Vol 35, No 12 (2024)

The review article presents a modern view of respiratory syncytial (RS) infection in adults and children, includes some aspects of etiology, epidemiology, clinical picture, pathogenesis and therapy. The article presents an analysis of promising antiviral drugs of different groups for the treatment of adults and children (presatovir, lumicitabine, ribavirin, and others). Modern methods of specific and non-specific prevention of RS infection are described, including the experience of using vaccines in a number of countries.

This publication presents an overview of physical medicine methods and approaches used in the treatment of women with neurovegetative, metabolic, urogenital and psychoemotional disorders that negatively affect the quality of life of patients, family relationships, social functioning, and their ability to work. The principles of therapy for climacteric syndrome are complexity, safety and accessibility, so it seems effective to implement complex treatment programs based on natural and preformed physical factors, as well as therapeutic exercise.

Chronic pelvic pain is an urgent problem for many patients. A multidisciplinary approach and proper routing of patients will improve the quality of medical care, patient satisfaction with medical care, as well as the quality of life of patients. This article discusses the probable mechanism of origin and pathogenesis of chronic pelvic pain, criteria for differential diagnosis, as well as treatment options for pain syndrome. Evaluation of the effectiveness of these treatment methods is evaluated according to standard scales and questionnaires.

The article presents the pathogenetic mechanisms of the development of skin diseases in patients with carbohydrate metabolism disorders, describes their clinical manifestations and treatment methods. Dermatoses in patients with diabetes mellitus are based on metabolic disorders and its complications in the form of neuropathies and angiopathy, consequences of the introduction of medical drugs into the skin, disruption of microbiota against the background of reduced bactericidal function of the skin. The prevalence of skin lesions directly depends on the duration and severity of diabetes mellitus and existing complications.

Type 2 diabetes mellitus is a chronic disease characterized by impaired insulin secretion in the body and loss of tissue sensitivity to it. Treatment of the disease is still not effective enough, which is due to the multifactorial nature of the development of carbohydrate metabolism disorders, the mechanisms of which have not yet been fully elucidated. Also, the complexity of its treatment is associated with the occurrence of side effects when taking first-line drugs. Among the most important complications is a decrease in the concentration of several groups of vitamins that play a key role in maintaining the health of the body and metabolic processes, including participation in the regulation of blood glucose levels. Studies show that a deficiency of vitamins D, B12, C and some others can increase the risk of developing diabetes progression. Therefore, it is important to maintain a balance of vitamins in the body through proper nutrition or taking vitamin complexes, such as Mezi-Vit Plus.

Objective. To determine associations of stress at work and some parameters of attitudes towards health among people engaged in mobile work at industrial enterprises of the oil and gas production complex of the Arctic, depending on their work experience.

Materials and methods. The object of the study was a “random” representative sample of male workers engaged in mobile labor in the Arctic latitudes of the Russian Federation. The sample included 750 men aged 25-54 years, the response rate was 82.4%. Determination of stress at work and attitude towards one's health was carried out through analysis of the standard WHO MONICA-MOPSY questionnaire.

Results. In the presence of stress in the workplace and a long period of work as an expeditionary shift worker in the Arctic, a tendency has been established towards a decrease in self-esteem of health and the lowest level of responsibility for one’s health. With less than ten years of experience as an expeditionary shift worker and the presence of stress in the workplace, a lesser desire for disease prevention and care for one’s health was determined.

Conclusion. Thus, the results of determining the associations of stress in the workplace with the parameters of attitude towards health, its self-esteem among workers of the oil and gas production complex engaged in mobile work, depending on the length of work on an expeditionary rotational basis, must be used as a significant part of a comprehensive preventive program at industrial enterprises in the Arctic.

Purpose. Determination of surgical tactics for non-tuberculous mycobacteriosis (NTM) of the lungs and combined mycobacterial infection (NTM/pulmonary tuberculosis [TB]) depending on the clinical manifestations of the disease and data from X-ray and endoscopic examinations.

Material and methods. Clinical, radiological and endoscopic data of 145 patients with NTM and concomitant mycobacterial infection (NTM/TB), as well as 150 therapeutic and diagnostic operations performed on patients, were analyzed. The patients were divided into three groups: 1st (n=44) – patients with an initial diagnosis of A16.0 and a diagnosis of NTM established during the study of surgical material; 2nd (n=64) – patients with NTM diagnosed before surgery who received surgical treatment for NTM; 3rd (n=37) – patients with combined NTM/TB pathology.

