Prostatic artery embolization (PAE) is an X-ray endovascular method for treating lower urinary tract symptoms. The use of PAE in patients with suprapubic urinary diversion in order to restore natural urination has not been described in the domestic literature, and in foreign literature there are only few publications based on small clinical material.

The purpose of the study was to evaluate the effectiveness of prostatic artery embolization to restore natural urination in patients with suprapubic urinary diversion performed for acute urinary retention due to benign prostatic hyperplasia.

Material and methods. From March 2021 to November 2023, PAE was performed in 10 patients with suprapubic urinary diversion. Efficacy was assessed at 4–6 weeks, 6 and 12 months after embolization. The average age was 68.5±7.1 years old, the average prostate volume was 153±68.1 cm³.

Results. All patients underwent PAE on both sides. No intra- or postoperative complications were observed. In 7 (70%) patients, natural urination restored after 4-6 weeks: Qmax 10.8±3 ml/s, and residual urine volume – 29±22 ml. After 12 months, no one reported worsening urination: Qmax – 12.0±1.6 ml/s.

Purpose. To compare the changes of the kidney position in patient posed on the back in Valdivia and Galdakao-modified supine Valdivia (GMSV) in order to select the optimal direction for puncture of the targeted kidney calix.

Material and methods. The study was conducted on 30 people. All patients underwent non-contrast and contrast urography.

Results. The total average distance between the calix and the puncture point in different positions was 96.1 (±18.7 mm) on the back versus 103.7 (±23.2 mm) on the GMSV (p<0.04). There was a decrease in thickness in the GMSV position of the right kidney> < 0.04). There was a decrease in thickness in the GMSV position of the right kidney in the area of upper calix, middle calix, lower clix by 4.6, 5.9, 7.4 mm (respectively); on the left kidney by 0.8, 1.1, 3.6 mm (respectively). There was a decrease in the angle in the axial projection relative to the horizontal in the right kidney in upper, middle, lower calices by 12.5°, 7.4°, 8.1° (respectively); in the left kidney by 4.2°, 7.5°, 15.7° (respectively).

An increase in the length of access to the calix, a decrease in the thickness of the kidney during patient’s rotation were determined. The angle of access became sharper in the side position. The changes in kidney was insignificant in the GMSV position and percutaneous nephrolithotripsy was still possible.

Conclusion. CT urography allows to determine the accuracy and safety of puncture of the targeted calix. Reduced thickness of the kidney in the GMSV position suggests a reduction in potential kidney injury. A slight displacement of the kidney in the GMSV position allows it to be widely recommended for PNL.

Purpose of the study. The presented surgical method for treating urinary incontinence after vaginal extirpation shows the possibility of achieving a lasting therapeutic effect by restoring the pelvic fascia defect using native tissues (stumps of ligaments and appendages).

Material and methods: 30 patients were operated on with complete uterine prolapse combined with urinary incontinence in the scope of vaginal hysterectomy without appendages with correction of urinary incontinence with the stumps of ligaments and appendages. Based on this method, a patent for invention No. 2799140 dated July 4, 2023 was developed and received. "Method of surgical treatment of urinary incontinence after vaginal hysterectomy".

Conclusion. The results obtained when using this method after vaginal extirpation of the uterus allows for the correction of stress urinary incontinence in combination with complete uterine prolapse without the use of a mesh implant using native tissues. As a result a stable preventive and therapeutic effect of recurrent urinary incontinence is achieved.

Aim. Using laser Doppler flowmetry (LDF) and intraoperative ultrasound diagnostics, to study the characteristics of blood flow and myometrial thickness in the lower uterine segment in women at full-term pregnancy, depending on the presence or absence of labor.

Material and methods. The study included 55 women in full-term pregnancy who gave birth for the first time by cesarean section, of which 33 (60%) women before the onset of labor and 22 (40%) after the onset of regular labor. During the operation, after surgical access to the abdominal cavity, all patients were assessed for the hemodynamics of the lower uterine segment using laser Doppler flowmetry, as well as for the thickness of the myometrium in this segment using intraoperative ultrasound diagnostics.

