Vol 26, No 2 (2025): Опубликован 27.06.2025

To conduct a comparative analysis of the clinical characteristics and medication used in patients with chronic heart failure (CHF) of functional classes I-II and III-IV and type 2 diabetes mellitus.

Materials and methods. From 2024.09.01 to 2024.31.12, 649 patients were examined in a cross-sectional study, divided into 2 groups: group 1 – 551 (84.9%) patients with CHF 1-2 FC (median age 63.0(54.0;70.0) years, 233 (42.4%) men), group 2 – 98 (15.1%) patients with CHF 3-4 FC (median age 70.0 (62.0;76.0) years, 36 (36.7%) men).

Results. Patients in group 2 were older, more likely to have morbid obesity (33.0% vs. 14.5%, p<0.001), hypertension (94.9% vs. 84.2%, p=0.004), and myocardial infarction (29.6%, p<0.001), atrial fibrillation (22.4% vs. 8.7%, p<0.001), previous stroke (21.4% vs. 9.6%, p=0.002), lower glomerular filtration rate according to the CKD-EPI formula (C3b 14.7% vs. 3.7%; C4 4.4% vs. 2.3%; C5 2.9% vs. 0.5%, p<0.001) when compared with group 1. During the collection of complaints and physical examination, it was revealed that weakness (92.9% vs. 70.4%, p<0.001), edema (63.6% vs. 46.6%, p=0.002) prevailed in group 2. The frequency of blood pressure measurements increased in group 2 (more than once a day, 46.9% vs. 31.8%, p=0.015). Patients in group 2 had a predominantly low ejection fraction (49.0% vs. 0.7%, p<0.001) compared with group 1. Analysis of CHF therapy showed a low incidence of iSGLT2 (13.3% vs. 8.7%), AMCR (4.1% vs. 6.9%), beta blockers (28.6% vs. 24.3%), ace inhibitors (53.1% vs. 45.4%), valsartan sacubitril (1.0% vs. 0.4%), ARBs (14.3% versus 12.7%), diuretics (27.6% versus 27.0%) in groups 2 and 1, respectively.

An assessment of the treatment of type 2 diabetes showed that iDPP4 was prescribed in 8.2% versus 5.4% of groups 2 and 1, respectively, biguanides – in 23.5% and 25.8%, sulfonylurea derivatives – in 53.1% and 54.3%, repaglinide – in 3.1% and 1.8%, thiazolidinediones – 1.0% and 0.4%, aGPP1 – 4.1% and 1.6% in group 2 and 1, respectively.

Conclusions. The study highlights the importance of monitoring the condition of patients with CHF and type 2 diabetes, monitoring the prescribed and accepted drug therapy in accordance with current clinical guidelines

The aim of the study was to evaluate the dynamics of clinical and laboratory parameters in patients with severe or critical COVID-19 during hospitalization and to develop a predictive model for in-hospital survival duration in this patient group.

Materials and methods. The study included 60 patients (53.3% male, 46.7% female; median age 70.0 [62.0; 72.0] years) hospitalized with severe or critical COVID-19 who died following the development of acute respiratory distress syndrome (ARDS). Clinical and laboratory data were recorded, including complete blood count, biochemical blood analysis, acid-base status and blood gas analysis, as well as C-reactive protein and procalcitonin. These parameters were documented twice: on the day of admission and prior to death. Troponin I was measured once.

Results and conclusion. During hospitalization, significant negative trends were observed in objective parameters (respiratory rate, systolic blood pressure, oxygen saturation) and laboratory markers (hemoglobin, erythrocytes, erythrocyte sedimentation rate, lymphocytes), alongside increasing signs of inflammation, tissue destruction, and impaired renal function (leukocytosis, band neutrophil shift, elevated creatinine, urea, lactate dehydrogenase). The survival prediction model including oxygen saturation, lactate level and obesity grade demonstrated high statistical significance (R²=74.3%; p=0.0001). Thus, these parameters may be used for early risk stratification and individual prognosis upon patient admission.

Currently, treatment of atrophic gastritis is aimed at eliminating symptoms and reducing the risk of complications, but is not always effective, since Helicobacter pylori becomes resistant to the lines of therapy used. This circumstance dictates the need for the use of new antibacterial drugs. This article is devoted to the analysis of the prospects for the treatment of atrophic gastritis with rifaximin.

Heart diseases consistently rank as the leading cause of death in developed countries, second only to COVID-19 in recent rankings. The development of diagnostic methods and risk assessment based on heart rate data plays an important role in research at the intersection of mathematics, data analysis, and medicine. The results of such research are being applied, including in the development of applications for mobile smartphones and wearable devices, as there is increasing focus on self-diagnosing heart conditions. The article analyzes heart tones collected by a stethoscope for diagnosing diseases caused by heart malfunction. The methods discussed in the study allow anyone to record heartbeats using a mobile device and use them for further analysis with various applications. The main task is to classify heart tones into 4 categories. The work was done in Python using libraries like tensorflow, librosa, pandas, and scipy. The results show that with the use of deep neural networks, a classification accuracy of 95% can be achieved on the test dataset. Additionally, this work can serve as a basis for further research, such as integrating the model with other layers of deep learning networks to reduce training time, which is important for using the results in mobile and wearable devices.

According to various international registries, the average duration of the pre-diagnostic period of pituitary tumors is about 5 years (in 24% of patients - more than 10 years). This is due to the fact that most gonadotrophic neuroendocrine tumors of the pituitary gland do not secrete a sufficient amount of biologically active hormones to determine the clinical manifestations of hypersecretion, so they are often non-specific, disguising themselves as neurological and/or reproductive diseases.

