Aging of population is an important medical and social problem. Specialized care to this population group remains the leading task of modern cardiology and cardiac surgery. Aged patients with ischemic heart disease (IHD) and lesions of the left main coronary artery (LMCA) have comorbid conditions that receive much attention.

 The aim of the study was to conduct a comparative analysis of the clinical condition and surgical treatment of patients with damage to the left coronary trunk with coronary heart disease over 65 years of age.

Material and methods. Cases of surgical treatment were studied in the cardiac surgery department of the Kirov Regional Clinical Hospital in the period from 2018 to 2020. The study included cases of coronary artery bypass grafting in patients with coronary heart disease with damage to the trunk of the left coronary artery. All patients were divided into groups based on age. The clinical condition and results of surgical treatment in these groups were assessed. Conclusions are drawn based on the results of the study.

Results. Operated patients over 65 years of age had more severe comorbidities. In patients over 65 years of age, higher rates of intraoperative and early postoperative period were documented compared to younger patients.

 Hospital mortality among patients was 1.2% (n=2) and in both cases, death occurred in the group of patients over 65 years of age due to acute myocardial weakness complicated by multiple organ failure.

The aim is to improve the results of treatment of patients with postoperative sternomediastinitis and restoration of the skeletal function of the chest using the method of three–stage surgical tactics: phased programmed sequestrectomy – active aspiration – partial thoracomyoplasty with vacuum aspiration.

 Material and methods. To perform a study in order to evaluate the results of treatment, a cohort model was selected, with a retrospective and prospective analysis of the medical records of 31 patients of the Department of Thoracic Surgery of the Bashkir State Medical University Clinic in Ufa. They were diagnosed with postoperative sternomediastinitis, hospitalization period from 2020 to 2023.

 The study uses descriptive statistics, the Mann-Whitney criterion to assess differences between small samples, the Kendall correlation coefficient. Reliability was assessed using the significance level (p) at 95%.

Conclusion. Programmed stepwise sequestrectomy and vacuum aspiration is a need in the treatment of sternomediastinitis.

Final partial thoracomyoplasty followed by vacuum aspiration allows closing the sternum defect without performing large plastic surgery and avoiding the chest frame function disturbance, and, respectively, severe respiratory failure.

Timely diagnosis will make it possible to predict the long-term consequences of the disease and to improve the quality of life of COVID-19 convalescents.

 The aim of the study is to predict the risk of developing pneumofibrosis in COVID-19 convalescents.

 Material and methods. The object of the study is COVID-19 convalescents aged 23-87 years old. The patients were divided into two groups: group 1 (N=14) with pneumofibrosis, group 2 (N=20) without pneumofibrosis. The inputs to the model were predictors with prognostic significance (p<0.05), evaluated in patients at discharge. The simulation was carried out by constructing classification trees.

 Results. The way out of the constructed mathematical model is the development of pneumofibrosis. The practical significance of the developed algorithms lies in the fact that, based on the values of laboratory and radiological diagnostic methods included in the standard for diagnosing a patient with COVID-19, it is possible to predict with high probability the risk of developing pneumofibrosis of the lungs in the outcome of the disease, which allows us to determine the algorithm for managing convalescences.

The purpose and objectives of the study. Identification of epidemiological, gender, clinical and laboratory differences in the course of the new COVID-19 coronavirus infection (NCVI) at the initial and final stages of the pandemic.

The material and methods of the study are a retrospective comparative analysis of the main clinical and epidemiological characteristics of NCVI, age and gender differences of patients at the initial (2020) and final (2022-2023) stages of the pandemic.

 Results. At the initial stage of the pandemic, the prevalence of more severe forms of the disease was revealed mainly among comorbid unvaccinated elderly and mostly male patients against the background of their untimely medical treatment. At the final stage, signs of a change in the clinical picture of the disease with the natural transformation of NCVI into an acute respiratory viral infection were confirmed.

 Conclusions. The study showed signs of a significant softening of the clinical picture of NCVI in the process of a natural evolutionary transformation of its pathogen.