Results. It was established that in the group of women who underwent a cesarean section in the presence of labor, hemodynamic indicators of the lower uterine segment were registered: perfusion of the microvasculature (PM, perfusion unit (pf.u.) – 5.04 [1.26;5.8 ], standard deviation (RMS, pf.ed) – 3.6 [2.6;3.71], coefficient of variation (Kv, %) – 16.0 [12.4;16.2]. In the group of women who had abdominal delivery at the similar time of pregnancy, but in the absence of labor contractions, hemodynamic parameters were: PM – 6.6 [5.02;7.02], SD – 3.41 [3.0;3.7], Kv, % – 16.0 [12.6;16.5]. Further statistical analysis of the obtained data revealed that in the group of women who underwent cesarean section in the presence of labor, the hemodynamic parameters of the lower uterine segment, assessed using laser Doppler flowmetry, and the thickness of the myometrium in it was significantly lower than in the group of women who were delivered abdominally before the onset of labor.

Conclusion. Patients who have had a cesarean section after the onset of labor have a decrease in microcirculation and myometrial thickness in the lower segment of the uterus, which must be taken into account when predicting the course of myometrial reparative processes, primarily angiogenesis in this area and the characteristics of scar tissue formation.

Objective. Evaluation of the influence of time intervals on the development of hemorrhagic transformation in patients with acute ischemic stroke after intravascular thromboembolectomy.

Material and methods. All patients were divided into two groups: with the development of hemorrhagic transformation (n = 68; 40.5%), average age 68.4±10.4 years old and without hemorrhagic transformation (n = 100; 59.5%), average age 66. 7±9.2 years. The correlation between the development of hemorrhagic transformation and time intervals was assessed: the time from the onset of symptoms to admission to the hospital, the time from the onset of symptoms to the start of brain multislice computed tomography, the time from admission to the hospital to the start of brain multislice computed tomography, the time from the onset of symptoms to the onset of thrombolysis, time from admission to the hospital to the start of thrombolysis, time from the onset of symptoms to arterial puncture, time from admission to the hospital to arterial puncture, time from the start of multispiral computed tomography to arterial puncture.

Results. In the studied groups, there was a direct weak correlation between the development of hemorrhagic transformation and the time to arterial puncture (coefficient r = 0.206 at p = 0.01 (from the onset of symptoms to arterial puncture), coefficient r = 0.188 at p = 0.015 (from admission to the hospital before arterial puncture), coefficient r = 0.172 at p = 0.026 (from the beginning of multislice computed tomography to arterial puncture)).

Conclusion. Analysis of time intervals allows us to understand at what stage there is a delay in time before arterial puncture, to analyze in detail the reasons and to take measures to eliminate these reasons to reduce the time before arterial puncture. Optimizing patient routing allows to shorten the time for arterial puncture, which reduces the chance of developing hemorrhagic transformation and improves treatment outcomes for patients with acute ischemic stroke.

The purpose. To study the attitude towards the disease in patients with noncalculous cholecystitis in combination with overweight.

Material and methods. Based on clinical guidelines for the diagnosis and treatment of cholecystitis, 48 people with chronic cholecystitis with normal body weight (group 1), 66 people with chronic noncalculous cholecystitis and overweight (group 2) aged 18-44 years old were examined. The control group was represented by 36 individuals who did not have diseases of the biliary system and were not overweight. These groups were comparable by gender and age.

Results. The main types of attitude towards the disease were identified among the examined individuals. In the first and second groups, the most common type of attitude to the disease was the hypochondriac type (33.9% and 36.8%, respectively), and the anxiety type (19.7% and 23.3%). There was no dysphoric type.

Conclusions. The leading types of attitude towards the disease in comparison groups with noncalculous cholecystitis with overweight (hypochondriac, anxious) were identified, which will allow taking into account the obtained data when carrying out treatment and preventive measures.

The aim of the research was to study the dynamics of clinical, laboratory and hormonal parameters of the thyroid gland and adrenal glands in adult patients with COVID-19, depending on the severity of the disease. 

Material and methods. 166 case histories of patients with a confirmed diagnosis of U07.1 Coronavirus infection (COVID-19), aged 18 to 65 years old, have been studied. Patients with moderate COVID-19 prevailed and amounted to 140 people (84.33%), severe infection was noted in 26 patients (15.66%). Patients were admitted to the hospital at different times from the moment of the disease (from the second to the 19th day of the disease), on average for 8.34±0.37 days. 

