Vol 36, No 1 (2025)

In review we focus on the features of maternal arterial blood entering the intervillous space from the spiral arteries. Besides the definition of the term "retroplacental blood," in our article we provide a method of this blood sampling. In addition, presents the results of all retroplacental blood researches by now, which were related to the study of immunological indicators, hormones and hormone-like substances, as well as enzymes.

Thus, retroplacental blood is a unique and almost unexplored biological substrate that may be useful for clinical medicine.

Secondary osteoporosis (OP) develops as a result of somatic pathologies (endocrine, genetic diseases, kidney damage, gastrointestinal tract, etc.), lifestyle habits or medications. Any patient with suspected secondary OP must undergo a series of laboratory tests (full clinical blood test, biochemical blood test, blood test for 25-hydroxyvitamin D, parathyroid hormone, etc.). The “gold standard” for instrumental diagnosis of OP is dual-energy X-ray densitometry of the lumbar spine and proximal femur to assess bone mineral density.

Treatment of secondary OP is etiological, aimed at identifying and eliminating the underlying cause of the disease, which usually involves discontinuation of medications (if possible) and correction of modifiable risk factors.

If it is impossible to influence the cause of secondary OP, pathogenetic therapy is used, including antiresorptive drugs, agents that enhance bone formation, and monoclonal antibodies. It is important to remember that the effectiveness of treatment of OP is influenced by indicators of phosphorus-calcium metabolism, therefore, before starting pathogenetic therapy, it is necessary to determine the levels of calcium, phosphorus and 25-hydroxyvitamin D in the blood, bring these indicators to normal values, and then continue taking these drugs along with pathogenetic therapy. To do this, they recommend a diet balanced in calcium, phosphorus and proteins, and the prescription of vitamin D supplements and calcium salts. One of the effective means for normalizing phosphorus-calcium metabolism is the drug Osteomed Forte.

Late preterm infants are more susceptible to various unfavorable factors than preterm infants. The leading place in the structure of morbidity, as well as the formation of long-term unfavorable outcomes in this group of children is occupied by respiratory disorders, impaired or delayed neurodevelopment. In order to study in detail the pathological conditions leading to adaptation disorders, we retrospectively analyzed the data of developmental histories of late premature infants and delivery histories. The relationship between placental abnormalities, including fetal growth and developmental delays, fetal conception, history of pregnancy termination, low birth weight, age of the woman in labor and increased need for respiratory support, as well as clinical manifestations of cerebral ischemia in newborns at 34 0/7–36 6/7 weeks gestation was revealed.

Sexually transmitted infections remain an important medical and social problem. Untimely detection and, accordingly, late initiation of treatment lead to chronicity of the infectious-inflammatory process and the development of complications such as infertility.

Purpose. Assess the validity of diagnosing an infectious-inflammatory process based on the results of a microscopic examination - leukocyte reaction.

Material and methods. A retrospective analysis of medical records of 102 women was carried out, the results of microscopic examination, polymerase chain reaction (PCR), and real-time PCR were analyzed.

Results. The clinical picture in patients with obligate pathogens and patients with an inflammatory process caused by opportunistic microorganisms did not differ significantly: slightly and moderately severe clinical symptoms predominated. The infectious-inflammatory process caused by obligate pathogens was accompanied by an increase in the number of polymorphonuclear leukocytes only in 22.73% of cases; in other cases, the pathological process proceeded without a leukocyte reaction.

Conclusion. When diagnosing an infectious-inflammatory process, it is necessary to use not only routine methods, but also screening studies aimed at excluding obligate pathogens.

Electronic medical record (EMR) improves the quality of medical services and the speed of transfer of medical information between organizations and the patient.

Purpose. To share the experience of developing a neonatal module and its implementation in a medical organization, and also, to show the advantages and disadvantages of EMR, the problems faced by the authors of the article during the development and implementation of EMR and their solutions.

Methods. The experience of developing and implementing the neonatal module of the automated information system Regional Obstetric Monitoring (AIST ROM) on the basis of the Yekaterinburg Clinical Perinatal Center is presented.

Results. After studying the regulatory framework, an EMR of the patient was developed and implemented. The neonatal module of AIST ROM includes all the necessary documents. The problems we have encountered in the development and implementation process are common. After studying the literature and taking into account the peculiarities of our medical organization, certain ways of solving them are proposed.