Objective. To study the epidemiological aspects and clinical and laboratory course of tularemia in St. Petersburg.

 Material and methods. 47 patients diagnosed with tularemia hospitalized in St. Petersburg State Budgetary Healthcare Institution “KIB named after. S.P. Botkin” in 2015-2023, divided into 2 groups: 1 — with comorbid pathology (n=25), 2 — and without it (n=22). Statistical analysis was performed using the nonparametric Mann—Whitney method (p≤0.05).

 Results. Before the disease, patients (n=38) visited: Leningrad region – 34.2%, Novgorod region – 13.2%, Karelia – 13.2%. The cutaneous bubonic form of tularemia was recorded in 72.3%, bubonic in 19.2%, anginal-bubonic in 6.4% and intestinal in 2.1% of cases. In comorbid patients, hospitalization periods were 1.2 times longer than in group 2 (p≤0.05). In 55.4%, the diagnosis was not established before hospitalization and in 23.4% penicillin drugs were prescribed.

Conclusion. Most often, before the disease, patients visited the Leningrad region. Late diagnosis is associated with a lack of vigilance on the part of doctors and the variety of forms and modes of transmission of the disease. The ineffectiveness of prehospital therapy associated with the resistance of Francisella tularensis to penicillins and the comorbid background of patients contributed to an increase in the duration of hospitalization.

Purpose. To study the immediate postoperative results of using a thulium fiber laser for transurethral en-bloc resection of the bladder.

 Material and methods. Transurethral resection of the bladder for bladder neoplasm was performed on 184 patients with an average age of 62.4 (35–84) years old, 91 (49.5%) patients underwent en-bloc transurethral resection of the bladder using a thulium fiber laser (group 1), 93 (50.5%) patients underwent transurethral bipolar resection of the bladder (group 2).

 Results. The average operative and hospitalization times were comparable between the patient groups. In group 1, a decrease in the incidence of obturator syndrome, duration of irrigation and catheterization of the bladder was observed (p<0.05). The muscle layer in the preparation was found in 83 (91.2%) cases in group 1, 74 (79.6%) in group 2 patients.

 Conclusions. The use of a thulium fiber laser for transurethral en-bloc resection of the bladder reduces the incidence of intraoperative complications, the time for irrigation and catheterization of the bladder after surgery and provides high-quality material for histological examination.

Objective is to establish qualitative and quantitative changes in the microstructure of the thyroid gland of rats after 60 days of intoxication of their bodies with toluene.

 Material and methods. An experimental study was carried out on 60 male rats of the reproductive period, divided into two groups: 1 – for 60 days it was seeded with toluene vapors at a concentration of 500 mg/m³, 2nd served as a control. After completion of the 60-days intoxication of the body with toluene, the thyroid gland was studied on days 1, 7, 15, 30 and 60. The method of light microscopy made it possible to evaluate qualitative, and the method of histomorphometry – quantitative changes occurring in the thyroid gland.

 Results. Qualitative transformation included functional disparity of lobules, vascular fullness, swelling and dilatation of stromal layers, topographic heterogeneity of follicles, flattening of follicular epithelium and thyrocytes nuclei, activation of desquamative processes, densification and sharp eosinophilicity of colloid, absence of vacuoles of resorption. Quantitative statistically significant changes were maximally expressed on the 1-st day of observation: a decrease in the height of thyrocytes by 14.70% and an increase in the diameter of follicles by 12.07%, the number of thyrocytes by 10.72%, the colloid accumulation index by 30.04%.

 Conclusion. Microscopic examination of the thyroid gland of rats exposed to toluene showed polymorphism of criteria for the morphofunctional state of the organ with a predominance of signs of its hypofunction during all observation periods.

The aim of the study was to investigate the structural transformations of the spleen of pregnant rats during immunosuppression and subsequent immunostimulation at 2 weeks of gestation.

 Material and methods. The study was carried out on 12 female white rats of the second week of gestation. To create an immunosuppressive state, rats were once injected with methotrexate at a dosage of 10 mg/m² of body area, and correction was performed by using imunofan according to the scheme. The rats were excised at the end of the second trimester of pregnancy in compliance with all ethical standards. The mass, volume-linear and micromorphometric parameters of the organ were measured.

