclusion. Genetically engineered biological drugs can improve lung function, reduce the frequency of exacerbations and hospitalizations, and reduce the consumption of inhaled glucocorticosteroids.

Introduction. In modern practice, massive bleeding is the most important and frequent preventable cause of death at the prehospital stage, which is why constant developments are underway in this area. The most modern and relevant solution to this problem, along with classical methods, is the use of local hemostatic agents, which at the same time not only increase the chances of survival of the victim, but also significantly reduce the risks of delayed complications.The goal of this study is to study the main types of local hemostatic agents, their mechanisms of action, the most optimal methods of application and give them a comparative characteristic, depending on the active substance and the form of release. Materials andmethods. The analysis of literary sources in text databases and citation systems Elibrary, PubMed, Scopus is carried out.Conclusions.The modern arsenal of local hemostatic agents is quite wide and diverse, including many active substances and forms of release, however, the most convenient and effective in the prehospital stage for massive bleeding, including arterial bleeding, are kaolin and chitosan preparations, produced in the form of special tampon bandages.

Introduction. The incidence of viral hepatitis B is a pressing issue in healthcare, prompting the need for new approaches to disease therapy. The question remains open regarding the development of new treatment strategies. Objective. To analyze contemporary data on the molecular mechanisms of viral hepatitis B pathogenesis and promising directions in antiviral therapy. Materials and methods. Literature search and analysis were conducted on platforms such as Elibrary, PubMed, CyberLeninka, and Scopus to identify the latest research results in the field of viral hepatitis B pathogenesis and key perspectives in antiviral therapy. Results. The data on the mechanisms of HBx protein functioning in viral hepatitis B have been obtained. Three promising directions in antiviral therapy aimed at reducing HBx protein production or limiting its activity were identified: nitazoxanide - a drug inhibiting the interaction of HBx with host cell proteins, which is important for the pathogenesis of viral hepatitis; dicoumarol - a substance promoting HBx degradation; monoclonal antibodies against HBx. Conclusions. HBx protein is the most important link in the pathogenesis of viral hepatitis B. Antiviral HBx-targeted therapy is potentially effective in the treatment of acute and chronic forms of viral hepatitis B and requires further studies.

This article examines the statistics of the incidence of gastric ulcer disease, the results of a marketing analysis of the market of medicines for the treatment of nosology according to clinical recommendations, as well as the results of marketing research on both the federal market of medicines in Russia and the regional one on the example of Kursk. Goal. To conduct marketing research of the medicines market for the treatment of diseases of the gastric ulcer. Materials and methods. Clinical recommendations for the treatment of peptic ulcer of the stomach and duodenum, the State Register of Medicines of Russia, the official website of the Pharmacy Reference Service, scientific literature were analyzed. The methods used in the work are: systemic, structural, graphoanalytic. Results. A list of recommended drugs for the treatment of gastric ulcer was established, marketing research was conducted on the following parameters: groups of drugs (pharmacotherapeutic, anatomical, therapeutic and chemical), which were analyzed according to the following classification feature - active ingredients, composition, trade names, medicines, dosage forms, manufacturing countries, novelty. Based on the results of the analysis of the federal market, a macro contour was compiled, which was used to assess the regional medicines market, additionally evaluated by the parameters of completeness, depth and breadth of the assortment. Conclusions. According to the results of the conducted marketing research, it was found that the range of medicines is able to fully meet the needs of the Russian population in the treatment of gastric ulcer, the local range of drugs in the city of Kursk is optimal, since it includes medicines with all possible recommended international nonproprietary names, as well as in all dosage forms.

Currently, there is a growing global interest in the use of herbal medicines and their main components for the development of new effective medicines with fewer side effects. Portulaca Oleracea L. is an annual succulent plant of the Portulaceae family, subclass of Caryophyllidae. It is widely distributed all over the world. In Russia, it grows in the south of the European part, in the Caucasus and the Far East, cosmopolitan, eurychorus. The distribution area is disjunctive, contour-dotted. It grows in well-moistened habitats - hygrophyte, light-loving. Due to the lack of scientifically sound data on both the chemical composition and the accumulation of plant metabolites, portulacea is not a pharmacopoeia species. And also, the raw materials are not included in the state pharmacopoeia of the XIV edition, and are used in official medicine of Russia. According to the data of foreign scientific literature, the aqueous extract of the plant shows high pharmacological activity. As a result, vegetable purslane is an actual and promising source of a valuable type of medicinal plant raw materials. The work examined and analyzed evidence-based data on studies of anti-inflammatory, antitumor, antioxidant

Abstract.