Results. In patients with moderate to severe COVID-19, catarrhal respiratory syndrome, intoxication syndrome and multiple organ dysfunction prevail. In severe disease, a pronounced immune-inflammatory syndrome develops and is characterized by a significant increase in serum levels of D-dimer (505.5±171.34ng/ml), C-reactive protein (52.75±11.52mg/l), fibrinogen (4.91±0.27g/l) (p<0.05). The revealed changes in the values of thyroid and adrenal hormones in patients during acute period of moderate and severe COVID-19 do not depend on the severity of the disease. In COVID-19 convalescents, 6 months after the disease, the content of thyroid and adrenal hormones in the blood generally reaches the values of the control group (p<0.05).

Post-Covid syndrome is one of the most common complications in patients after COVID-19. This condition affects the quality of life and contributes to the development of autonomic and cognitive disorders. Therapy for asthenic disorders should include personalized drug and non-drug treatment methods.

The purpose of this work is to assess the condition of patients after COVID-19 with post-Covid syndrome before and after stepby-step therapy with Elkar (international nonproprietary name - Levocarnitine) and Carnicetine (international nonproprietary name – Acetyl-carnitine).

Material and methods. The study involved 60 patients after COVID-19 of varying severity. They were divided into groups, the first group consisted of 30 patients who were prescribed complex therapy with Levocarnitine (10 ml intravenously/intramuscularly for 10 days) and Acetyl-carnitine (295 mg capsules, 2 capsules 2 times a day for 2 months), and the second was a control group, which also consisted of 30 patients, but they did not receive therapy. Patients were observed 14 or more days after diagnosis to determine the presence and severity of post-infectious asthenia syndrome. The level of asthenia was assessed using the Asthenic State Scale.

Results. The study found that therapy with Levocarnitine and Acetyl-carnitine not only helps to reduce the clinical manifestations of post-Covid syndrome, but also improves the general condition of the body and prevents the development of a protracted course of asthenia.

The current conditions of the dissolution test are not regulated for the dosage forms that can disintegrate in the oral cavity.

The aim of the study was to investigate the parameters of dissolution medium that could affect the release of active substances from orodispersible dosage forms.

Material and methods. The object of the study was chewing gums "Nicorette" 4 mg "Fresh mint”. Reproduction of the dissolution test was carried out by model that could simulate the chewing process. The content of the active substance was determined by spectrophotometric method using spectrophotometer "SF-56".

Results. When assessing nicotine release from the chewing gum the influence of medium content and its pH was compared, as well as surface tension and viscosity. Using pH=6.0 buffered solution there is 74.30% of nicotine release. Use of purified water, 0.9 % of saline solution, phosphate buffered saline with pH=7.4, solution of nonorganic salts showed nicotine release from chewing gums from 45.30 to 55.90 %. Decreasing the surface tension of the dissolution medium by adding surface acting agent (Tween 80) leads to an increase in nicotine release. Increasing the dissolution medium’s viscosity using a guar gum doesn’t allow to assess the effect on the nicotine’s release.

Conclusion. In the course of the study of nicotine release from chewing gums, the influence of the constituent composition of the dissolution medium that simulated human salivary fluid on the values of pH, surface tension and viscosity was evaluated. We showed the change in nicotine release from chewing gums when dissolution media with different pH values were used. It was confirmed that the addition of surfactants leads to an increase in nicotine release by reducing the surface tension of the dissolution medium. The obtained results can be used as a basis for the development of dissolution media that fully reproduces the physiological conditions of the oral cavity.

Recently, pyrimidine derivatives are increasingly being used in medicine and pharmacology, showing high activity in the treatment of various diseases: Alzheimer's disease, viral infections, mycotic and microbial lesions, malignant tumors, wound healing pathologies of various etiologies.

Aim. Synthesis of new thietane-containing hydrazonopropyl derivatives of pyrimidine bases and analysis of their wound healing activity.

Material and methods. New hydrazone derivatives were obtained by reacting thietan, oxo- and dioxothietane-containing 6- methylpyrimidine-2,4(1H,3H)-dione with 1-chloropropan-2-one, followed by condensation with isonicotinic acid hydrazide. The structure and identity of the synthesized compounds were confirmed by nuclear magnetic resonance and infrared spectra, thin layer chromatography, elemental analysis and melting point determination. Preliminary prediction of acute toxicity was carried out in silico using the pkCSM web service and in vivo according to the standard method (Litchfield J. and Wilcoxon F.) modified by V.B. Prozorovsky.

