Молодежный инновационный вестник

Benign neoplasms of the rectum are true neoplasias of the intestinal mucosa and are obligate precancerous diseases of the colon. Approximately 10% of adenomatous rectal polyps transform into adenocarcinoma. Colorectal cancer is one of the leading cancer diseases in terms of morbidity and mortality. Despite visual localization, most malignant tumors of the rectum are detected only at late stages. The purpose of the work was to demonstrate a clinical situation that confirms the possibility of transition of a benign tumor with foci of high-grade dysplasia of the rectum into a malignant one. For this purpose, an analysis of medical documentation was carried out: inpatient and outpatient cards of the State Budgetary Institution "City Clinical Hospital No. 6" of the city of Tver, data from additional examination methods. The result of histological examinations carried out during the observation of the patient was a polyp of the lower ampullary rectum. Subsequently, a planned operation was performed; the surgical material revealed a serrated adenoma of the ampullary rectum with high-grade neoplasia and adenocarcinoma in situ. The clinical situation confirms the possible path of transformation of a rectal polyp with a high degree of intraepithelial neoplasia into a malignant neoplasm.

Introduction. This article analyzes the condition of newborns in women belonging to different age groups, but having a third or more pregnancy. Goal. Analysis of the condition of newborns born in the third or more pregnancies. Materials and methods. Primary medical documentation (birth histories, newborn histories, exchange cards). Results. Height, weight, as well as the presence of pathological conditions of the newborn, make it possible to develop certain tactics of childbirth in women of this group and timely prevention of complications of childbirth. Conclusions. The information obtained will help in providing effective care to premature infants, organizing the work of staff at perinatal centers and improving the level of equipment of healthcare organizations, which will be able to reduce infant and maternal mortality rates.

Introduction. Physiological adaptation is a complex and multifaceted process that can cause significant difficulties for university students. Exceeding the body's capabilities can disrupt the adaptation process, cause disadaptation and negatively affect the health and performance of students. Goal of the work. Assess the physiological adaptation of students to physical and mental work, determine effective methods for preventing maladjustment. Materials and methods. The study group consisted of 350 students (1st-3rd year), aged 17-20 years. Adaptation to physical work was assessed using functional breathing tests; Harvard Step Test Index (HST). Results. The physiological adaptation of students to physical and mental work has been assessed, and effective methods for preventing maladaptation have been identified. Conclusion. Physiological adaptation and maladaptation of students depends on the physical and mental state of the body, motivation for professional activity.

Introduction. Mast cells (MCs) are one of the substrate components that infiltrates lung tissue during the new coronavirus infection (NCI) COVID-19. Cardiac damage also occurs in this pathology, but little is known about the role of MCs in this process. Goal. To analyze the relationship between MC phenotypes in the lungs and heart in patients who died from COVID-19. Materials and methods. The study included 40 patients diagnosed with severe and extremely severe NCI with a fatal outcome (21 men and 19 women; mean age 66.65 ± 7.40 years). The death of all included patients occurred due to acute distress syndrome. Immunohistochemical analysis was performed to detect tryptase, chymase, and carboxypeptidase A3 (CPA3). Results. The number of all MC phenotypes was more prevalent in the lungs compared to heart tissues (p=0.0000). Among all phenotypes, MCs with signs of degranulation predominated. Correlations were also identified between the number of chymase-positive and CPA3-positive MCs in samples of lung and cardiac tissue. Conclusions. MCs of all phenotypes predominated in lung tissue. Along with this, direct relationships were observed between their amounts in the heart and lungs, which may indicate a proportional involvement of the heart in the systemic inflammatory process in patients with COVID-19. 

Abstract.

Actuality: A typical representative of a new class of devices is iQOS, developed using “Heat-Not-Burn” (HNB) technology. Electronic cigarettes consist of three elements: a heater (also known as a stick holder), a tobacco stick and a charger. The sticks contain reduced tobacco, glycerin and propylene glycol. Cellulose fibers, guar gum and flavorings may also be added. The stick contains a hollow acetate filter, behind which there is polylactide, which should reduce the heating temperature]. It is almost impossible to prevent the process of harmful substances entering due to the design of the cigarette.

The purpose of the work: to study the effects of harmful substances and decay products of electronic cigarettes on the human body.

Material and methods: analysis of the collected literature, scientific articles and recommendations, study of the chemical composition of electronic systems for smoking.

Results: the study showed that e-cigarettes can cause serious organ disorders and diseases in humans, as well as increase the risk of secondhand smoke.

Conclusion: Smoking conventional and electronic cigarettes negatively affects human health, causing changes in the functioning of all organs and tissues, stimulating the development of severe systemic diseases and increasing the risk of cancer. E-cigarettes also contribute to the development of nicotine addiction. Quitting smoking is the most correct decision to maintain health.

Introduction. Genetic factors play an important role in the development of autoimmune thyroiditis (AIT). Polymorphisms of the vitamin D gene (VDR) may be pathogenetically significant in this disease. Target. To study the genetic polymorphism rs1544410 of the VDR gene among women with autoimmune thyroiditis. Materials and methods. We examined 373 women whose age indicators (Me [Q1-Q3]) were 49 [35-62] years. Detection of VDR gene polymorphism (rs1544410) was carried out using the polymerase chain reaction method in real time. Statistical analysis of the results was carried out using the Medstat statistical software package. Results. Analysis of molecular genetic studies showed that the genotype frequencies of the studied polymorphism corresponded to the Hardy–Weinberg law and did not differ from the expected values (p>0.05). There was no association between polymorphic variants of the VDR gene and AIT in a group of postmenopausal women. However, among women of reproductive age, AIT showed an association with the GG genotype (p = 0.043) and the G allele (p = 0.041) of the rs1544410 polymorphism. Conclusions. The results obtained indicate that the presence of the G allele and the GG genotype of the rs1544410 polymorphism of the VDR gene increases the likelihood of autoimmune thyroid disease in women of reproductive age.

