University proceedings. Volga region. Medical sciences

Modern research defines stress as one of the factors in the development of periodontitis. However, the pathophysiology of stress has an extremely ramified mechanism affecting several body systems at once. Of course, stress can be regarded as one of the links in the pathogenesis of periodontitis, but only in combination with many other factors such as oral microflora, lifestyle, nutrition, heredity, etc. As a result, the periodontium acts as one of the body structures that can be exposed to the pathological effects of stress. 53 domestic and foreign sources containing information on the physiology and impact of stress on the human body and periodontal tissues were analyzed. A systematic search of articles was performed in the PubMed and eLibrary databases. Stress is an important factor influencing the occurrence and progression of changes in periodontal tissues. An individual approach to optimizing the level of psychoemotional stress can be regarded as one of the methods for preventing diseases such as periodontitis. 

Background. To conduct a study of the nature of injuries to the civilian population as a result of gunshot wounds and the nature of assistance for such injuries at the prehospital stage. Materials and methods. The study is retrospective, in order to achieve this goal, an analysis of the results of treatment of 46 wounded civilians who were injured in the facial area in a local military conflict was carried out. Of the total number of women surveyed, there were 15 (32.6%), and men – 31 (67.3%) people. The average age was 38 ± 4 years. Results and conclusion. It was found that most of the victims of gunshot wounds received multiple wounds, which led to injuries of moderate severity – 45,6%. Facial injuries led to capillary bleeding, which was noted in 82.6% of the victims. At the same time, self- and mutual assistance prevailed as first aid for such wounded people at the scene – 50% of observations. It should be noted that such assistance was performed in full and correctly in 80.4% of the observations, in the remaining 13.0% of cases errors were noted related to incorrect dressing and failure to perform temporary hemostasis. Moreover, all errors were recorded during the provision of first aid by random witnesses who do not have the skills to provide such assistance. As a result of the analysis, it was found that the correctness and timeliness of first aid is of great importance in the development of complications in the wounded in the immediate postoperative period.

The literature review is devoted to the issues of diagnostics of pelvic venous disorders (PeVDs), including pelvic and vulvar varicose veins, pelvic venous insufficiency, compression stenosis of the left renal and iliac veins. The possibilities of clinical, ultrasound and X-ray methods of research are presented, diagnostic criteria of various types of PeVDs are considered, comparative characteristics of instrumental diagnostic tests in identifying pelvic venous reflux, non-thrombotic stenosis of the left renal and iliac veins are presented. A critical analysis of literature data on the capabilities of duplex ultrasound, computed tomography, magnetic resonance and direct contrast venography in determining the hemodynamic significance of compression stenosis of the renal and iliac veins was performed. Based on the available literature data, a conclusion was made on the necessity to continue scientific research on the diagnosis of PeVDs. 

Electronic cigarettes (EC), vapes are becoming increasingly popular among modern youth, creating a false impression that EC are less harmful than tobacco products. More than a quarter of young people are users of electronic cigarettes and vapes, while 80 % of them have been using electronic smoking devices for more than one year, and 2/3 continue to smoke “traditional cigarettes”. Every fourth person using ES and vapes complains of irritation of the respiratory tract, a feeling of lack of air, shortness of breath, increased heart rate and blood pressure, headache, gastrointestinal disorders immediately after using the smoking device. Every fifth person feels changes in the emotional sphere in the form of increased irritability, anxiety, and restlessness. However, only 2/3 are not against stopping using electronic smoking devices in the future. Preventive work among students, along with increasing hygiene literacy, should take into account the specifics of young people's use of electronic smoking devices and focus on preventing them from becoming involved in smoking tobacco products in the future.