 The results of the study. The experiment showed that the studied effect leads to statistically significant changes in the morphometric parameters of the rat spleen during pregnancy.

 Conclusion. The results of the study indicate the active participation of this organ in the work of immune regulatory mechanisms in the body during gestation.

The aim of the study was to investigate the structural features of the pineal body of experimental animals during immunostimulation.

 Material and methods. The study was carried out on 60 mature rats after administration of imunofan. The rats were excised after administration of the drug after 1, 7, 15, 30 and 60 days. The features of the organometric and micromorphometric parameters of the pineal gland were studied.

The results obtained indicate an active response of the pineal gland to immunostimulation. The injection of an immunostimulator led to a statistically significant increase in the morphometric parameters of the pineal gland at late stages of observation at both the organ and light-optical levels of study, which may indicate a systemic reaction of the organ to immunotropic effects.

The aim of the study is to identify the features of morphometric indicators of the tongue in normal human fetuses and with a cleft of the hard palate.

 Material and methods. The object of the study were 41 tongues of human fetuses aged from 16 to 22 weeks of prenatal development. In 2 fetuses (4.9%), a cleft of the hard palate was detected. The study was carried out using methods of macro- and microscopic preparation, morphometry, and the variation-statistical method.

 Results. The normal length of the tongue in fetuses of the studied period was 13,8±4,3 mm, the width of the tongue at its widest part – 12,0±2,5 mm, the longitudinal-latitudinal index of the tongue – 130±10%, the angle formed by the terminal groove of the tongue – 112,5±9,9°. Features of the morphometric indicators of the tongue with a cleft of the hard palate can be considered a tendency to increase the length, width at the level of the terminal sulcus, and the length-latitude index.

 Conclusion. It is likely that the larger than normal size of the tongue may interfere with the fusion of the palatal shelves or be part of a concomitant pathology. At the moment, the mechanism for the development of such a relationship is not disclosed in the literature. This makes further research using different methodological approaches relevant.

Purpose of the study. To select morphometric parameters of the radius bone necessary for the most accurate description of its proximal part.

Material and methods. The material of the study was 82 macerated radius bones (38 male, 44 female) of people, the average age of which was 60.5±28.5 years old. Statistical processing of the research results was carried out using the Statistica 13 for Windows application package.

 Results. The study showed that in osteometry of macerated radial bones, the selected parameters are 4-21% less than similar indicators obtained from autopsy of the elbow joints.

Conclusion. For a more detailed description of the proximal part and its most accurate modeling, it is necessary to take into account such parameters as: diameters and height of the head in the frontal and sagittal planes, depth of the articular fossa, length and width of the tuberosity, sagittal diameter of the proximal part in the area of the tuberosity.

Periodontal diseases are widespread among adult population. They lead to loss of dental attachment and destruction of the supporting bone tissue of the teeth. Thus, the issue of effective immobilization of movable teeth seems acute and important. This article presents a clinical case of a 32-year-old patient with movable teeth 3.3, 3.2, 3.1, 4.1, 4.2, 4.3. The treatment protocol includes CAD/CAM additive technologies. A polymer splint was manufactured for temporary immobilization. Permanent immobilization was carried out six months later with an individual milled splint made of zirconium dioxide. Periotestometry was used for quantitative analysis of tooth mobility. Local hemodynamics was assessed by doppler ultrasound. Changes in microbiocenosis were evaluated by real-time PCR. All measurements were performed three times: before treatment, after non-surgical periodontal treatment and temporary immobilization, as well as 6 months after fixing a permanent splint.

Congenital giant pigmented nevi (CGPN) are benign formations consisting of melanocyte cells containing the pigment melanin and located in various layers of the skin. CGPN is not only a medical problem, but also causes a violation of social adaptation when localized in open areas of the body. Their removal is accompanied by difficulties in the form of the inapplicability of certain treatment methods or the risk of scarring and functional changes.

