Vol 26, No 3 (2025): Опубликован 29.09.2025

The excessive use of antibiotics to treat COVID-19 patients was caused by the fact that the new infection has symptoms similar to pneumonia. Almost 80% of COVID-19 patients received antibiotics. Cephalosporins were most often prescribed (30.1% of patients), followed by azithromycin (26% of patients). The use of antibiotics can have a number of negative consequences for the intestinal microbiota, including a decrease in species diversity, changes in metabolic activity, and the selection of antibiotic-resistant organisms, thereby indirectly affecting the immune system. Many of them have pronounced immunotropic properties and are also able to influence metabolic processes. Cephalospores significantly increase the secretion of cytokines such as TNF, IL-1b and IL-6. In addition, the expression density of the CD14 LPS-recognizing molecule on monocytes is also reduced, thus suppressing the response of monocytes to LPS. They also have an immunostimulating effect on the phagocytosis of neutrophils exposed to lipoteichoic acid (LTA) of Staphylococcus aureus (LTA). The aim of the work is to study the effect of cephalosparin antibiotics on the immunometabolic processes that occur during a new coronavirus infection. The study included 68 people. The first group consisted of 50 patients who did not receive antibiotics at the outpatient stage of treatment. The second group included 18 patients who received standard cephalosporin antibiotics on an outpatient basis. The study showed that antibiotics of the cephalosporin group affect the synthesis of protein and albumin by the liver in patients with a new coronavirus infection. Cephalosparins worsen leukopenia, lymphopenia and thrombocytopenia caused by the new coronavirus infection, as well as further inhibit the adaptive and humoral antiviral immune response.

Gastroesophageal reflux disease with esophagitis is a chronic, frequently recurring disease of the mucous membrane of the upper gastrointestinal tract. Its prevalence among young and middle-aged people increases every year and is about 14% of the population. This pathological condition requires outpatient physicians to be highly alert regarding timely diagnostic and therapeutic tactics in view of the development of oncopathology, as well as other complicated forms (bleeding, perforation). The search for new diagnostic markers that can be used during the period of remission of symptoms and contribute to the timely correction of therapeutic measures remains relevant.

A common complication of anthracycline therapy in patients with acute myeloid leukemia is the development of cardiovascular toxicity. Endothelial dysfunction is one of the pathogenetic mechanisms of cardiovascular disease development, which is why there is interest in its assessment in clinical practice. The aim of the study was to assess endothelial dysfunction in patients with acute myeloid leukemia during chemotherapy.

Materials and methods: The study included 110 patients with newly diagnosed acute myeloid leukemia who were prescribed polychemotherapy with anthracycline drugs. Patients were divided into groups based on the detection of cardiovascular toxicity, defined as a decrease in global longitudinal deformation of the left ventricle by more than 15%. All patients underwent assessment of endothelial damage biomarker levels (endothelin-1, asymmetric dimethylarginine) and laser Doppler flowmetry parameters during the study.

Results: In patients with acute myeloid leukemia, signs of endothelial dysfunction are determined during chemotherapy with anthracycline drugs, which is manifested by an increase in the concentration of endothelial damage biomarkers (endothelin-1 and asymmetric dimethylarginine) and a decrease in microcirculation parameters assessed using laser Doppler flowmetry (microcirculation index, blood flow variation coefficient, amplitudes of myogenic and endothelial vasomotions and blood flow fluctuations associated with cardiac rhythms; results of respiratory and occlusion tests). Correlation relationships were revealed between the levels of endothelial biomarkers and laser Doppler flowmetry parameters in patients of the study group.

Conclusion: Patients with acute myeloid leukemia receiving chemotherapy with anthracycline drugs show signs of endothelial dysfunction. Evaluation of microcirculation parameters using laser Doppler flowmetry is an accessible and reliable method for early detection of endothelial dysfunction.