The main task of conscious parents who hear and respect their child is his harmonious development. An important aspect in the formation of personality is the psychophysical state of the younger generation. Who, if not a parent, can notice their child's reaction to changing external and internal stimuli in time when achieving a particular result and react quickly to it? Due to the timely and correct assessment of the child's condition by parents, it is possible to prevent the development of many diseases.

The purpose is to analyze the possibility of using subjective opinion in an objective assessment of the psychophysical state of primary school children.

1247 questionnaires of children aged 6-12 years were studied on the basis of the IOCC MR. For the purpose of discrete analysis, the questionnaire forms were divided into groups: grades 1-3 – 823 questionnaires, grades 4-7 – 424 questionnaires. In the course of the study, 2 types of questionnaires were used: 1 - for a subjective assessment by parents of the level of the child's psychophysical state, 2 - for an objective assessment of the children's dexterity, which was a test with questions. As a result of the survey, the predominance of "dexterous" boys and girls over awkward ones was revealed.  As for the morbidity of children, it coincides (for the most part) in both sexes, regardless of age category, but over time there is a tendency to manifest diseases of the musculoskeletal system and heart.

It was also found out that the boys of the first group have a predominant passion for swimming in sports, the second for martial arts, and the girls of both the first and second groups have a dance direction. Thus, in order to assess the psychophysical state of children's health, the subjective opinion of parents can be used, since it coincides statistically.

Introduction. The negative dynamics of the reproductive health of adolescents and young people sharply reduces the prospects for the population to implement their reproductive plans for the reproduction of future generations. The purpose of the study is to study the reproductive attitudes of medical students. Materials and methods. An anonymous online survey of 137 medical students, based on a specially designed questionnaire. Results. The respondents were mostly girls aged 18-25. Almost half of the respondents have a positive attitude towards starting a family, and a large proportion plan to have children in the future. More than a third of respondents are neutral about marriage, but almost one in five does not plan to get married. They believe that it is necessary to get married and give birth to the first child in 20-25 years, and most plan to have 2 children. The most effective measures to support the demographic situation are considered to be the availability of expert information on the preservation of reproductive health of the population, the formation of reproductive attitudes, the prevention of unwanted pregnancies, as well as medical, psychological and pedagogical measures aimed at preparing young people for a happy marriage, conscious parenthood. Conclusions. There is a need to develop and implement measures aimed at improving the system of early detection of disorders in the development of children, focusing primary health care on the prevention of reproductive disorders in adolescents and youth, introducing medical, psychological and pedagogical measures into the work of educational and medical organizations aimed at shaping the reproductive behavior of the younger generation, developing organizational approaches to the formation of valuex installations for a positive demographic response.

Introduction. The development of dental technologies and pain management methods plays a key role in achieving effective and comfortable treatment. New methods of anesthesia help to reduce pain of patients during procedures, as well as provide more accurate and safe operations. The goal of this study is the determination of the frequency of allergy to local anesthetics during dental interventions and treatment planning at the stage of anesthesia, taking into account the individual characteristics of the patient. Materials and methods. During the year, the analysis of medical records of patients who received treatment at a dental clinic in Voronezh was carried out, after which the incidence of patients with allergic reactions to local anesthetics was determined. Results. The frequency of allergic reactions to local anesthetics during various dental procedures was determined. The main manifestations of allergic reactions during the use of anesthetics were identified. Conclusions. Data have been obtained on anesthetics, allergic reactions to which are most common. The use of the obtained data will reduce the negative impact of local anesthesia on the patient's body as a whole, on individual systems and organs, and will also reduce the risk of complications.

Objective. To analyze the turnover of patients with acute intestinal obstruction in surgical departments of Ivanovo region from 2020 to 2022. Materials and methods. Theoretical and empirical methods: Study of literature and other sources of information. Collection of data on the study from all kinds of paper media and the Internet. Survey: in questionnaire format. Results. Etiology of acute intestinal obstruction, types and features were studied. A sociological survey of the population of Ivanovo city was conducted. The obtained statistical data for the periods from 2020 to 2022 of surgical departments of Ivanovo region hospitals were evaluated. Conclusions. Acute intestinal obstruction was and remains today one of the main diseases of emergency surgery (10 - 13% of cases.) To date, late application for surgical help of patients with acute intestinal obstruction is a serious problem in surgical treatment and prevention of complications in patients. (65 - 67% of cases). The availability of mass media and the Internet has a negative impact on the timely treatment of emergency surgical diseases. This disease remains little known among the population of Ivanovo, however, many of the respondents believe that inaction can lead to lethal outcome.

Introduction. In the modern world, mankind cannot imagine its life without a phone, computer, smart watch, etc. We use gadgets for various reasons, to learn some new information, to facilitate math calculation, to contact the people we need anywhere and at any time, to distract ourselves, to have fun, to cook a new dish. But are gadgets so useful for a person? Maybe the facilitation of life hides human degradation and helplessness, which will lead mankind to extinction? Objective. To identify the impact of gadgets on human life, health, cognitive functions. Materials and Methods. Theoretical and practical methods: Study of literature and other sources of information. Collection of information on the topic of research from books, magazines, newspapers, disks and the Internet. Survey: questionnaire survey. Results. Literature sources were searched, the data were analyzed. The survey, questionnaire. Conclusions.   The use of gadgets in the modern world makes life easier, however, many of the respondents are examples of cognitive decline. Among those surveyed participated at the age of 18 years and over 30 years. Of these, 55.9% use gadgets for more than 5 hours a day daily, 32.4% for 3-5 hours, 11.8% for 1-2 hours. Gadgets are used for communication purposes 88.2%, searching information 82.4%, watching YouTube 82.4%, working 70.6%, playing games 47.1%, watching a movie 44.1%. When asked whether people can live without gadgets for 1 day, 73.5% said they could, 14.7% could not and 11.8% found it difficult to answer.