 Recently, publications have appeared on the study of the effects of «blue» laser radiation with a wavelength (λ) of 450 nm for use in clinical practice. The problem of the most effective removal of CGPN remains relevant, which requires the research and introduction of new methods of treatment of this pathology in children.

 Purpose. Determination of the possibility of layer-by-layer removal of CGPN with «blue» (λ) 450 nm laser radiation in children.

 Material and methods. The layered removal of the CGPN was carried out with «blue» laser radiation (λ) 450 nm on the Lasermed 10-03 apparatus, Russian Engineering Club LLC (Tula). At the CRIEPST, treatment of various forms of CGPN was carried out in 12 children: 4 patients with a small form, 5 children with an average form and 3 with a truly gigantic form. The children ranged in age from 6 to 18 years old. The localization of CGPN in 5 children was on the face, in 2 on the back, in 2 on the anterior surface of the chest, in 1 patient on the abdominal wall and in 2 children on the lower extremities.

 Results. The final good clinical and aesthetic result was noted in 9 children with small and medium forms of CGPN, a preliminary good clinical and satisfactory aesthetic result in 3 patients with a truly gigantic form at the treatment stage, a bad result was not noted.

Conclusion. The first experience of using «blue» laser radiation with a wavelength (λ) of 450 nm for layered removal of CGPN in children has shown the possibility of its further effective use in the clinical practice of a pediatric surgeon.

The aim. To study affective disorders in patients with amyotrophic lateral sclerosis (ALS).

Material and methods. Fifty patients with ALS were investigated using ALSFRS-R (ALS Functional Rating Scale), Kings College staging system, Patient Health Questionnaire (PHQ-9) and The Generalized Anxiety Disorder 7 scale (GAD-7). Methods of non-parametric statistics were used for the analysis. 

Results. Symptoms of clinically significant depression were registered in 42 out of 50 (84%) patients. Anxiety disorders were identified in 13 (26%) patients with ALS. Comparative analysis did not reveal significant difference in the severity of depression and anxiety in patients with ALS depending on sex, form and stage of the disease (p>0,05).

Conclusion. The results of the study confirmed high frequency of affective disorders in ALS. This needs to be taken into account while planning measures of palliative care.

Composition analysis of kidney stones is an important step in the diagnosis and treatment of urolithiasis. Up-to-date research methods, including spectroscopic ones, provide accurate information about the composition of stones. Further research of diagnostics of chemical nature of calculi can help to personalize treatment of this disease. 

This study is aimed at studying the composition of kidney stones by X-ray diffraction in patients with urolithiasis living in the Republic of Bashkortostan.

Material and methods. The study included 129 patients diagnosed with urolithiasis. The chemical composition of the stone was analyzed in all patients using a Rigaku Ultima IV X-ray diffractometer (Japan) with Bragt-Brentano geometry.

Results. Oxalates prevailed among the seized stones, while phosphates and urates were less common. And the most common minerals were wevelite, then weddelites, struvites, hydroxyapatites, carbonapatites, uric acid.

Aim. To assess the characteristics of measles incidence in the Republic of Bashkortostan during the period of activation of epidemic process and to establish the clinical, epidemiological and laboratory characteristics of the disease.

Material and methods. Analysis of 27 medical records of patients diagnosed with measles who underwent inpatient treatment at the Ufa Republican Clinical Hospital in the period from March to August 2023.

Results. Measles was most often registered in children aged 3-7 years old, while in 67% of cases the children had never been vaccinated against measles; only 2 children received 1 dose of the vaccine. Among adults, only 1 person was not vaccinated; the rest had received only 1 dose in childhood. All patients had moderate measles and, in general, had a typical course. Atypical course of measles was detected in 1 patient in the form of absence of enanthema and exanthema. More than 70% of patients showed absolute and relative leukopenia in the general blood test. The diagnosis of measles was confirmed by enzyme immunoassay analysis. Four family foci of infection were identified, one of which is given as a clinical example.