Introduction. The topic of primary health care stowage for amateur sporting events remains unexplored. One of the reasons for this problem is the lack of necessary information on the division of stowage depending on the type of sport, the level of competition and the place of care. A special urgency arises in connection with the implementation of the federal project "Sport is the norm of life", the main goal of which is 70% of Russians regularly engaged in sports by 2030. The goal of this study is to examine the order of completing medical aid stowages during amateur sports competitions. Materials and Methods. A social study was conducted on the basis of an amateur sports basketball league. Health care providers participated in this study. The sample volume amounted to 100%. Results. It was found that the health care pads were placed in different containers. 32.2% of the respondents indicated that the packs do not have any identifying marks. 25.8% of the respondents indicated that it was inconvenient to use the pads. 67.8% of the respondents state that the storage of the stacks is done in the staff room. 32.3% of respondents assessed that the staffing of the pads does not correspond to the quality of health care provided to the athlete. Conclusions. It is necessary to introduce into the normative requirements the order of completing the medical and sanitary care packages depending on the type of sport and level of sporting events, that is to determine the type of packages, places of their storage, rules of replenishment and use.

According to the current State Register of Medicines, 10 trade names of medicines currently have a valid registration certificate for the dosage form “lozenges”. At the same time, the share of medicinal lozenges intended for resorption is 60%, and the remaining 40% are intended for chewing, but are represented by preparations of animal origin. The purpose of this work is to develop the basis of medicinal chewable lozenges using polymers of plant origin. Materials and methods. As objects of study, six prescriptions of medicinal chewable lozenges of various compositions, manufactured according to individually selected technological schemes depending on the physicochemical properties of plant polymers: pectin, agar-agar, xanthan gum, were considered. According to the results of the study, Recipe 4 was considered optimal, containing 0.2 g of agar-agar and 0.1 g of pectin, sucrose, glucose, citric acid, purified water, flavor and odor flavoring agents. Also, the best characteristics were shown by lozenges made using technology II, which takes into account all the features of working with agar-agar and pectin. However, this composition and manufacturing technology require correction and further research to obtain medicinal chewable lozenges with the best elastic-plastic properties, storage stability and less scatter in the data obtained.

Abstract.

Introduction. In the process of selection and optimisation of nutrient media and in vitro cultivation conditions, morphological, cyto- and histochemical analyses of E. prunastri lichen cells and tissues were performed. In order to create optimal conditions for lichen cultivation, lichen growth was carried out on different variants of nutrient media: liquid, solid and with the addition of alcoholic extracts or aqueous decoctions from plants on which E. prunastri grows in natural conditions. Materials and methods: the study was conducted using E. prunastri lichen plants collected in natural habitats of the Crimean peninsula, using the in vitro tissue culture method. Results: the optimal conditions for growth and development of lichen E. prunastri (L.) Ach were determined during the study. Conclusion: based on the obtained data, a number of regularities at the morpho-, cyto- and histochemical levels were identified, which contribute to the creation of the most favourable nutrient medium for cultivation of the studied plant.

Introduction. In the conditions of the Far North, the immigrant population is exposed to a combination of extreme environmental factors, which requires great strain on the compensatory-adaptive and reserve capabilities of the organism. High demands are also placed on the psychological health. Nowadays immigrants are represented not only by migrants from Russia and the nearest countries, but also by international students from foreign countries. There is a high percent of African students, including Egypt ones, in the North-Eastern federal university (Yakutsk) who are forced to adapt to the abrupt climate change conditions and other difficulties.

The goal of this study is to research general health and the quality of life of the 38 male students of Egypt studying in NEFU, Yakutsk. Materials and methods. The assessment of the quality of life was carried out by the SF-36 international questionnaire. Results. The general health was normal. The quality of life was reduced mainly due to the Psychological component. The Physical component of the health and separate rates were mainly shown satisfactory or high points. The General heath by the SF-36 questionnaire was satisfactory or high in 74% students that was good tendency. Conclusions. The general adaptation syndrome has not reached the resistant phase. The work of curators, timely psychological help are especially important in that period.

Currently, there is an acute problem of finding an effective and affordable treatment for open skin lesions. One of the obstacles to the rapid healing of skin wounds is the free radicals formed during alteration. The role of free radicals is twofold; both their positive and negative effects are known. In this regard, when developing drugs, a more detailed study of the effects of reactive oxygen species in the wound area, as well as antioxidant defense systems, is necessary.

The purpose of this study was to study the activity of the enzymes catalase and superoxide dismutase in the area of layer-by-layer wound defects in the skin of rats.

For this purpose, 27 male rats were used, which were divided into three groups: The first group was the control group, which included 9 intact animals. The second group included 9 rats that underwent a model of acute excisional skin wound, blood was taken from them on the 7th day of the study. The third group included rats that underwent a model of acute excisional skin wound; blood was taken from them on the 14th day of the study.

In the obtained blood, markers of the state of prooxidant-antioxidant systems were assessed, namely: the activity of the enzyme superoxide dismutase (SOD), determination of catalase activity. For this purpose, reagents from Cayman Chemical Company (USA) were used.