Abstract: Relevance. The article discusses modifiable risk factors for thrombosis in women of reproductive age in the city of Tyumen outside pregnancy. The relevance of the study is due to the increase in cases of venous thromboembolic complications and the incidence of venous thromboembolic complications in 110 per 100,000 people in the Russian Federation.

The aim of the work is to assess the prevalence of modifiable risk factors for thrombosis among women of fertile age living in the city of Tyumen.

Materials and methods. A questionnaire was conducted on the modifiable risk factor for thrombosis among women aged 18 to 35 years (n=101). The results were processed using the Microsoft Office Excel 2007 program.

The results of the study. 85.4% of women in the survey have modifiable risk factors for thrombosis. The most significant risk factors are physical inactivity (41.6%), smoking (32.7%), and changes in BMI (28.71%). Chronic diseases also affect the development of venous thromboembolic complications: cardiovascular (11.98%), endocrine (5.94%), gastrointestinal tract (10.98%).

Conclusion. Thus, the majority of respondents have modifiable risk factors for thrombosis. In order to reduce the risk of thromboembolic complications, prevent thrombosis in early pregnancy, and reduce maternal mortality, risk factors for venous thromboembolic complications should be identified and adjusted in advance. The prevention of reducing risk factors are: quitting smoking, the need to carefully assess risk factors when prescribing combined oral contraceptives, rational nutrition and weight control, as well as combating physical inactivity in the form of an active lifestyle and taking 10,000 steps a day.

Keywords: modifiable risk factors; thrombosis

This paper examined methods for minimizing injuries in physical education classes in higher educational institutions, and also presented an analysis of a survey of Volgian State Medical University students on the topic of physical education classes and related cases of injuries

The purpose of the work. To carry out a comprehensive analysis of the treatment of residents of the Republic of Mordovia with diseases of the oral mucosa (SOPR) at the Department of Dentistry of the Ogarev Moscow State University.
Materials and methods of research. To achieve this goal, a retrospective analysis of 16 outpatient records of residents of the Republic of Mordovia who applied with diseases of the oral mucosa to the Department of Dentistry of the Ogarev Moscow State University in the period from September 2023 to January 2024 was carried out.
The results of the study. Most often, elderly people (60-75 years old according to the WHO classification) apply to the Department of Dentistry – 81.25%, less often middle–aged (44-59 years old according to the WHO classification) – 18.75%. The highest percentage of referrals (87.5%) to the Department of Dentistry is observed among women, and only 12.5% are male. The majority of patients (56.25%) were initially referred by doctors of urban polyclinics and private clinics to the State Medical Institution of the Republic of Moldova "Republican Oncological Dispensary", with an assumed diagnosis of C00-C14 ("Malignant neoplasms of the lip, oral cavity and pharynx"). From there, in the same amount (56.25%), after examination by an oncologist, they were redirected to the Department of Dentistry of the Ogarev Moscow State University, with the exception of the malignant nature of the course of diseases of the SOPR. Another 43.75% of patients were referred to the Department of Dentistry from the advisory link of the State Medical Institution of the Republic of Moldova "Mordovian Republican Skin and Venereological Dispensary", with an assumed diagnosis of lichen planus (L43). Of the 16 patients with COPD diseases, the following were identified: lichen planus, erosive and ulcerative form - 56.25%; lichen planus, typical form – 18.75%; chronic trauma of COPD – 12.5%; lichen planus, bullous form and exfoliative cheilitis, dry form of 6.25% each. Of the total number of patients examined, 87.5% of patients live in the city of Saransk and 12.5% live in remote areas of the Republic of Mordovia, while it is worth noting that patients living in the districts have the most severe forms of COPD diseases. During the examination of the oral cavity, all patients revealed sharp edges of teeth and fillings, as well as orthopedic structures of inadequate quality. In addition, the hygiene level was analyzed using the OHI-S plaque index, while the average level of oral hygiene was observed in 68.75% of patients, while the remaining 31.25% had an unsatisfactory hygiene index.
Conclusion. The conducted research shows that elderly women living in Saransk most often come to the Department of Dentistry of the Ogarev Moscow State University with diseases of the SOPR. It can also be concluded that the largest number of patients have facultative precancerous diseases of COPD, with a predominance of lichen planus among those who applied. From the results of the examination of the oral cavity of patients, it is safe to say that dentists of the Republic of Mordovia rarely use the method of individual grinding of teeth. Referral of any patient to an oncologist is a strong stressful factor, and overdiagnosis adversely affects the quality of life of such patients during the diagnosis period.

The relevance of the study lies in the importance of the primary school period
for children and their adaptation to new conditions. Objective. Research, identify and analyze indicators of children's primary school readiness, their motivation, emotional and intellectual spheres. Materials and methods. The study included complex tests performed on 48 elementary school students (22 girls, 26 boys) covering 3 blocks: academic motivation, level and nature of anxiety and intellectual ability . Result. In grades 1-2, ready motivation at levels 4-5 is demonstrated. In year 3, the dominant motivation was motivation level 3. In year 4, motivation levels 3, 2 and 1 accounted for 81%, while level 4 accounted for 19%. During the first year, levels 2 and 3 of intellectual preparation predominate. In the 2nd year, the 2nd level of intellectual preparation prevails. In the 3rd and 4th years, the level of intellectual preparation is mainly at levels 1 and 2. Among all the levels, levels 2 and 3 have the highest levels of anxiety. The lowest levels of anxiety were among 1st and 4th graders. Conclude. In grades 1 and 2, high motivation prevails, in grades 3 and 4 motivation gradually decreases. The average level of intellectual readiness prevails in grades 1-2, in grades 3-4 the number of students with a high level of intellectual readiness increases. Anxiety was identified at all levels, with levels 2 and 3 having the highest levels. Following the study, recommendations were made to reduce the academic anxiety levels of elementary school students and increase their intellectual preparedness.