Conclusion. EMR in neonatology will improve the quality of care, reduce the number of errors, ensure the availability of information, and reduce the burden on medical personnel.

Hemorrhoidal disease is the most common of all diseases of the rectum, the first mention of which dates back to the XVIII century BC. Methods of surgical treatment of hemorrhoidal disease are aimed at both minimizing the pain syndrome and early postoperative rehabilitation. They have evolved over many centuries and currently continue to improve. This historical review presents the changes in trends in the surgical treatment of hemorrhoidal disease.

The article examines options for preventing adhesive disease based on a comparative analysis of methods of barrier prevention of adhesion formation and the use of immunomodulatory drugs.

Purpose. To examine and describe the steps involved in creating a surgical guide for dental implant installation, and to assess the advantages of using surgical guides compared to traditional implant placement methods.

Materials and methods. The study utilized data from cone-beam computed tomography, intraoral scanning, and specialized software for data merging and surgical guide modeling. A clinical case with the installation of three implants was analyzed to evaluate the effectiveness of the method. Additionally, 15 similar cases were reviewed where implant placement was performed without using a surgical guide to compare operation times.

Results. The results showed that using a surgical guide reduced the operation time to 23 minutes compared to the average duration of 58 minutes with the traditional method.

Conclusions. The use of guides minimizes the need for constant checks and adjustments, reduces the risk of complications, and improves patient comfort by shortening the time spent on the operating table. Patients feel more confident in the outcome since the template minimizes the likelihood of medical errors.

Purpose. To evaluate the ability of neutrophils to form extracellular traps in children with latent TB infection with different sensitivity to recombinant tuberculosis allergen (ATR) to form an individual approach to therapeutic and preventive measures.

Material and methods. The study involved 22 children with a moderate and mild reaction to ATP (group 1) and 31 children with a pronounced reaction (group 2).

Results. According to the general clinical blood test, there were no differences between the groups. The median of intact neutrophils in group 1 was 52.0, in group 2 – 35.6 (p=0.251). The median of hyperactivated neutrophils in group 1 was 10.7, in group 2 – 2.9 (p=0.0295).

Conclusion. In the group with a pronounced reaction to ATR (group 2), there was an increased readiness of neutrophils to form extracellular traps (the number of early NETosis cells exceeds that in the comparison group) and a greater number of formed cloud-like neutrophil extracellular traps (incomplete NETosis). At the same time, in children with a calmer reaction to the test with ATR (weak and moderately expressed), the readiness of neutrophils to form extracellular traps is observed, but at the same time hyperactivation of the neutrophil and the formation of full-fledged thread-like neutrophil traps are achieved.

Purpose. To study changes in the levels of cortisol, prolactin and oxytocin in the blood serum of pregnant women depending on the perinatal preparation program used.

Material and methods. The study involved 537 women at 34 weeks of pregnancy, who were divided into 2 groups: main (n=273) – pregnant women who underwent perinatal training under the “Conscious Motherhood” program; comparison group (n=264) – pregnant women who were trained under the program of a traditional maternity school. The levels of the studied hormones were determined by enzyme immunoassay.

Results. The initial levels of cortisol, prolactin and oxytocin in the groups did not differ significantly and corresponded to the reference values for pregnant women. After classes in perinatal training programs, the levels of cortisol and prolactin did not change significantly and did not differ between groups. Classes in the “Conscious Motherhood” program increased the content of oxytocin by 2.2 times, while in the comparison group (traditional motherhood school) no significant changes were detected.

Conclusion. Thus, perinatal preparation does not affect the levels of cortisol and prolactin. At the same time, classes in the “Conscious Motherhood” program, conducted together with husbands, cause an increase in oxytocin levels, which may have a beneficial effect on the course of childbirth.

The article analyzes scientific research on the use of calcium and vitamin D preparations. The role of calcium and vitamin D in bone tissue homeostasis is shown. A review of calcium and vitamin D medicines registered in the Russian Federation has been conducted. Special attention is paid to one of the urgent pharmacological and therapeutic problems – safety. Research data demonstrate that calcium and vitamin D supplements have a positive effect on bone metabolism and bone strength. It has been revealed that an overdose of calcium and vitamin D may have undesirable consequences for human health, in particular, increased stone formation and the development of urolithiasis. One of the solutions to the problems associated with the risk of overdose may be the use of biologically active additives Osteomed, Osteo-Vit D3, Osteomed Forte.