Vol 22, No 1 (2025)

This article covers the circumstances for inducing labour, indications, methods of induction, assessment, monitoring. It aims to unifying approaches, improve advice and care for pregnant women who are thinking about or having induction of labour. This article is directed at multiple stakeholders, including healthcare providers, healthcare delivery organizations and providers and professional organizations.

Molar-incisal hypomineralization (MIH), or systemic enamel hypoplasia, as it can be found in the ICD-10 revision rubricator used in the Russian Federation, is increasingly being detected at a dental appointment. Every day, clinicians are faced with the problem of competent management of such patients, choosing effective methods of prevention and therapy. The review presents modern points of view on the etiology of the disease, the rationale for the use of treatment and preventive measures regarding this nosology, which contribute to improving the quality of dental care. Particular attention is paid to drugs produced by domestic manufacturers.

There are many different scientific systematic reviews and studies devoted to pubic symphysis, mainly in foreign literature. Despite the fact that the study of this anatomical formation has allowed us to obtain valuable data for practical medicine, some morphofunctional aspects of the pubic articulation remain unclear to this day. Any, even small gaps in knowledge prevent a full understanding of the normal shape and function of the joint, which is especially important when studying the mechanisms of various pathological conditions in the pubic symphysis area. This review is devoted to the modern understanding of the normal anatomy of the human pubic symphysis with an emphasis on its components, blood supply, innervation, biomechanics and physiological changes during pregnancy, and also examines issues of forensic anthropology concerning quantitative morphological and microarchitectural changes in the surface of the pubic symphysis in unidentified remains.

Weightlifting in Russia is very popular and traditionally demonstrates high results on the world stage. This sport requires intensive training with high energy consumption, which invariably puts some pressure on the mental sphere of athletes. Daily super-intensive loads improve strength and endurance indicators, as well as the technique of exercise by athletes. Nevertheless, training and competitive processes often lead to injuries, professional burnout and decreased motivation. Based on this, in the professional training of weightlifters, the mental component is no less important than the physical, tactical, technical and integrative. It seems relevant to consider emotional intelligence and individual parameters of its structure as a component of an athlete’s psychological stability. These qualities of a weightlifter will serve as informative markers of success with a personalized approach to selection, as well as training and competitive processes. The purpose of this research was to study the typological features of emotional intelligence in representatives of weightlifting with different levels of training in order to improve personal results in training and competitions. The work used the method of studying emotional intelligence according to J.-M. Bear (2007) and the method of assessing the level of athletic training (credit classification book). Results of study: The value of the coefficient of general emotional intelligence in weightlifters with 1^st and 2^nd adult grades (M ± SD = 112 ± 4, 95 % C 107–117 points) turned out to be lower than in candidates for masters of sports and masters of sports (M ± SD = 122 ± 9, 95 % CI 101–143 points, p < 0,001), but higher than in athletes with the 3^rd adult grade (M ± SD=81 ± 7, 95 % CI = 76–86 points, p < 0,001). Consequently, high-class professional weightlifters have the most developed emotional intelligence compared to middle-level professionals, and especially amateur athletes. Conclusion: The athletic level of weightlifters corresponds to the level of their general emotional intelligence. In other words, athletes with developed emotional intelligence show higher athletic performance in competitions. Based on this, emotional intelligence can be considered one of the professionally important qualities of a modern athlete, reflecting his ability to adapt to the effects of physical and emotional stress. It seems to be a very promising approach to improving athletic performance in weightlifting based on the development of emotional intelligence of athletes.

Prosthetic treatment of patients with complete absence of teeth is a problem for dentists. The construction of prostheses has a number of features due to functional changes in the chewing muscles. The study of chewing function is the main factor in the management of this category of patients. In this work, the functional features of the state of the masticatory muscles in patients with complete secondary adentia were determined by electromyographic examination. The data obtained were compared with a group of healthy individuals of the same age. To exclude the influence of the occlusal component, the examination of the control group was performed according to the author’s methodology. During a two-stage examination, atrophy and asynchrony of the masticatory muscles were revealed in the patients of the comparison group. Conducting a functional examination of the condition of the masticatory muscles makes it possible to identify structural changes. Knowledge of the functional features of the chewing muscles in patients with complete absence of teeth will allow timely prevention of the development of a number of dental diseases, as well as to make a competent plan for prosthetic treatment of this category of patients.