Introduction. The high prevalence of asthma and osteoarthritis (OA) creates a high probability of their concomitant course. Both diseases are closely associated with obesity, which creates interest in studying this combination of pathologies, including their impact on the patient’s physical activity. Goal. To evaluate the impact of OA on physical activity (PA) and the course of asthma in obese patients. Materials and methods. The study included 137 patients with moderate asthma. Participants were divided into two groups: group 1 consisted of patients with asthma without signs of OA; group 2 – patients with asthma and OA. Clinical assessment of diseases, determination of the Lequesne index, X-ray examination of the knee and hip joints, spirometry, assessment of physical activity and asthma control were carried out. Results. In patients with asthma and OA, inflammatory indicators and body mass index (BMI) were higher and PA, spirometric indicators and the level of asthma control were significantly lower than in patients with asthma without OA. Conclusions. The results of the groups’ comparison indicate a negative impact of OA on the course of asthma, which is manifested by a decrease in physical activity and asthma control as well as an increase in inflammation in obese patients.

Introduction. In the last decade, more and more studies have reported the presence of congenital thrombotic thrombocytopenic purpura in patients suffering from complications of pregnancy and childbirth such as repeated fetal loss, stillbirth, intrauterine growth retardation and preeclampsia. This pathology requires a special approach in diagnosis and therapy. The aim of the study is to analyze the relevance of the diagnosis of the ADAMTS13 genetic defect in Upshaw-Shulman syndrome, to determine the practicality and productivity of technologies used for the treatment of emerging obstetric complications. Materials and methods. A retrospective analysis of 21 medical records of patients who were treated at the department from 2017 to 2023 was carried out. Results. In total, 21 pregnancy episodes occurred in women from the groups analyzed by the author, of which 15 had obstetric complications, including 46.7% (7/15) premature fetal loss (<10 weeks), 26.7% (4/15) late fetal loss (≥10 weeks) and 26.6% (4/15) premature live births. Conclusions. Monitoring of ADAMTS13 serum levels is carried out when planning a subsequent pregnancy. Long-term complications of TTP should be taken into account: ischemic strokes, secondary hypertension, coronary heart disease, cognitive abnormalities and a decrease in quality of life. Pregnancy with Upshaw-Shulman syndrome will become one of the main areas of obstetric development in the coming years, further associative and high-quality research is needed to form the best therapeutic innovations and opportunities in the future.

Introduction. The steady incidence of children in the first year of life, which is largely related to the lifestyle of women before and during pregnancy. Goal. A study of the lifestyle of pregnant women, their awareness and satisfaction with information about the impact of various factors on fetal health. Materials and methods. There were 475 women among the respondents who filled out a questionnaire consisting of 94 questions. The survey was conducted anonymously. Results. The study involved 475 women aged 26 to 39 years who are in the second and third trimesters of pregnancy. Most of the respondents consider their lifestyle to be healthy, but many have problems with various lifestyle components. Most are also confident in their awareness of the prevention of child health problems before birth, but the main source of information on this issue for them is the Internet. A detailed analysis showed that many respondents are unaware of the negative impact of their bad habits on the health of the unborn child. Most of the respondents receive information about improving their lifestyle during pregnancy from medical professionals, but almost half consider this information incomplete or incomprehensible. Conclusions. There is a need to develop medical and social support programs for expectant parents in the system of antenatal child health care.

Currently, in the treatment of parovarial ovarial cysts in adolescents, the emphasis is on organ-preserving treatment, taking into account the low malignancy rate and the importance of preserving reproductive functions in the future. This pathology is most common in adolescents, but can occur at any age, from newborn girls to menopausal women. Objective. To study a clinical case of giant paraovarial cyst in an adolescent girl. Materials and Methods. Retrospective analysis of the patient's medical history. Results. Patient E., 15 years old. In November 2022, she went to the polyclinic at the place of residence with complaints of abdominal enlargement in size. When undergoing ultrasound of the abdominal cavity, a cystic formation of the abdominal region of large size was detected; the child was referred for consultation to the pediatric surgeon of ODKB No. 2 in Voronezh. MR signs of a cystic volumetric mass of irregular oval shape with the dimensions of 23x23x10 cm. 02.12.2022 Laparotomy, removal of the right paraovarial cyst, drainage of the abdominal cavity. The postoperative period proceeded well without complications. The patient was discharged from the hospital on the 15th day in satisfactory condition. Conclusion. In the practice of pediatric surgeon one can meet with rare cases of paraovarial cysts formation in uterine appendages. Minimally invasive technique should be sought. To find out the state of reproductive potential of girls with such masses, a detailed examination will be required when they reach adulthood.

Introduction. A high-quality full-fledged night's sleep should have a certain duration and periodic change of phases, violations of which affect the mental processes of a person. Sleep is controlled by the autonomic nervous system (ANS), but there is no information about the effect of its condition on sleep characteristics. Goal. To investigate the influence of the state of tone of the centers of the autonomic nervous system on the qualitative characteristics of night sleep in students. Materials and methods. The study involved 33 students aged 18-19. To assess the qualitative characteristics of sleep, the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the sleep quality monitor in the Xiaomi fitness bracelet were used. The assessment of the tone of the VNS centers was carried out using the pulse monitor in the Xiaomi fitness bracelet. The monitoring took place during the week. Statistical processing of the results was carried out using spreadsheets of the MC Excel software package and a statistical processing program openepi.com . Results. Half of the surveyed students (55%) have problems with sleep duration and regime, what due to a violation of the NREM- phase. which is shortened. The analysis of the state of the VNS centers tone showed that a large percentage (63%) of students are not normotonics, while sympathononia affects the NREM- phase, and vagotonia affects the REM one. According to the data obtained from the questionnaire, sympathotonics disrupt sleep patterns less, they need a lot of time to fall asleep, they often have vivid dreams. Vagotonia wake up more often, there are more people with chronic diseases among them. Conclusions. In order for sleep to be of high quality and full–fledged, sympathotonics are recommended to follow the sleep regime, especially the time of falling asleep no later than 23 hours, and vagotonics are recommended timely prevention of chronic diseases.