Results. A preliminary prediction of the wound-healing activity of new hydrazonopropyl derivatives of 6-methylpyrimidine2,4(1H,3H)-dione was carried out using the integrated online platform Way2Drag.

Determination of the wound healing effect of the most active hydrazone derivative was carried out in vivo under a linear wound model on laboratory mice.

Preliminary screening of the wound-healing activity of the synthesized hydrazone derivatives made it possible to identify new active stimulators of wound-healing processes and identify some qualitative and quantitative structure-activity patterns, also with the help of the ADMET Prediction Service.

Conclusions. As a result of the study, new N1-hydrazone derivatives of thietane-containing 6-methyluracil were obtained, new biologically active molecules were identified that exhibited the effect of stimulating wound healing.

The aim of this study is to conduct macroscopic, microscopic and qualitative analysis of Salvia stepposa.

Material and methods. The research studied the grass and leaves of Salvia stepposa, harvested on the territory of the Republic of Bashkortostan during the flowering period of the plant in July 2022. Macroscopic and microscopic analysis was carried out using methods described in regulatory documentation [6]. Pharmacological chemical reactions for flavonoids and phenolic compounds were carried out with the obtained alcoholic extracts. The same groups of substances were studied by thin layer chromatography. Thin layer chromatography was carried out on Sorbfil PTSH-AF-A 100×150 mm plates in the system of ethyl acetate - formic acid - water (15:3:4) using standard samples of flavonoids and hydroxycinnamic acids.

Results. Diagnostically significant morphological characteristics of the plant under study have been established, which can be used to identify raw materials. Experiments have shown that the raw material contains flavonoid compounds such as rutin, luteolin7-glycoside, hyperoside and also phenolic compounds — caffeic and chlorogenic acids. Chromatographic study suggested that luteolin-7-glycoside is the main flavonoid of this plant. The conducted research can be used to develop regulatory documentation for S. stepposa raw materials.

Aim of research. To assess current condition of information security for consumers, using online pharmacy services in Russian Federation.

Material and methods. We analyzed 92 questionnaires from consumers living in different cities of Russia and 105 questionnaires from pharmaceutical industry specialists, obtained during a sociological survey on the Internet using originally developed questionnaires.

Results. The experts correctly noted 6 out of 7 types of information that is the most important for consumers about prescription of drugs, except for the expiration date. For over-the-counter drugs, 6 out of 9 types were noted. The expiration date, manufacturer and analogues on the market were chosen by the experts less often. According to the GAP theory, there is a type I gap in the specialists’ understanding of the most important information for consumers about over-the-counter drugs.

Conclusion. Despite the presence of a type one gap, the risks to information security of consumers interacting with online pharmacies to purchase prescription and over-the-counter drugs remain minimal.

The number of reconstructive operations of the femoral-popliteal segment is growing every year; the most acceptable material for a shunt being autovein. However, in the absence of a suitable autovein, synthetic prostheses and xenografts are used, which leads to an increase in cases of degeneration of xenoprostheses. Degenerative changes are the most pressing problem when using xenografts.

The aim of the study is to analyze cases of degeneration of xenoprostheses.

Material and methods. The article presents two cases of surgical treatment of xenoprosthesis degeneration in the Department of Vascular Surgery of the Emergency Hospital, Ufa.

Results. Both clinical cases had one characteristic pattern – aneurysmal degeneration of the prosthesis occurred under the sartorius muscle. Other options for placement of the xenoprosthesis should be considered, for example, in the interfascial space between the sartorius fascia propria and the medial head of the muscle quadriceps femoris. Regular monitoring of patients after using xenografts is required for timely detection of their degeneration.

The aim of the study was to evaluate the effectiveness of a new surgical method for the treatment of corneal ulcers.

Material and methods. All patients underwent surgical treatment, namely lamellar keratoplasty and corneal grafting with an autoconjunctival flap using the allografts for Alloplant surgery. The group under study included 11 patients (5 males and 6 females) with the age ranging from 17 to 80, with complicated and uncomplicated corneal ulcers.

Results. With the operations performed, we have managed to stop the inflammatory process in the 91% of the cases (a recurrence of the ulcerative process was observed only in one case). The increase in visual acuity in the long-term postoperative period was in 63% of cases.