As a result of the studies, it was found that excision damage to the skin leads to activation of the enzymatic component of antioxidant protection, which is manifested by a persistent increase in the activity of SOD and catalase in the blood serum

Target. To study the influence of speleoclimate on the ionic composition of blood and saliva, the ionic composition and general urine analysis of an adult healthy person. Materials and methods. The study involved 40 1st and 2nd year student volunteers at VSMU. N.N. Burdenko (12 boys and 18 girls). Study participants were divided into two groups. During the course of speleotherapy, 20 subjects (2 boys and 18 girls) took calcium gluconate 2 tablets 2 times a day with meals, the second group underwent a course of speleotherapy without the use of calcium gluconate. Statistical processing of the obtained data was carried out using Excel and IBM SSPS Statistics 26. Results. The level of potassium, sodium and chlorine in the blood increased after the third procedure relative to the resting state before speleotherapy, and decreased after the tenth speleotherapy. The level of Ca2+ in urine increased after the third speleological procedure and increased further by the end of speleoclimatotherapy. Under the influence of the speleoclimate, an increase in the amount of ketones, bilirubin, urobilinogen, and protein was noted, which indicates changes in the metabolism of the study participants. Conclusions. An increase in urine ketones and protein under the influence of speleoclimate, bilirubin dynamics, changes in the ionic composition of blood and saliva, ionic composition and general urine analysis for the first time suggested the influence of speleoclimate on the metabolism of an adult healthy person. The combined use of Ca and speleoclimate did not affect the detection of ketones, but increased the amount of detected protein.

Resume. Introduction. The relevance of the nursing process in the care of patients with pneumonia lies in the fact that for each patient, often close and dear people do not have the opportunity to provide the necessary care for him. Almost all medical institutions provide such a service. Providing competent care, fulfilling doctor's prescriptions, proper nutrition and rehabilitation after pneumonia is an important criterion for noticeably accelerating recovery and preventing the occurrence of complications. [2] Pneumonia is a disease characterized by damage to the lung tissue. The need to study this disease is due to the fact that the outcome of this disease and the ability to work of patients in the future largely depend not only on early diagnosis and adequately conducted therapy, but also on the organization of nursing care for patients with pneumonia in a hospital setting. [1]The purpose of the study: to study the role of a nurse in the organization of nursing care and training in respiratory gymnastics for patients with pneumonia. Research methods: System analysis, statistical data processing, comparative and structural analysis, ranking. The results of the study: The survey was conducted on the GOOGLE platform, and respondents with potential pathologies of pneumonia participated. The results are encrypted and confidential. After conducting a survey, it can be revealed among patients that many face problems of ignorance about breathing exercises and their performance. This is one of the leading problems of rehabilitation after upper respiratory tract diseases. This work largely depends on the effective work of the nurse, the ability to find a common language with the patient. Keywords: respiratory gymnastics., pneumonia., disease., survey., patient.

Introduction. The article “Yoga as a method of psychotherapeutic self-help and its influence on stress resistance of 1st-2nd year medical university students” examined the role of yoga in improving mental health and the ability of students to endure stressful situations. Target. To evaluate the influence of yoga on stress resistance of medical university students and increasing the relevance of physical activity such as yoga among students of VSMU named after. N.I. Burdenko. Materials and methods. The study included an analysis of changes in the psycho-emotional state, stress level and overall self-regulation effectiveness of participants after starting regular yoga classes. Using questionnaires and testing, a performance assessment was conducted among first- and second-year medical university students who practiced yoga for nine months. Results. There was a significant increase in stress tolerance and a decrease in anxiety in participants practicing yoga compared to the control group. The results of the presented work allowed us to better understand the connection between the practice of yoga and the level of stress resistance in students, as well as highlight the key aspects of its use as an effective means of self-help and increasing psychological resilience in the educational environment. Conclusions. Based on the results obtained, it can be seen that yoga has a positive effect on students, helping to improve sleep quality, concentration and memory.

Currently, the topic of war crimes committed by the Nazis and their accomplices during the Great Patriotic War are of increased public and scientific interest. In the Russian Federation, the project "No statute of Limitations" is being implemented, aimed at perpetuating the memory of victims among the civilian population. The Nazis and their accomplices carried out mass terror against civilians, one of the groups of victims to be destroyed were people with disabilities. The authors studied archival documents of the archive declassified within the framework of the project and were able to reconstruct the events of July 14, 1942 – the day of the mass shooting of patients of the psychiatric hospital in Orlovka.

Introduction. Studying at a medical university is inextricably linked with educational and cultural components, which contributes to the development of empathy, responsibility, moral stability and the ability to sacrifice oneself. These spiritual qualities are key to building trusting relationships with patients and providing quality medical care. Spiritual values help to form a deep sense of morality and professional ethics of the future doctor. Goal. To determine the position of spiritual values in relation to material values among students of medical universities. Materials and methods. The study was conducted by analyzing the activities of medical students. Results. For a medical university student, awareness of the priority of spiritual values over material ones is not only a personal choice, but also a need for professional development. It is on moral constants that the formation of both a qualified specialist and a person capable of deep compassion, understanding and willingness to help others depends. Conclusions. Spiritual aspects play a key role in the value system of a medical university student. They form the basis of professional ethics, determine the level of personal and professional development. It is especially important for a future doctor to preserve and develop moral ideals, focusing on serving people and society.