Scientific Bulletin of the Omsk State Medical University

Omsk region is included in the list of 14 subjects of the Russian Federation, on the territory of which the number of additional cases of all causes of mortality associated with atmospheric air pollution exceeds the average Russian value by more than 1.5 times.

The aim of the work was to estimate tentatively the territorially distributed cause-and-effect relationships between carcinogenic risks to public health under the influence of chemical substances polluting the atmospheric air of the city of Omsk and the mortality of the city residents from malignant neoplasms.

Material and methods. The data of the federal state system of socio-hygienic monitoring and the national ecological system of atmospheric air pollution observation for the period 2009-2022 on average annual concentrations of chemical substances were used for health risk assessment. To calculate the actual “rough” and standardized mortality rates of the population of Omsk city, the data of socio-hygienic monitoring and the territorial body of Rosstat for the period 2017-2022 were used. To standardize mortality by age composition, a direct method using the WHO world standard was used. The territorial distribution of multi-year data on carcinogenic risks and mortality of the population from MND was assessed in the context of five administrative districts, 8 stationary observation posts. The assessment of differences between the territories was carried out by statistical methods: dispersion analysis, Student's criterion, Mann-Whitney test; relative risks of mortality (RR) and correlation analysis were used.

Results. Uneven distribution of average annual concentrations of the studied carcinogens and individual carcinogenic risks on the territory of the city was established; relatively “clean” and “dirty” micro-territories were determined. In the territories with long-term increased levels of carcinogenic risk - the mortality rate from malignant neoplasms was significantly higher RR=1.27 (95% CI 1.252-1.288), including the group of nosologies “leukemia” (C91-C95).

Conclusion. It is advisable to include algorithms of supervision over the territories with increased mortality rates from STDs under conditions of environmental pollution by chemical carcinogens in strategic programs to combat oncological diseases with the strengthening of interagency cooperation in this area on the part of medical organizations, Rospotrebnadzor, environmental agencies and municipal authorities.

Every year there is an increase in diseases of the cardiovascular system, both in childhood and in adolescence (over the past 15 years in Russia more than 2 times). The likelihood of complications and irreversible changes in the body often occurs due to the lack of qualified, timely therapy. At the same time, the complexity and complexity of modern technologies for diagnosing and treating heart disease is constantly increasing. Currently, congenital heart disease (CHD) is the leading cause of death among other developmental disorders in children. In the Orenburg region, a high prevalence of congenital heart defects remained. The prevalence of congenital carditis and cardiomyopathies was 0.5 ‰ and 0.8 ‰, respectively, and there was no significant improvement in early diagnosis of CHD. Infant mortality from CHD has decreased. Infant mortality from CHD has decreased. The structure of congenital heart defects was dominated by malformations with enrichment of the pulmonary circulation (MCC), such as ventricular septal defect, atrial septal defect and common ductus arteriosus. Vices with impoverishment of the pulmonary circulation, such as Fallot's tetrad, pulmonary artery stenosis, and Ebstein's anomaly, ranked second, and vices with normal blood flow in the pulmonary circulation, such as aortic coarctation, aortic stenosis, and mitral valve stenosis, ranked third. A high percentage of late-onset congenital heart defects leading to mortality persisted.

The purpose of the article is to highlight the problem related to the cultural and historical aspect of Greek-Latin medical terminology in the learning process, the purpose of which is to form terminological literacy among students of a medical university. This problem is directly related to the peculiarities of the language of medicine, as well as to the understanding of the relationship between the "term↔object". Material and methods. Taking into account the fact that medical terms represent a lexical symbiosis of ancient Greek and Latin languages, the use of etymological analysis of terms has led to a cultural and historical approach in choosing and working with sources of different times, the authors of which relate mainly to ancient Greek, European and Russian cultures. Discussion. The article outlines the features of the language of medicine, the structural unit of which is the term as a means of judgment, beginning with the name of the object (according to Aristotle). The peculiarity of the language of medicine is the fact that the lexical Greek-Latin resource is not replenished with new words, since the cultures that used these languages have disappeared from the historical scene, and the speakers of these languages have left their legacy in the form of treatises and other written monuments. In addition, a lexical resource also preserved in the corresponding dictionaries (Ancient Greek-Russian, Latin-Russian), where the meanings of the etymons of medical terms are presented with an indication of the authors who used them, the lexical resource is preserved in the relevant dictionaries (Ancient Greek-Russian, Latin-Russian). In other words, the appearance of new words in these ancient languages is impossible, therefore it is necessary to instill in students respect for the heritage of past cultures and, accordingly, for respect for Russian culture represented by carriers of medical knowledge (M.V. Lomonosov, M.Ya. Mudrov, N.I. Pirogov, V.F. Voino-Yasenetsky (St. Archbishop Luke of Simferopol and Crimean), N.V. Sklifosovsky, S.P. Botkin, etc.). Conclusion. The article actualizes the cultural and historical aspect of some terms, which is an analysis of the content of the etymons of terms, explaining the reasons for the terminologization of words in common ancient Greek and Latin languages and justifying their transition into the language of medicine. Taking into account the cultural and historical aspect in teaching medical terminology contributes to the development of motivation for further study at the university and corresponds to the propaedeutic role of the discipline "Fundamentals of medical Terminology" in the process of medical education.