Results. In group 1, there was a low frequency of complaints about bronchopulmonary symptoms and intoxication syndrome, the pathological process in the lungs was characterized as limited, and there was no endobronchial pathology, which made it possible to perform an atypical lung resection in this cohort of patients. In groups 2 and 3, the frequency of complaints about respiratory symptoms was higher, intoxication syndrome and pathological endobronchial picture were more often observed; pathological changes in the tracheobronchial tree were combined with X-ray patterns: a predominance of cavities (in 46.9 and 59.5% of cases, respectively) and bronchiectasis (in 14.9 and 15.5%, respectively) with pulmonary cirrhotic changes. The high prevalence of pathological processes in the tracheobronchial tree and lesions of the pulmonary parenchyma in groups 2 and 3 determines the choice of a radical surgical approach - anatomical resections of various volumes of the lung. In groups 2 and 3, large-volume resections predominated (38.5 and 68.3%, respectively) and complications in the early postoperative period were statistically significantly more common (15.4 and 14.6%, respectively).

Conclusion. The obtained data allow us to conclude that surgical methods have a high therapeutic and diagnostic efficiency with a satisfactory safety profile both for mycobacteriosis and for the combination of NTM + TB.

Orofacial pain syndrome is an urgent problem in dentistry, due to the multifactorial and polyetiological nature of the disease. One of the causes of myofascial pain syndrome is hypertonicity of the masticatory muscles, which determines the direction diagnostics and treatment.

Objective. Correlation analysis of functional diagnostic methods in the dynamics of relief of hypertonicity of the masticatory muscles in an experiment.

Materials and methods. To achieve this goal, an experimental study was conducted on 30 laboratory male Wistar rats. To simulate muscle hypertonicity, a 10% calcium chloride solution was injected into the area of the masticatory muscle on the right and left. In order to influence the area of hypertonicity, ozonation was carried out using the Ozotron apparatus. To assess the effectiveness of the impact, electromyographic and laser doppler flowmetry (LDF) studies were carried out before the introduction of a 10% calcium chloride solution, immediately after ozonation, after 3, 7 and 14 days.

Results. Experimentally, based on the analysis of data from electromyographic and LDF-metric studies, a direct relationship between the state of local blood flow and the functional activity of the masticatory muscles has been proven. With an increase in the average amplitude of the masticatory and temporal muscles, spastic disturbances of the bloodstream are observed, thus, microcirculatory disorders play a key role in the regulation of muscle tone and the distribution of blood flow.

Conclusion. The experiment proved the indirect effect of ozone therapy on the functional state of the masticatory muscles in laboratory animals, which justifies the feasibility of conducting a clinical study in the treatment of patients with muscle hypertonicity.

Hypertension and type 2 diabetes mellitus (DM) are often combined and mutually enhance the adverse effects on vascular and renal prognosis. One of the features of hypertension in type 2 diabetes is the frequent occurrence of isolated systolic hypertension (ISG) and resistant hypertension (RH).

Objective. To study the features of the structure and function of the left ventricle (LV), categories of circadian rhythm during outpatient blood pressure monitoring (OBPM), as well as the structure and function of blood vessels in people with type 2 diabetes, depending on the presence or absence of ISG and RH.

Materials and methods. An observational descriptive one-step study was conducted 139 patients with hypertension in combination with type 2 diabetes (64 men and 75 women aged 73.9±11.7 years). ISAG was isolated if systolic blood pressure (BP) exceeded 140 mmHg, and diastolic blood pressure was less than 90 mmHg. RH was determined if, despite lifestyle changes and taking three classes of antihypertensive drugs, it was not possible to achieve target blood pressure levels. All patients underwent OBPM, echocardiography, ultrasound examination of the brachiocephalic arteries and a reactive hyperemia test.

Results. Among 139 patients with hypertension in combination with type 2 DM, systolic-diastolic hypertension was present in 80 (57.6%) cases, ISG in 59 (42.4%), RH in 57 (41.0%), hypertension without resistance to antihypertensive treatment in 82 (59.0%).

Conclusions. Patients with ISG characterized by more pronounced and eccentric LV hypertrophy (LVH), types II and III of LV diastolic dysfunction (DD), the "non-dipper" category in OBPM, as well as a significant thickening of the intima-media complex (IMC) of the common carotid artery (CCA). Patients with RH characterized by more pronounced and concentric LVH, types II and III of LV DD, the "night-peaker" category in OBPM, significant thickening of the IMC CCA and impaired brachial artery response in the reactive hyperemia test.

The article analyzes the accounting form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical organization” of one adult clinic in Orenburg according to the number of cases of respiratory system diseases among the adult population for 2018–2022.