Conclusion. In order to reduce the incidence of measles, it is necessary to maintain a high level of population commitment to vaccination, as well as to ensure full immunization coverage of individuals who have not received the second dose of the vaccine.

The medicinal plant raw materials can serve as a source not only of medicinal herbal preparations, but also as a raw material for obtaining food products with dietary and functional properties. These types of medicinal plant raw materials include hawthorn fruits used in the treatment of heart and vascular diseases. Fruits of hawthorn (Crataegi fructus) contain flavonoids and saponins, as well as macro- and microelements. Analysis of the scientific literature of recent years convincingly shows that the experience of using of hawthorn fruits for dietary and functional nutrition is becoming increasingly popular. Addition of hawthorn fruits to food and beverages improves their taste and technological properties. Foods with the addition of hawthorn fruits have high nutritional value and contain fewer calories. It has been shown that the use of food additives with hawthorn fruits in food production is an important decision in the creation of functional and dietary food products for the prevention of diseases of the cardiovascular system.

Prostate cancer is the second most frequently diagnosed tumor in the structure of malignant neoplasms in men in most countries of the world. The formation of ideas about the principles of immunotherapy in oncourology, in particular prostate cancer, is based on the study of molecular aspects of carcinogenesis. 

Purpose of the study is to review the scientific literature about role of mononuclear phagocytes in prostate carcinogenesis. 

Material and methods. We reviewed domestic and foreign publications using the resources of scientific electronic library search – PubMed, elibrary.ru, Google Scholar, Science Direct.

Results Modification of macrophage phenotype from M1-, which fulfills the role of antitumor, to M2- is associated with the formation of cell pools with uncontrolled growth and carcinogenesis. Macrophages promote tumor genesis and participate in progression of existing prostate cancer through redistribution and uncontrolled accumulation of cholesterol, a precursor substrate of hormone-dependent tumors. 

Conclusion. The significant role of mononuclear phagocytes in prostate carcinogenesis indicates the necessity of studying oncopathology and forming new ideas about prostate cancer immunotherapy based on molecular mechanisms. 

Atherosclerotic renal artery stenosis (ARAS) is a condition in which the renal arteries narrow due to atherosclerosis, which leads to a decrease in blood flow to the kidneys and various renal complications. The effectiveness of interventional treatments such as renal artery angioplasty and stenting remains a matter of debate, making it difficult to select patients for these procedures. 

This review is devoted to the diagnosis and treatment of ARAS with special emphasis on the potential role of functional magnetic resonance imaging (MRI) in the assessment of renal function and the mechanisms of its development. Summarizing modern approaches to diagnosis and the results of interventional treatment, the review emphasizes the importance of making informed clinical decisions in the management of ARAS. Functional MRI is becoming a promising non-invasive tool for assessing kidney function, helping in patient stratification and treatment planning. 

Main conclusions: The effectiveness of interventional methods of treatment of ARAS requires further study and careful selection of patients. Functional MRI is a promising non-invasive method for assessing kidney function and mechanisms that can become the basis for making more effective clinical decisions in the treatment of ARAS. Further research in the field of diagnostic methods, in particular functional MRI, can expand our understanding and improve the results of treatment of ARAS.

Stress urinary incontinence (SUI) is a common condition that significantly impairs the quality of life of women. Existing surgical treatments, including the use of mesh implants, have been shown to be effective, but their use is associated with risks of complications such as organ perforation, infections, and tissue erosion. This has contributed to a decline in their popularity in recent years. As a result, there has been increased interest in alternative methods, such as autologous fascial slings, although these require an additional surgical procedure and carry risks of complications at the donor site of the graft.

Recently, hybrid slings combining traditional and modern technologies have been the subject of active research regarding their effectiveness. The modification of slings by using a combination of synthetic materials and natural grafts aims to improve the outcomes of surgical treatment for SUI.

This review article analyzes current data on the use of hybrid slings in treating stress urinary incontinence in women, highlighting their advantages and disadvantages compared to classical mesh implants. It also reviews the mechanisms by which they influence anatomical and functional surgical outcomes, as well as the potential risks and complications associated with their use.