According to the World Health Organization (WHO) the rate of obese children has increased 4 times over the past 30 years.

The purpose of the study: to study of the prevalence of obesity in children and adolescents in the Ryazan region from 2014 to 2023 years, considering age characteristics.

Materials and methods: a comparative descriptive epidemiological study was performed. The analysis of the data of the statistical form No. 12 was carried out from 2014 to 2023 years among children 0-17 years old living in the Ryazan region. In addition, a comparative analysis of the prevalence of obesity in children in the Ryazan region and the Russia was conducted from 2014 to 2022 years.

The results of the study: The prevalence of child obesity in the population from 0 to 17 years old increased by 51.0%, while over the past 10 years the indicator has increased more than 1.6 times among children aged 0 to 14 years (from 23.3/1000 to 36.2/1000), and 15-17 years – 1.4 times (from 53.1/1000 up to 71.8/1000) (p<0.05). During the COVID-19 pandemic and the post-pandemic period, there was an increase in the prevalence of obesity in children aged 10-14 years by 1.6 times and by 26% - among children aged 15-17 years old (p<0.05).

Conclusion. The prevalence of child obesity in pediatric population increased by 51,0% in 2023 compared to 2014. The dynamics of the prevalence of child obesity of the Ryazan region corresponds to the global trend

Asthma is a heterogeneous disease. One of the non-allergic phenotypes is exercise-induced asthma, which can aggravate the course of asthma, requiring enhanced therapy. Diagnosis of exercise-induced asthma is difficult due to underestimation of symptoms - wheezing appears only during physical exertion. A promising direction in the diagnostics of exercise-induced asthma  is dynamic electronic auscultation of wheezing during bronchoprovocation tests.

Objective of the study: to evaluate the capabilities of dynamic electronic auscultation in real time in the diagnosis of exercise-induced asthma in patients with an established diagnosis of asthma during a test with physical exertion.

Material and methods. The prospective, observational experimental clinical study included 42 outpatients with suspected exercise-induced asthma (32 mild and 10 moderate BA). Computer spirometry was performed using a Vitalograph ALPHA spirometer (England). Dynamic electronic auscultation of the lungs was performed using our own developed technique during and after physical activity. The resulting audio files were subjected to computer analysis.

Results. Registration of respiratory sounds during physical activity and after the test was successfully performed in all 42 patients. Wheezing rales were recorded during physical activity in 11 patients, of which wheezing resumed in 7 patients at 8-14 minutes of the recovery period - 9,8 (7,1; 13,2)  min. In 5 patients, the dynamics of the auscultatory picture corresponded to bronchoobstruction - a decrease in FEV1 by 17% or more, in 2 patients, despite the appearance of dry wheezing during physical exertion, clinically significant dynamics of external respiration function were not noted - a decrease in FEV1 by 0.16 ± 0.04 l (by 3.4 ± 0.25%). In 5 patients, there were no wheezing during physical exertion, but in the recovery period at 5-8 minutes - 6,3 (5,3; 7,7) min. Wheezing with a corresponding decrease in FEV1 by 17% or more was recorded. Exercise-induced asthma was diagnosed in 12 of 42 asthma patients (28%). A direct strong correlation was observed between the occurrence of wheezing and obstructive changes in the function of external respiration (r= 0.76, p˂0.05).

Conclusion. Dynamic electronic auscultation in real time has proven to be a highly sensitive method that allows reliable recording of the occurrence of wheezing both during the exercise test and in the recovery period in patients with bronchial asthma. This method allows specifying the time intervals of occurrence and disappearance of wheezing and can be used remotely.

Anosmia or hyposmia, a complete loss or weakening of the sense of smell, is a characteristic symptom of an acute infection caused by a new coronavirus infection. There are two possible mechanisms for the development of anosmia. The first is a lesion of olfactory sensory neurons, the second is a pronounced inflammatory reaction in the mucous membrane of the olfactory zone, indirectly affecting the functions of neurons. The immunological pathogenicity of COVID‐19 is complex. This may be due to both the virulence of SARS‐CoV‐2 and the lack of temporal coordination between innate and adaptive immune responses. SARS‐CoV‐2 triggers both innate and adaptive immune responses too strongly, which can lead to tissue damage. The mechanisms of damage to the central nervous system in COVID-19 are complex and multifaceted, and often contradictory. Like other diseases, the new coronavirus infection can occur with different phenotypes and endotypes. The aim of the work was to determine the immunometabolic course variant (endotype) in patients with a new coronavirus infection with anosmia symptoms.

The fundamental goal of this scientific article is to study not only the historical processes of the emergence and use of tactical medicine in the internal affairs bodies, but also to analyze the current regulatory framework that regulates tactical medicine in the internal affairs bodies, to assess the current level of its development. It will also be important to touch upon the problems of the development of tactical medicine both at earlier stages of its development and at the present time, methods for improving the tactical and special training of police officers in the field of tactical medicine using the example of the Voronezh Institute of the Ministry of Internal Affairs.

This article is dedicated to Viktor Ivanovich Zavrazhny, whose social and scientific activities are closely connected with the Medical Faculty of Voronezh State University. A participant in the Great Patriotic War, a graduate student, an assistant, an associate professor, and then the head of the Department of Pharmacology. Contemporaries honor his memory and keep documents and scientific works left by him during his lifetime. Thanks to all this, we have the opportunity to learn details from the history of Russian and military medicine, as well as people who have made their invaluable contribution to the development of pharmacology. We should be proud of the scientists who have devoted half a century to the service of science and adopt their experience.