The article highlights the relevance of the use of artificial intelligence in therapeutic dentistry. The paper raises the issue of the use of artificial intelligence in the daily practice of a dentist therapist for diagnosis and diagnosis, the possibility of using artificial intelligence in the early stages of diagnosis of diseases of the hard tissues of the tooth and pathologies of the dental system. The purpose of the work is to identify the main advantages and disadvantages in diagnosis. To analyze the main methods and technologies that can contribute to the optimization of diagnosis, preparation of a treatment plan and prevention of the dental system, which will allow the dentist therapist to more accurately diagnose and prescribe better treatment in different clinical cases and improve the quality of treatment at different stages of the disease. Results. All programs using artificial intelligence for diagnostics in dentistry are based on the use of neural networks. Programs based on deep neural learning are used in the practice of a dentist therapist to process and diagnose complex two-dimensional and three-dimensional images

Abstract.

Introduction. The number of women exercising childbearing function in older reproductive age is growing [1]. Age is one of the unmodifiable factors of oocyte aging, a process in which 2 main mechanisms are distinguished: a decrease in the expression of the gene encoding the enzyme DNA topoisomerase [2], which leads to impaired chromosome condensation, chromatid separation and torsion stress relief; and oxidative stress [3], realized by a decrease in melatonin and an increase in tumor necrosis factor alpha (TNF-alpha) in follicular fluid [4]. Both mechanisms lead to embryo aneuploidy. The goal of this study is a preservation of genetically high-quality material in women in delayed motherhood programs. Materials and methods. The outcomes of in vitro fertilization (IVF) programs in 156 patients of reproductive age were analyzed. A total of 797 embryos were obtained. A retrospective study of the dependence of the quantity and quality of 797 embryos on the age of patients in the department of infertility treatment and IVF of the Lapino Clinical Hospital for 2022 was conducted. Results. Statistical analysis showed an inverse average relationship between the age of patients and the number of embryos received; an inverse strong relationship between the age of patients and the proportion of euploid embryos; a significant decrease in the proportion of euploid embryos in patients aged 35 years and older and a uniform decrease in the ratio of euploid embryos to the total of embryos in subsequent age groups. Methods for improving the outcomes of delayed motherhood programs are proposed. Conclusions. The higher the patient's age, the worse the yield in terms of the number and quality of embryos, especially euploid ones. It is necessary to inform women about the influence of the age factor on reducing the chance of obtaining a genetically healthy embryo (even in assisted reproductive technology (ART) programs) and about the greater effectiveness of delayed motherhood programs for cryopreservation of oocytes at a younger age.

Keywords: infertility; delayed motherhood; female age factor; euploid embryos; oocyte aging

Abstract.

Introduction. There is a need in clinical medicine to improve diagnostic techniques and evaluate the efficacy of antihypertensive drugs. The aim of the study was to evaluate the efficacy of indapamide and perindopril combination in patients with acute coronary syndrome (ACS) and chronic kidney disease (CKD). Materials and Methods. The following parameters were analysed using volumetric sphygmography on a VS-1500 device: central and peripheral blood pressure (SBPao and PBpao), augmentation index (AI), pulse wave velocity index (PWV) and cardiac ankle vascular index (CAVI). In addition, electrocardiogram, echocardiography, and blood creatinine concentration were studied, and the glomerular filtration rate (GFR) was calculated. Arterial and pulmonary hypertension in patients divided into 3 groups was analysed. Group 1 used perindopril, group 2 used a combination of indapamide and perindopril, and group 3 used perindopril alone. The results show a decrease in SBPao and DBpao, blood creatinine levels, and an increase in GFR during three months of therapy with the indapamide/perindopril combination drug. Conclusions. Noliprel Bi-Forte may be the drug of choice for treatment of this cohort of patients.

Introduction. Despite the availability of vaccination against the hepatitis A virus at the present time, as well as the availability of this vaccine in the calendar of Minsk on a free basis, cases of hepatitis A among the child population continue to be registered in the Republic of Belarus. In previous years, isolated cases of hepatitis A among children were registered (the number of hospitalized patients diagnosed with hepatitis A in the Minsk City Children's Infectious Clinical Hospital from 2 to 5 people per year from 2017 to 2023). However, since the beginning of 2024, an increase in the incidence of hepatitis A in children has been recorded. The goal of this study is to analyze the anamnesis, clinical and laboratory data of patients hospitalized at the Minsk City Children's Infectious Clinical Hospital with a diagnosis of hepatitis A since the beginning of 2024. Materials and methods. A retrospective analysis of data from 17 medical records of inpatients who were treated at the Minsk City Children's Infectious Clinical Hospital with a diagnosis of B15.9 (Hepatitis A without hepatic coma) from 01.01.2024 to 03.12.2024 was carried out. The diagnosis was established on the basis of a typical clinical picture of the disease and was confirmed by detecting immunoglobulins M to the hepatitis A virus in the blood serum using ELISA. The data obtained as a result of the study were processed using traditional methods of mathematical statistics using the Statistica 13.0 application program. Results. Data from medical records of inpatients were processed and analyzed, anamnesis data was studied, including epidemiological and vaccination status, the patterns of the course of the disease in patients were determined, and the results of laboratory tests were processed and analyzed. Conclusions. All cases of hepatitis A were reported in unvaccinated children over 7 years of age. With hepatitis A, the typical course is a symptomatic course in the form of a moderate form with the presence of vomiting and fever in the prodromal period. In children over 7 years of age, in most cases, the icteric form develops, with an increase in the biochemical blood test of transaminases, LDH, alkaline phosphatase, GGTP, and in most patients, the presence of bilirubin metabolic products in the urine and hepatomegaly is observed, both by palpation and according to ultrasound data of the BBP. A practicing physician should always remember this diagnosis in his practice, especially when identifying cases of hepatitis in unvaccinated children. In order to prevent cases of hepatitis A, efforts should be intensified to increase the coverage of preventive vaccinations among the population, in particular against the hepatitis A virus.