The aim of the work is to evaluate the long-term outcomes in children treated with therapeutic hypothermia in the early neonatal period by conducting a systematic review of available literature sources. Мaterial and methods: We conducted a systematic literature review using PubMed and the Cochrane Library. Selection criteria were randomized, controlled trials including children treated with therapeutic hypothermia in the early neonatal period. Exclusion criteria included publications with unspecified date and location. No language restrictions were applied. Results: We reviewed 30 literature sources from 2011 to 2022. A number of child follow-up studies confirm that therapeutic hypothermia improves not only neonatal outcomes but also reduces disability before 18 months of life. Neurologic outcome in children treated with therapeutic hypothermia in the neonatal period was assessed from 18 months to 8 years of age. Based on a careful selection of information, it was found that children who underwent therapeutic hypothermia in the early neonatal period had cognitive and motor impairment, difficulty in concentration, slow reaction time and decreased visual-spatial processing at school age. Conclusions: At present, therapeutic hypothermia is the latest method of treatment for neonates with severe neonatal encephalopathy, based on neurobiological advances and is recognized by clinicians worldwide as an effective method. However, studies show maximum effectiveness of this method in assessing short-term outcomes and ambiguous assessment of long-term outcomes. The presence of a possible neurological deficit in children treated with therapeutic hypothermia in the early neonatal period dictates the development of an individual algorithm for monitoring this category of newborns with an early start of habilitative neuroprotective measures followed by annual cognitive and motor tests until the patients are transferred to the adult network.

HIV-associated tuberculosis poses an immediate and serious public health threat, especially in developing countries. People living with HIV are at greater risk of developing tuberculosis due to decreased immunologic reactivity. According to WHO, the risk of developing tuberculosis is 20-30 times higher in HIV-infected individuals than in HIV-negative individuals. HIV infection is the most powerful known risk factor predisposing to infection with Mycobacterium tuberculosis and progression of the disease to active form, which increases the risk of reactivation of latent tuberculosis by 20 times. Tuberculosis is also the most common cause of AIDS-related deaths. Thus, tuberculosis and HIV act synergistically, accelerating the decline in immunologic function and leading to subsequent death if untreated.

Patients with HIV infection often present with atypical clinical presentation of tuberculosis and an unfavorable outcome. Due to the atypical course of the disease, the diagnostic search in HIV-infected patients requires the use of additional methods of examination, such as MSCT of OHC at the stage of disease detection and PCR of diagnostic material for MBT DNA in addition to sputum bacterioscopy with Cyl-Nielsen staining for CUM. The course of tuberculosis in HIV-infected patients depends on the degree of immune response suppression; atypical clinical and radiologic features of tuberculosis in such patients are noted with a significant decrease in CD4+-lymphocytes. The course of pulmonary tuberculosis combined with HIV infection leads to a significant aggravation of clinical forms of tuberculosis with an increase in the number of disseminated and generalized forms.

Thus, the above data confirm that tuberculosis in HIV-infected patients is an urgent problem of modern phthisiatry. The significance of this problem is related to the unfavorable prognosis of further spread of tuberculosis, which is caused, on the one hand, by high infection of the population with MBT, and on the other hand, by the wide spread of HIV infection in the world, including the Russian Federation. HIV infection is not only a risk factor for the development of tuberculosis, but also a cause aggravating the course of tuberculosis and reducing the effectiveness of treatment. Literature data on the course and effectiveness of tuberculosis treatment in HIV-infected patients are contradictory. In this regard, scientific research devoted to the study of various clinical and pathophysiological aspects of tuberculosis development in patients with HIV infection, as well as the development of scientifically substantiated methods of pathogenetic treatment of patients in this category remain in high demand.