Community-acquired pneumonia (CAP) is a global healthcare problem and one of the leading causes of death and hospitalization among respiratory diseases. Cough is the most common symptom of pneumonia. One of the objective indicators for assessing cough is its sound. Objective. To determine the significance of spectral analysis of cough sounds in patients with pneumonia. Materials and Methods. A systematic review of more than 80 publications was conducted to assess the potential of spectral analysis of cough sounds for the diagnosis of pneumonia and other respiratory diseases. The sources of information included peer-reviewed domestic and international publications indexed in the eLibrary and PubMed databases from 2000 to 2024.The inclusion criteria for the review were as follows: Publications containing information on methods of recording and spectral analysis of cough sounds in patients with confirmed pneumonia of various etiologies; Articles published in English or Russian; Studies involving at least 50 patients with confirmed pneumonia; Research focused on the application of artificial intelligence, machine learning algorithms, and neural networks in the analysis of cough sounds. Results and Conclusion. Spectral analysis of cough sounds using signal processing methods can serve as a supplementary rapid diagnostic tool and assist in the differential diagnosis of productive and dry cough. It also enables the identification of bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), COVID-19, whooping cough, and pneumonia, and holds significant prognostic value.

The study included 33 pediatric palliative patients in the palliative care unit and 56 newborns in the intensive care units of the neonatal pathology department of a multidisciplinary children's hospital. Palliative patients have severe incurable diseases with a high risk of death. Among the palliative conditions associated with brain damage, the most common were severe forms of cerebral palsy, severe forms of organic brain damage, malignant epilepsy, and severe consequences of neuroinfections genetic syndromes. The average age of newborns was 20.0 days, and that of palliative patients was 6.9 years; the significance of differences was p=0.0001, meaning that the groups were statistically different. The newborns were preterm infants according to the clinical classification (average gestational age was 36 weeks). The medical history and neurological status were assessed. Computed tomography and ultrasound were used to diagnose individual brain lesions. All children underwent routine EEG with a tendency to monitoring research and further software amplitude-integrated (aEEG) processing. The EEG and aEEG indices in palliative patients generally do not differ from the indices in the comparison group consisting of newborn children. Consequently, the functional state of the brain of palliative patients of older childhood, which suffered as a result of organic damage (cerebral palsy, hydrocephalus, neuroinfections, apallic states, etc.) due to a kind of ontogenetic regression, resembles the functional state of the brain of newborn children (recorded using EEG, aEEG).

Antibiotic-associated diarrhea remains one of the most common adverse events that occur during the course of antibiotic therapy. Despite the proven effectiveness of preventive administration and treatment with probiotics, there remains a high prevalence of pathology and a tendency to a more severe course of the disease. We evaluated 150 medical records of children and surveyed their parents for the appearance of diarrheal syndrome during inpatient treatment. Every 4 (24%, n=36) had a complication of antibiotic therapy in the form of diarrhea, while there was no dependence on the group (penicillins, cephalosporins), duration and cause of antibiotic administration. Diarrhea syndrome was more likely to develop on days 2-4 (86.1%), had a duration of 4-5 days in most children (41.6%), and more often corresponded to type 5 on the Bristol scale (69.4%) with a frequency of up to 3 times a day (61%). It was found that children under 3 years of age have AAD more often, and correction of this condition is carried out only in 61.1%, and most often a drug containing a complex of bacteria Lactobacillus acidophilus
(LA-5) and Bifidobacterium animalis subsp. lactis (BB-12) is used.

This study presents an analysis of a clinical case associated with the development of interstitial lung damage caused by prolonged use of amiodarone. In the diagnostic process, it is advisable to apply a systematic approach that includes an assessment of an individual medical history. This approach will make it possible to determine the most appropriate therapeutic strategy for this pathology and prevent possible complications resulting from the treatment.

As part of an assessment of the effectiveness of basic skills training in tactical medicine in law enforcement agencies of the Russian Federation, an analysis of the primary means and methods for providing assistance in stopping massive bleeding was conducted using the Voronezh Institute of the Ministry of Internal Affairs of Russia as an example. It was found that up to 90% of wounded patients die before receiving qualified medical attention. Up to 50% of these fatalities did not have life-threatening wounds; their deaths were due to inadequate first aid. The development of tactical medicine, specifically in the area of first aid for massive bleeding, will reduce medical losses during the performance of operational tasks by law enforcement officers.

It is vitally important in the training of cadets and students to emphasize the development of skills in providing self- and mutual aid in case of injuries using means of stopping massive bleeding.