Goal. A study of the attitudes of medical students towards modern methods of contraception, as well as their awareness of the prevention and complications of abortion. Materials and methods. Among the interviewed 219 medical students who filled out a questionnaire consisting of 34 questions. The survey was conducted anonymously. Results. The study involved 219 medical students, mostly girls under the age of 20. These studies made it possible to assess not only the awareness of respondents on contraception and abortion prevention, but also to identify preferred sources of information. Conclusions. There is a need to develop medical and social programs of an approach to raising awareness among young people on the prevention of unwanted pregnancies.

Introduction. Many women, when symptoms of PMS or dysmenorrhea appear or worsen, turn only to a gynecologist, as a result of which neurological disorders disappear from the field of view. Goal. To identify the frequency of symptoms of severe dysmenorrhea and PMS, to determine their dependence on the symptoms of DDTS. Materials and methods. A survey of young women with a regular menstrual cycle. There are 3 groups for the presence of symptoms of PMS or dysmenorrhea and 5 groups for the presence of symptoms of nervous tension. Results. The average age is 21.8±4.1 years. The normal BMI is 77.5%. The normal menstrual cycle is 88.8%. When dividing by DDTS, bleeding is longer, and tension is higher in groups with severe PMS or dysmenorrhea. When dividing by the presence of reproductive disorders, girls without them have lower levels of distress, depression, anxiety and somatization. Conclusions. Symptoms of PMS and dysmenorrhea are significantly associated with the severity of symptoms of DDTS both in the allocation of groups of PMS and dysmenorrhea, and in groups with different levels of DDTS. The participation of a neurologist is necessary for the competent relief of symptoms of DDTS.

Symptoms of PMS and dysmenorrhea are detected in 95% of women aged 15 to 45 years, and neuropsychiatric disorders are a significant risk factor. Hormone therapy is often used, but it is not always possible. Goal. To evaluate the differences in the manifestations of PMS, dysmenorrhea and DDTS when using combined oral contraceptives. Materials and methods. A survey of Volgograd female students with an assessment of the neuropsychiatric status and frequent symptoms of PMS and dysmenorrhea in different periods of the cycle. Results. The average age of the examined patients was 21.8 ± 4.1 years. The normal BMI is 77.5%. All the examined patients were divided into groups: taking COCA and protecting themselves with non-hormonal means. Among COCA users, indicators of PMS and dysmenorrhea of high and moderate levels are less common than in those who are protected by non-hormonal methods or are not protected at all. There are also significant differences in the indicators of neuropsychiatric disorders with a better outcome in the examined patients who take COCA. Conclusions. The surveyed people who take COCA have significantly fewer reproductive and neuropsychiatric disorders than those who do not take COCA.

The aim of the study was to assess the stress level and resistance to it in 1st and 2nd year students of a medical university using the Bayevsky index. The study showed statistically significant differences in the Bayevsky index between 1st and 2nd year students (p = 0.036), which may indicate better adaptation and increased stress tolerance over time at a medical university. Analysis of the index in the context of physical activity revealed (p = 0.012) that moderate activity is associated with the best regulation of the autonomic nervous system, while low and high activity are associated with increased tension of regulatory systems. These results highlight the importance of moderate physical activity for optimizing adaptation to stress and learning load.

Introduction. The high level of urbanization in the Voronezh region is characterized by developed industrial production, numerous motor vehicles, which invariably leads to artificial pollution of the atmosphere. These substances have a complex effect on the body of residents and lead to the development of various diseases or exacerbation of chronic nosologies. Monitoring and recording of pollutant concentrations is necessary to develop measures to ensure hygienic safety.

Materials and methods: in the course of the study, a mathematical and statistical analysis of data from scientific articles and publications, as well as the results of monitoring atmospheric air pollution in the Voronezh Region for 2020-2022, was carried out.

Results: The main factors of atmospheric pollution are the components of emissions from stationary and mobile sources. At thirteen posts in the Voronezh city district and in several districts of the region, the average daily concentration of the following substances is estimated: carbon monoxide, sulfur dioxide, nitrogen dioxide, suspended solids, ozone, phenol. The concentration of four carcinogenic substances is also taken into account: lead, styrene, formaldehyde and soot.

Conclusion: the high level of urbanization, and the associated growth of industrial production, motor transport, leads to the development of diseases of the respiratory and nervous systems in residents of the Voronezh region. In children under 14 years of age, the development of bronchial asthma is most common, in adults — chronic bronchitis and emphysema of the lungs.

Absrtract. Introduction. Flat feet are an extremely urgent problem in the modern world. From 20 to 37% of the population have flat feet to one degree or another. Despite the widespread prevalence among the population, there is no single and accurate diagnostic system. The development of such a system is hampered by the polyethological nature of the disease, as well as the inability to assess the severity of the disease only by morphological signs, it is necessary to evaluate the functionality of the foot. Pathological flat feet caused by various etiological factors lead to certain types of flat feet and require appropriate treatment. Goal. Consideration of narrow shoes as a factor in the development of unstable mobile flat feet in a healthy adult population. Squats as a way of physical therapy. Materials and methods. The analysis of literary sources was carried out on the basis of the scientific electronic library Elibrary. The modern classification of flat feet and various etiological factors of occurrence were described. The differences between pathological and physiological flat feet are determined. The biomechanics of the foot in pathology and methods of its correction using a basic squat exercise are also considered. Conclusions. Flat feet are a common phenomenon in the modern world and in most cases do not require correction and are not a pathology. In case of pain and discomfort, it is necessary to correctly determine the type of flatfoot in order to choose the appropriate treatment. With mobile flat feet without concomitant pathologies of the musculoskeletal and ligamentous apparatus in adults, it is necessary to wear the right shoes, exercise to improve joint stability with strict observance of exercise techniques.