Aim: To study the potential of the melatonin isostere, the compound K-165, to reduce intraocular pressure in old animals with elevated ophthalmotonus, and to evaluate its local irritant effect and cytotoxic properties. Materials and methods: The study was conducted in old rats over two years of age with intraocular pressure (IOP) above 16 mmHg. The level of ophthalmotonus was measured using a portable contact tonometer Tonovet ICare (Finland). The presence of IOP-lowering activity of the tested substance was assessed by the maximum reduction in ophthalmotonus compared to baseline pressure levels. The assessment of local irritant effects was conducted using a three-point scale after applying the substance to the eye tissues of the laboratory animal. Cytotoxicity was studied on HepG2 cell lines (human hepatocellular carcinoma) (CLS Cell Lines Service). Result: The compound K-165 reduces the level of intraocular pressure (IOP) in old animals, outperforming melatonin comparator. K-165 decreases ophthalmotonus by 21 % from baseline by the third hour and does not have a local irritating effect on the eye conjunctiva. It is shown that the mean cytotoxic concentration exceeds 100 μM for the compound K-165 (R² = 0.9), indicating low cytotoxicity. Conclusion: The compound K-165 significantly reduces IOP, does not have a local irritating effect, and is classified as a compound with low cytotoxicity.

The aim: to study the severity of the inflammatory response and morphometric parameters of the spleen in patients with COVID-19 and diabetes mellitus. Materials and methods: The study included 98 patients who were treated at the State Budgetary Healthcare Institution “Infectious Diseases Hospital of the Kaliningrad Region” from March 2020 to December 2022 with a diagnosis of “Coronavirus infection caused by the SARS-CoV-2 virus”. Upon admission, patients were divided into two groups: “Diabetes mellitus (DM)”, n = 50 and “Hyperglycaemia”, n = 48. The dynamics of C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), interleukin-6 (IL) and IL-8 were studied, and the neutrophil-lymphocyte index (NLR) was calculated. An ultrasound examination of the spleen was performed, and the mass and spleen mass ratio (SMR) were calculated. Results: On admission to hospital, patients in the “DM” group had statistically significantly lower levels of CRP, LDH and NLR compared to those in the “Hyperglycaemia” group (21.6 [10.0; 82.0] mg/L, (491.6 ± 154.1) U/L and 3.5 [2.5; 4.8]; 32.5 [12.0; 114.6] mg/L, (623.1 ± 270.2) U/L and 4.5 [2.6; 8.3], respectively) (p < 0.05). In the acute period of COVID-19, microspleen was detected in patients in the “DM” group, the spleen weight was (122.0 ± 50.3) g, the IMR was (1.4 ± 0.6), in 10 (20 %) observations a critical decrease in the spleen was recorded, a decrease in IMR was less than 1.0. In the “Hyperglycaemia” group, the spleen weight was (162.6 ± 60.9) g, KMS (2.0 ± 0.5) (p < 0.001). By the 5th day in the “DM” group, CRP was 6.5 [1.2; 10.2] mg/l, in the “Hyperglycaemia” group – 2.3 [0.7; 5.9] mg/l (p = 0.741), ferritin, respectively, 131.2 [61.4; 410.5] μg/l and 345.2 [193.1; 542.8] μg/l (p = 0.01), LDH (509.8 ± 177.5) U/l and (536.5 ± 167.3) (p = 0.582). NLR in patients in the “DM” group increased by the 5th day of treatment and was 4,3 [2,7; 5,4], in the “Hyperglycaemia” group it also increased by the 3rd day, but by the 5th day it decreased to 4.4 [3.3; 7.9]. No statistically significant differences were found between the groups (p > 0.05). Conclusion: The course of coronavirus infection in patients with diabetes mellitus is characterized by a less pronounced inflammatory response and a decrease in the size of the spleen, which can be regarded as a state of immune imbalance.

The aim of the study is to review the evidence base on the use of platelet-rich plasma in surgical practice for long-term non-healing wounds and trophic ulcers. Materials and methods: A systematic methodology was used in the work. An electronic search was conducted in the Elibrary, the Cochrane Library, the PubMed database of medical and biological publications. At the same time, filters designed to identify systematic reviews were applied. An additional manual search was performed using the snowballing methodology. Results: The analysis of thirteen secondary scientific papers showed that the subject of research were chronic wounds and trophic ulcers of various etiologies and localization in six systematic reviews, diabetic foot – in five and trophic ulcers in chronic venous insufficiency – in two ones., Calculations were performed based on the results of randomized studies in eight out of the thirteen systematic meta-analytical reviews, and on the results of both randomized and non-randomized studies – in five ones (Level of Evidence-1 and Level of Evidence-2, respectively). A consistent expert analysis was made only in one out of the secondary scientific papers. The conclusions of the meta-analyses are consistent. Platelet-rich plasma improves the healing of long-term non-healing wounds and trophic ulcers of various etiologies. At the same time, the quality of primary research on the analyzed topic is low, which can compromise the results of meta-analyses. Conclusion: The highest efficacy and efficiency of the use of platelet-rich plasma has been noted in the treatment of long-term non-healing wounds and trophic ulcers. Questions of the preferred method of its use in the area of pathological changes in soft tissues require further study.