Relapsing polychondritis is a rare disease of autoimmune nature. At this stage, the problems of understanding the pathophysiology of relapsing polychondritis, its diagnosis, assessment of activity and prognosis, as well as treatment have not been resolved. The disease develops through exacerbation of remissions. It is characterized by clinical poly-morphism, requiring a team approach from specialists from different specialties. Manifestations usually occur gradually over time, and their frequency depends on the duration, activity and severity of the disease. Clinical heterogeneity of the disease is a source of diagnostic errors. The differential diagnosis in most cases concerns the involvement of each organ, which may appear immediately in a particular patient, but in most cases appears gradually, with an average of two symptoms at the onset of the disease. Purpose of the study: analysis of a clinical case of relapsing polychondritis, the clinical picture, the need for early diagnosis and the prescription of pathogenetic therapy. The article discusses our own clinical observation of relapsing polychondritis identified in a 62-year-old patient. A differential di-agnosis was made between the patient’s disease, systemic scleroderma and necrotizing vasculitis. 

The article discusses the key aspects of a personalized approach to the management of patients with cardiovascular diseases at the outpatient stage. Personalized medicine based on a deep understanding of the individual characteristics of the patient makes it possible to optimize strategies for the prevention and treatment of cardiovascular diseases. The review highlights the issues of stratification of individual cardiovascular risk using validated scales and imaging methods, the selection of targets for blood pressure, lipids and blood glucose, taking into account the clinical profile of the patient. The importance of selecting the optimal drug therapy based on concomitant diseases, potential drug interactions, predictors of efficacy and safety is emphasized. Approaches to increasing patient adherence, control of tolerability of therapy and drug interactions are considered. The role of patient-oriented counseling, patient involvement in the decision-making process and training programs is discussed. The importance of continuity of patient management, multidisciplinary interaction of cardiologists, primary care physicians and specialists is highlighted. It is con-cluded that the introduction of the principles of personalized medicine into outpatient prac-tice opens the way to more effective, safe and patient-oriented care for patients with cardiovascular diseases.

Background. Currently, there is an increase in scientific interest in the problem of constitutional peculiarities of young people and especially representatives of the student community of various professional fields, which is due to the importance of this aspect in the practice of preventive and clinical medicine. The purpose of the study: to identify the features of the level of physical fitness of students, taking into account sexual dimorphism and differences in morphological constitution. Materials and methods. A comprehensive study of constitutional anatomy in combination with physical fitness of students was conducted using the example of Yaroslavl State Medical University. It was attended by 398 students of the I-IV courses of medical, pediatric and dental faculties. The average age of the girls studied was 19.5 ± 1.1 years, and that of the boys was 18.9 ± 1.1 years. Students are classified according to their constitutional characteristics. Results. Significant differences in the anthropometric characteristics and indices of physical development of girls and boys representing different constitutional morphological types have been identified. The maximum differences in boys and girls were found between body weight, BMI, chest circumference and waist, Pinier index, waist/height index of representatives of hypersthenic and asthenic types, smaller differences in similar measurements were found in representatives of normosthenic and asthenic types. Significant differences in the physical fitness of the surveyed students were determined. Conclusions. Differences in the physical fitness of the subjects were recorded depending on gender and constitutional characteristics, which indicates the importance of systematically conducting such studies among students.

Angiosarcoma is a highly malignant soft tissue sarcoma originating from vascular endothelial cells. It can be of various localizations, its occurrence does not depend on age and gender. At the clinical level, this disease can be primary or secondary in relation to var-ious etiologies. Depending on the place of occurrence, there may be variants of the cellular structure. General microscopic signs of angiosarcoma include angiogenesis structures, nu-clear polymorphism, hyperchromasia, increased mitotic activity, areas of necrosis. The leading diagnostic method is immunohistochemical examination. Surgery and chemotherapy are used as treatment. This article considers in more detail angiosarcomas of the skin, mammary gland, soft tissues, heart, bones. In the course of this work, an analysis of scientific literature was carried out in order to thoroughly study the microscopic structure of angiosarcomas of various localizations and the relationship of clinical manifestations with morphological features. This article aims to form a more accurate understanding of the pathogenesis of angiosarcomas.