Introduction. Current practice shows an increasing number of people suffering from a combination of diseases, among which ischaemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) are prominent, associated with common risk factors. The aim of the present study is to determine the significance of indicators such as coronary angiography (CAG), pulmonary hypertension (PH) and blood lipid profile in patients with IHD, arterial hypertension (AH) and COPD 2-3 st. Materials and methods. The study was based on the analysis of medical records of 108 participants divided into 2 groups: 1 with IHD, AH and COPD, and 2 with IHD. The results demonstrate increased lipid levels in group 1 patients, suggesting an increased risk of cardiovascular complications. In addition, the analysis showed an uneven distribution of atherosclerotic plaques in the coronary vessels, with group 1 patients showing more severe coronary artery damage. Conclusions. There is an emerging need to develop and implement effective diagnostic and therapeutic techniques for comorbid patients.

Introduction. Malignant neoplasms of the female reproductive system are widespread among the population and have an extremely nonspecific clinical picture, which often leads to their late diagnosis. That is why it is of scientific interest to study the dynamics of morbidity in this nosological group. The goal of this study is to analyze the dynamics of the incidence of malignant neoplasms of the female reproductive system in the Kursk region in 2012-2021. Materials and methods. The analysis of the dynamics of the incidence of malignant neoplasms of the body and cervix and ovaries in the Kursk region in 2012-2021 was performed, which included the compilation of dynamics series, their alignment by the moving average method and an assessment of the reliability of changes in dynamics. Results. A tendency to decrease the incidence of malignant neoplasms of the body and cervix and ovaries in the Kursk region in 2016-2021 was found. Conclusions. Despite the decrease in the incidence of malignant neoplasms of the body and cervix and ovaries in the Kursk region, it is necessary to actively conduct sanitary and educational work and improve the coverage of the population with gynecological care (including preventive).

Introduction. This scientific article presents a multifactorial analysis aimed at studying the interrelationships between various personal characteristics, family background and the dynamics of romantic relationships. Relevance. The study offers a new perspective on the factors that can influence the duration and quality of romantic relationships, providing valuable data for further research in the field of relationship psychology and family therapy. Goal. Analyze and compare the responses received during the passage of questionnaires by couples in a relationship. Materials and methods. The analysis is based on data collected from 42 participants (21 couples) between the ages of 18 and 21. The study covers such parameters as matching desires regarding the frequency of meetings, BMI, sports, having a normal relationship with parents in childhood, as well as the ratio of temperament types in a couple. Results. The correspondence of desires regarding the frequency of meetings varies depending on the duration of a romantic relationship, while BMI, sports and temperament types did not show a statistically significant effect on the duration of the relationship. Couples who have a normal relationship with their parents in childhood tend to have a longer romantic relationship. Special attention is paid to the analysis of changes in preferences and relationships in couples over time, emphasizing the importance of communication and mutual understanding to maintain a harmonious relationship. Conclusions. Further study of the psychology of couples in relationships is required, as this issue is still relevant.

Introduction. The use of anesthesia in dentistry is an important aspect of providing quality and painless dental treatment. However, for some patients, local anesthesia may be intolerable or ineffective, making treatment difficult. In such cases, the use of anesthesia becomes necessary to ensure the patient's comfort and safety. Target. The aim of the study was to determine the most commonly used general anesthetic. Materials and methods. In the process of carrying out the work, an analysis of foreign as well as domestic literature on the use of general anesthetics was carried out. In addition, data from dental clinic websites was analyzed to determine the most commonly used anesthetic. Results. The study identified the anesthetic drug most often used for allergies to local anesthetics. Conclusion. The most common choice of dentists is the drug propofol. It is connected with the lowest likelihood of side effects.

Relevance. Obesity is one of the global problems of our time and remains relevant not only in Russia, but throughout the world. WHO statistics for 2023 on the total number of obese people among different countries provides us with data from which we can conclude: the United States remains in first place (78 million), China (46 million), India (30 million), Russia (28 million). million) and Brazil (22 million) [3]. It is known that obesity is a risk factor for many pathologies: diabetes mellitus, coronary heart disease (CHD), arterial hypertension, fatty liver, arthrosis. Therefore, the problem of obesity is relevant.

Target. The purpose of the study is to analyze the prevalence of overweight and obesity among students of Kursk State Medical University.

Materials and methods. The research method was an anonymous survey, which was carried out on a voluntary basis, and a statistical method. The survey was conducted using YandexForms. 203 students of KSMU took part in the study.

Research results. BMI in the range from 25.0 to 29.9 is recorded in 15.4%; 30 or more in 11.6%. Overweight or obesity before the age of 16 was observed in 1/3 of respondents. 76.3% of students regularly engage in physical activity (sports). More than half (65%) watch their weight.

Conclusion. 54 people had a BMI above 25. Most students had relatives who were overweight or obese. It is necessary to take a more responsible approach to the issue of obesity and conduct campaigns and lectures on the relevance of maintaining a healthy lifestyle and reducing body weight to optimal values.

Abstract.

Introduction. Dermatoses, in particular eczema, force patients to change their social and professional activities, and the use of ineffective drugs reduces motivation for treatment, which affects their mental status. Goal. Evaluation of the effectiveness of the use of combined external agents in the treatment of microbial eczema. Materials and methods. A comprehensive analysis of data on 32 patients diagnosed with microbial eczema was carried out. The collection of anamnestic data included a detailed analysis of existing NHS, transmitted infectious diseases, and the influence of social and household factors.   The EASI index was used to determine the severity of microbial eczema. The correlation analysis of the dermatological index with the gender and age of patients was carried out using the squares method (Pearson's formula). To assess the effectiveness of treatment, we have developed a questionnaire reflecting the subjective feelings of patients at different stages of the therapy used. To assess the microbial diversity of the skin, a cultural method with quantitative determination of contamination was used. Results. It turned out to track the dynamics of the effect of the therapy on the change in clinical symptoms, the prevalence of the process, and the subjective feelings of patients.  Conclusions. An already compromised organism is susceptible to the disease, which complicates the tasks of treatment, but nevertheless combined drugs show positive results. 