Conclusion. Lamellar keratoplasty with an allograft followed by the autoconjunctival flap plasty can be successfully used to treat corneal ulcers including the complicated ones. The grafts used do not require special storage conditions are available for use in emergency.

Anti-LGI1-Antibody Autoimmune Encephalitis (LGI-1-АE) represents one of the rare forms of limbic encephalitis, which is characterized by cognitive decline (mostly mnestic), mental problems, faciobrachial dystonic paroxysms, sometimes bilateral tonicclonic paroxysms and hyponatremia. Timely diagnosis and immunosuppressive treatment can achieve good results.

Objective. To present a typical case of LGI-1-AE in a 45-year-old woman and brief review of the literature on this disease.

Material and methods. The clinical case description contains generally accepted methods for diagnosing this disease: clinical examination, including neuropsychological evaluation, laboratory tests (blood cerebrospinal fluid), magnetic resonance imaging of the brain, electroencephalography.

Results. After a course of plasmapheresis, methylprednisolone pulse therapy and anticonvulsant treatment, the patient was discharged with improvement in the form of the absence of epileptic seizures and a slight improvement in memory for current events.

Conclusions. LGI1-AE is uncommon, and the likelihood of timely diagnosis of this disease is low. With timely treatment, the prognosis is favorable.

One of the global problems of humankind in the 21st century is the growth of antibiotic resistance. In this regard, in 2015, the World Health Organization adopted the resolution, which identifies the global consensus on the growth of antibiotic resistance, which poses a serious threat to human health. The Government of the Russian Federation is also taking measures that determine the State policy to prevent and limit the spread of antimicrobial resistance on the territory of the Russian Federation.

The problem of resistance to antibacterial drugs is most relevant for nosocomial infections (NI), among them the most common pathogens are representatives of the order Enterobacterales (Klebsiella pneumoniae and Escherichia coli), their share in the structure of NI is 50%. The highest clinical significance is the high prevalence of enterobacteria resistance to cephalosporins and carbapenems.

This clinical case demonstrates an example of the development of pneumonia caused by polyresistant Klebsiella pneumonia with fatal outcome.

A microbiome is a collection of microorganisms found in a specific biological environment. A number of scientists have proven that dysbiosis (a violation of the composition of the microbiome) can be associated with the development of many diseases. Until recently, studies on the bladder microbiome have not been conducted. Previously, it was believed that the bladder of healthy people does not contain microorganisms. But with the development of molecular biology, this statement has been questioned. The discovery of the bladder microbiome made it clear that this microflora may play a role in the development of bladder cancer. Bladder dysbiosis can lead to the development of chronic inflammation of the urothelium, and subsequently lead to bladder cancer. The characteristics of the urinary tract microflora can help in stratifying patients according to the risk of occurrence and recurrence of the bladder cancer, as well as in treating such patients.

Bladder cancer is a common, aggressive and still difficult to predict disease. The development of accurate, noninvasive urine and blood tests for bladder cancer would greatly facilitate the detection and management of a disease with a high rate of recurrence and progression. MicroRNAs, whose extensive potential roles have been identified in many aspects of carcinogenesis, can be considered as a new diagnostic tool. The wide distribution of many microRNAs in urine and blood makes it possible to use them as promising non-invasive diagnostic tumor markers.

The purpose of this article was to review the results of scientific studies to evaluate the diagnostic value of microRNAs as noninvasive biomarkers of bladder cancer.

Conclusion. The diagnostic potential of urinary and serum miRNA expression values represents a promising alternative biomarker.

Urolithiasis is a systemic recurrent metabolic disease that forms a significant part of the socio–economic burden of the healthcare system. The increase in the prevalence and frequency of recurrence of nephrolithiasis, which has been going on for several decades, highlights the need to find ways for prevention and metaphylaxis of the disease.

The review summarizes current domestic and foreign data on the variable causes of uroliths in the kidneys. The article contains information on innate and modifiable risk factors for urolithiasis: genetic aspects of stone formation, the influence of components metabolic syndrome cluster, the importance of the diet, the role of the intestinal microbiota.

Age-related macular degeneration is a socially significant disease that threatens human vision. The main diagnostic method of this disease is optical coherence tomography. Due to the increase in morbidity, the load on the ophthalmologist is increasing. This review presents the latest developments in the implementation of artificial intelligence in the diagnosis of age-related macular degeneration.