Internal abdominal paracecal hernias are a rare surgical pathology. The authors present 4 own observations of complicated paracecal hernias of different localization and clinical picture, both acute intestinal obstruction and acute appendicitis.

Myopia is a disease of the accommodative apparatus of the eye or its anatomical features that lead to impaired visual acuity in the distance. With insufficient vision correction, myopia can progress with the development of irreversible retinal damage. Objective: To study the advantages of the author’s method over the classical exercise scheme of E.S. Avetisov – K.A. Mats in the correction of the main visual parameters in young athletes with mild myopia. Materials and methods: The author’s program combines physical exercises and a set of exercises for the eyes. The subjects were two groups of non-professional athletes: track and field athletes and swimmers, aged 9–12 years with mild myopia and accommodation spasm. Based on the results of the selection, the children were divided into two comparison groups: one performed 3 cycles of exercises using the author’s method, while the other attended a sports section without special eye exercises. Results: The study involved 60 participants: 30 in the experimental group and 30 in the control groups. In the first group, the ratio of boys and girls was equal, in the control group – 16 girls and 14 boys. According to the results of the work, statistically significant (p < 0.05) were changes in visual acuity without correction (0.79 ± 0.02) versus (0.73 ± 0.01), refractometry, obtained using a refractometer and skiascopy; values for the objective method of refractometer research: (–1.52 ± 0.06) versus (–1.61 ± 0.14), the reserve and volume of relative accommodation increased and the further point for the experimental group became further (42.50 ± 0.77) versus (4.47 ± 1.44). Conclusion: Thus, the author’s technique for children with myopia has shown its effectiveness in correcting vision indicators and preventing disease progression. In the future, the study will use it on a larger number of participants, as well as a sample from different groups: athletes and children who do not engage in physical activity. In the future, cooperation with health centers and sports sections is possible to introduce the author’s program into the course of classes to improve the vision of athletes and more effectively correct myopia.

A comparative analysis of the clinical and functional results of the treatment of progressive myopia in 92 children (178 eyes) was carried out: The first group (control) consisted of 66 children (127 eyes) before and after surgical procedures and the second group (main group) – 26 children (51 eyes) before and after scleroplastic operations and the use of orthokeratological lenses. The average age of the patients was (13.6 ± 2.1) (from 9 to 17) years. Follow-up periods are in 1, 2 and 3 years. The best results on reduction of the annual gradient of myopia progression were noted after 3 years in the patients of the main group on the change of the anteroposterior size of the eye and by changing the refractive index (p = 0.011). The use of scleroplasty and of orthokeratological lenses was the most effective tactic for the treatment of progressive myopia in children.

Aim: Assessment of the resources of the health care system involved in the management of obesity patients, based on a analysis of data from the primary medical documentation. Materials and method: We analyzed the outpatient records of 1000 patients who were followed up for 1 year by a general practitioner or an endocrinologist in an outpatient treatment and prevention facility (TPF) in 8 regions of the Russian Federation (RF). Men and women over 18 years of age who had been diagnosed with obesity for at least one year before inclusion in the study were included in the study. Results: The final analysis included 801 patients (55.2 men and 44.8 % women), mean age 55 [45...62] years. Analysis of the distribution of patients by body mass index (BMI) showed that the majority of patients at the start of follow-up had grade I obesity, in 94.4 % of patients weight did not change or increased during the 1-year follow-up. Arterial hypertension (AH) and type 2 diabetes mellitus (type 2 DM) were predominant in the structure of comorbid pathology 82.3 and 33 %, respectively. Evaluation of the frequency of clinical, laboratory, and instrumental examinations, as well as the frequency of follow-up, revealed a pronounced discrepancy between the recommended and actual frequency of patient appointments and examinations, as well as the number of visits to the doctor. Hospitalization during the observation period was required for 32 % of patients, with cardiovascular disease (43.5 %) and DM (28.5 %) being the most common reasons for hospitalization. About 21 % of patients received drug therapy for obesity during the year of observation, but the frequency of prescription of drugs for the treatment of obesity did not meet the standard. It was shown that the average cost of managing 1 obese patient was 66 130 rubles per year. The cost of drug therapy differed significantly depending on the source of funding – the total cost of therapy received by patients was about 21,000 rubles per year, while the patient received therapy in the amount of about 800 rubles per year in the framework of preferential drug coverage. Thus, the share of drug therapy in the structure of costs per patient from the state’s point of view was only 9.46 %, and the maximum costs were in outpatient care (24 %), hospitalizations (26 %) and disability payments (18.5 %). The amount of direct costs for the management of obesity excluding drug therapy (examination, inpatient and outpatient treatment) averaged 25,828 rubles/year. Conclusion: The actual practice of managing obese patients in the Russian Federation differs significantly from the clinical recommendations, which leads to the fact that obesity therapy within 1 year does not result in a pronounced decrease in body weight. Low coverage of patients with subsidized drug coverage may be one of the reasons for non-compliance with recommendations on drug therapy in outpatient settings.