Introduction. Considering self-esteem as a physiological phenomenon is a very important task at the present stage of scientific development. Goal. To assess the ability of college and higher education students to objectively self-assess when working with text, to establish a deviation of self-esteem under the action of a stressor, to investigate the degree of this deviation in various groups (sympathotonics, vagotonics, normotonics). Materials and methods. In this experiment, students were given the opportunity to write a summary of the text they had read. After completing the summary, they were asked to evaluate their own capabilities and provide a percentage assessment of their work (the method of universal learning skills). The study was conducted in two stages. In the first stage, the summary was written and evaluated while the students were at rest. In the second stage, the students were in a state of stress while writing. At the second stage, we evaluated the self-esteem levels of three groups: sympathotonics, normotonics and vagotonics. To evaluate the accuracy of self-assessment, author considered the discrepancy between the student’s personal evaluation of the amount of information conveyed in their summary and the author’s objective assessment of the text written by students. Results. The findings showed that self-esteem is affected by the dominant activity of either of the sympathetic or parasympathetic divisions of the autonomic nervous system. Also, the tendency to overestimate of one’s own capabilities (inflated self-esteem) during rest, and, conversely, underestimation of one’s own work (low self-esteem) during stress, were revealed. Conclusions. The study revealed an involuntary component in the formation of self-esteem and differences in the formation of self-esteem in sympathotonics, vagotonics and normotonics due to an involuntary component.

Introduction. An analysis of the organization of the process of conducting training sessions in the discipline “Public Health and Healthcare” at a medical university was carried out from the perspective of preventing resource losses. Value flow maps of the current and target state of processes were developed and analyzed, analysis was carried out and design solutions were developed to bring the process to the target state. Technologies of modern management of organizations in healthcare and education are aimed at achieving the goals of improving processes by identifying and reducing losses, which reflects the practice of “lean production”. In accordance with the concept of lean manufacturing, all activities of an organization are divided into operations and processes that add value to the customer and operations and processes that do not add value to the customer. The goal of lean manufacturing is the systematic reduction of processes and operations that do not add value and the use of tools that allow you to get rid of operations that do not add value and their associated costs 1. The basic principles of lean manufacturing as a process are: determining the value of a specific product, defining and ensuring a continuous flow of the product value creation flow [2, 3]. 2. Goal: to optimize the organization of the process of conducting training sessions in the discipline “Public Health and Healthcare” by identifying unreasonable losses of resources - time, labor efforts of teachers, consumables. Research methods: in 2023, a prospective study was conducted on the basis of the Federal State Budgetary Educational Institution of Higher Education Ivanovo State Medical University of the Ministry of Health of Russia. Subject of research: educational process. Research methods: timing method, expert, sociological, methods adopted in “lean production” technology. Results. The leading losses have been identified: loss of time when issuing and collecting knowledge control tasks on paper; suboptimal use of the teacher’s labor efforts; limited capabilities for visualizing educational information; limited opportunities for developing students’ skills in searching for information on the Internet and assessing its quality; loss of time in the process of checking student work done exclusively in handwritten form on paper. As part of the project, a digital case of an educational lesson was created and implemented using the example of one of the topics in the cycle of the thematic plan of a university semester, including extracurricular and classroom preparation of students for the lesson. Conclusions. Lean manufacturing technologies are an effective tool for optimizing the educational process in a medical university.

There is little data on the prevalence of various oral cavity changes caused by e-cigarettes. The aim of the work was to determine the propensity for oral diseases among medical university students and schoolchildren using vapes. The research method was a questionnaire and subsequent analysis of statistical data. Data processing was carried out using Exсel 2019 software. 203 people aged 12 to 22 years took part in the survey (average age 17.0±1.0 years), 24 of them were men, 4/5 of all respondents were girls (78.3%). According to the results of the survey, it was revealed that 72% have tried e-cigarettes at least once, and 34% use them on a regular basis. A positive correlation was found between the presence of disorders in the oral cavity and vaping smoking. The most common manifestations of oral cavity changes are: plaque enlargement, marginal bone loss, loss of clinical attachment, tooth loss, increased pocket depth and decreased bleeding during probing. Therefore, the identification of such symptoms in e-cigarette smokers allows us to establish a tendency to damage the oral mucosa under the influence of electronic carrier vapor. 

Introduction. When malignant neoplasms of the abdominal cavity are irradiated, healthy hepatocytes can also be exposed to toxic ionizing radiation, which can cause disruption of their life cycle, death and the development of signs of acute radiation hepatitis. Target. Immunohistochemical assessment of proliferation and apoptosis of hepatocytes in a model of acute radiation hepatitis. Materials and methods. Experimental animals (Wistar rats) were divided into 2 groups: control and experimental. The latter was subjected to local irradiation with electrons at a dose of 30 Gy. Then, the morphology of liver fragments was studied and immunohistochemical reactions were performed with antibodies to Ki-67 and caspase-3. Results. A week after local irradiation with electrons at a total dose of 30 Gy, a shift in the proliferative-apoptotic ratio towards apoptosis was found, confirmed by an increase in the proportion of caspase-3-positive hepatocytes and a decrease in the number of Ki-67-stained cells compared to the control group. Conclusions. An immunohistochemical study of the proliferation and apoptosis of hepatocytes revealed that a week after fractional irradiation with electrons in an SOD of 30 Gy, there is a decrease in mitotic activity and an increase in cell death, and mild signs of radiation hepatitis indicate a more “sparing” effect of electrons compared to other types of ionizing radiation.