Objective: Is the improvement of treatment results of patients with phlegmons of the forearm through the development and implementation of a modern complex of therapeutic measures. Materials and methods: In the course of the study the results of treatment of 52 patients with purulent-inflammatory diseases of forearm divided into two clinical groups were analyzed. In Group I (the main group) an original differentiated approach was used followed by the introduction of an algorithm of postoperative management, including the method of indirect lymphotropic antibacterial therapy. For patients of Group II, classical phlegmon dissection and drainage in combination with traditional intramuscular administration of antibacterial drugs were carried out. Results: The effectiveness of the proposed method was evaluated according to the cytological picture of the wound surface in different phases of the wound process, the results of the VAS scale questionnaire, the DASH questionnaire was used to evaluate the motor capabilities of the affected limb. The complete epithelialization of the wound surface in the patients of the main group occurred within (14.3 ± 2.7) days. There were no unsatisfactory treatment results, complete or partial loss of limb function in Group I. In the comparison Group, the average period of recovery of the covering tissues was (22 ± 4,5) days. In the first case of deep phlegmon, the finger flexor tendons were involved, which resulted in impaired function of the affected limb. Conclusion: The algorithm used allowed to reduce pain, edema, the period of wound cleansing and wound epithelization, as well as to reduce the cost of treatment by reducing the duration of hospitalization, daily dose and frequency of drug administration.

Introduction: Osteomyelitis is a serious complication of diseases of the musculoskeletal system. Materials and methods: 332 patients aged 18 to 65 years with osteomyelitis of the extremity bones were examined. A set of studies was carried out, including microbiological studies with determination of antibiotic sensitivity. Results: According to the localization of the pathological process, damage to the tibia prevailed – 113 (34 %) patients. The etiology of osteomyelitis is dominated by staphylococci. Chronication of the process occurs due to gram-negative bacteria with a high level of resistance. Conclusions: Monitoring of pathogens is an important link in creating local protocols for empirical antibacterial therapy for osteomyelitis of the extremities.

The formation of circulating autoantibodies capable of inhibiting factors of the blood coagulation system is accompanied by the occurrence of spontaneous and/or post-traumatic bleeding in patients without a history of previous disorders of the hemostatic system. One of the reasons for the development of such conditions is acquired hemophilia. Aim: Identification of the mechanisms of development of the acquired inhibitory form of hemophilia A in elderly patients using the example of our own clinical observation. Material and methods: Analysis of a clinical case and analysis of current scientific literature. Results: The presented clinical case allowed us to study the pathogenesis, principles of diagnosis and treatment of acquired coagulopathy. Conclusions: Knowledge about the development mechanisms and features of the course of the acquired inhibitory form of hemophilia A should help the clinician in the early diagnosis of this coagulopathy and, as a consequence, the timely initiation of treatment aimed at preserving the patient’s life.

The atrial septal defect (ASD) represents one of the most common heart defects. The article focuses on the clinical case of a middle-aged female patient in whom ASD was diagnosed in combination with an atrial septal aneurysm. This case illustrates the challenges that physicians face in diagnosing and treating patients with multiple cardiovascular pathologies. The clinical picture of ASD is determined not only by the size of the defect but also by the pressure gradient between the ventricles, which affects the hemodynamics of the blood flow, leading to further cardiovascular complications. In this regard, the importance of timely diagnosis and adequate treatment to prevent the development of serious complications, such as right ventricular failure and pulmonary hypertension, is emphasized.