Молодежный инновационный вестник

The cellular component of the prostate stroma is a key regulatory mechanism for maintaining homeostasis, actively influencing the glandular epithelium, forming the immune microclimate and supporting the fibrous component of the stroma in dynamic interaction. Pathological changes in benign prostatic hyperplasia lead to the development of more serious conditions, which often lead to death. In our work, a morphological study of mast cell activity and its proinflammatory protease, tryptase, was performed in the biopsy material of 5 patients diagnosed with benign prostatic hyperplasia. Quantitative indicators were evaluated with staining of micro-preparations with Gimza solution and immunohistochemical determination of tryptase, as well as functionally, and the features of degranulation were noted. The data obtained indicate a close interaction of mast cells and the mediators they produce in the development of processes such as hyperplasia, the formation of pro-inflammatory and profibrous background in the tissues of the gland. Mast cells are considered as potential targets for the development of new strategies for the treatment of inflammatory conditions of the prostate gland. 

The article examines parents’ readiness to use digital services in pediatric clinics and proposes recommendations for optimizing outpatient care. Based on a survey of 300 respondents, focus groups, and statistical analysis, it was found that the most popular feature is online appointment scheduling (85%), while access to electronic medical records and telemedicine consultations is less common. A significant correlation was identified between users’ age and digital service engagement: younger parents (20–30 years) show higher activity (78%) compared to older age groups (48–58%). Key barriers include technical difficulties (35%), lack of information (40%), and data security concerns (25%). The study recommends interface improvements, educational programs, and digital navigation tools to enhance accessibility. 

The loss of protein in the urine of a healthy person does not exceed 150 mg/day, in a single portion - 33 mg/l, which means trace proteinuria. Detection of a larger amount of protein in the urine is a reason for further examination. Proteinuria is divided into physiological and pathological. The causes of physiological proteinuria can be physical activity, increased insolation, hypothermia, hyperthermia. Usually, the level of protein in the urine with physiological proteinuria is no more than 1 g/l. Pathological proteinuria is divided by severity into minimal (up to 1 g/day), moderate (1-3 g/day) and nephrotic (more than 3 g/day). According to the pathophysiological mechanism, proteinuria is divided into prerenal (due to the excretion of a protein amount higher than the capacity for its reabsorption), glomerular (with increased permeability of the glomerular filter) and tubular (impaired reabsorption of protein molecules in the tubules). In addition, proteinuria can be selective and non-selective. Long-term persistent proteinuria, not accompanied by edema syndrome, erythrocyturia and extrarenal manifestations, is a reason for genetic testing, since several dozen mutations have been described that are clinically accompanied by proteinuria. The results of genetic testing can significantly affect the prognosis and tactics of patient management.

Due to the high availability of nasal topical decongestants, the number of people suffering from drug-induced rhinitis remains significantly high. Prolonged use of these drugs contributes to the development of reactive mucosal hyperplasia and vasomotor dysfunction, which in turn negatively affects nasal breathing. Therapy of this disease begins with the mandatory refusal to use vasoconstrictor drugs, but this may not improve the situation, but rather worsen it due to withdrawal syndrome. In this regard, additional medicinal and non-medicinal treatment methods are prescribed. Nasal corticosteroids are primarily the drugs of choice for relieving symptoms, the benefits of which have been noted in clinical observations and in randomized controlled trials. If the use of pharmacotherapy is ineffective, the patient is offered surgical treatment, which is a vasotomy. There are several types of this procedure. Laser and radio wave destruction of the lower nasal concha are often used, as well as classical surgical vasotomy performed with a scalpel that mechanically destroys the vascular plexuses.  This method of treatment is well tolerated by patients, and is also effective and safe.

In the modern healthcare system, more and more attention is being paid to the patient-oriented approach, which implies the active participation of the patient in the treatment process. However, the effectiveness of any therapy directly depends on the patient's compliance with medical recommendations and treatment regimen. Failure to follow prescriptions can lead to a deterioration of the condition, the development of complications, a decrease in the effectiveness of treatment and an increase in healthcare costs. In this regard, the issue of the patient's responsibility for non-compliance with medical recommendations is becoming particularly relevant. This article analyzes various aspects of this problem, including ethical, legal, and practical considerations. Goal. To analyze existing approaches to determining patient responsibility for non-compliance with medical recommendations and violation of the treatment regimen, identify factors affecting treatment adherence, and suggest ways to increase patient responsibility for their health. Materials and methods. We have analyzed Article 27 of Federal Law No. 323-FZ dated 11/21/2011 "On the fundamentals of public health protection in the Russian Federation", regulatory legal acts of the Russian Federation regulating healthcare issues, rights and duties of patients, scientific articles devoted to the problems of compliance, adherence to treatment and responsibility of the patient, the results of sociological research on the attitude of patients to their responsibilities during the treatment process. as well as reviews of judicial practice in cases involving non-compliance with medical recommendations. Results. In the course of the work, we found out that treatment adherence depends on many factors, including the quality of communication between the doctor and the patient, the complexity of the treatment regimen, the patient's faith in the effectiveness of therapy and socio-economic conditions. Failure to follow medical recommendations leads to negative consequences for the patient's health. Conclusion. The study showed that the regulatory framework of the Russian Federation does not provide for specific measures of responsibility for non-compliance with medical recommendations by the patient, although it establishes the duty of citizens to take care of their health and follow the treatment regimen.

Autism spectrum disorder is currently a widespread and understudied public health problem. Analysis of available statistical data from PubMed, Embase, PsycINFO information systems estimated that in 2024 there were 61.8 million (95% uncertainty interval 52.1-72.7) individuals (1 in 127) worldwide. The global age-standardized prevalence was 788.3 (663-8-927-2) per 100,000 people, equivalent to 1064-7 (898-5-1245-7) autistic males per 100,000 males and 508-1 (424-6-604-3) autistic females per 100,000 females. Autism spectrum disorders accounted for 11.5 million (7.8-16.3) DALYs, equivalent to 147.6 (100.2-208.2) DALYs per 100,000 people (standardized for age) worldwide. The frequent prevalence and high rating of the nonfatal burden of autism spectrum disorders among people younger than 20 years of age raises the challenge of early detection of this condition in order to timely correct the neuropsychiatric condition of patients. In this case, one of the relevant options is early postnatal diagnosis of this problem. Early assessment of changes in the concentration of neuroprotective serum proteins in newborns can be used as a promising diagnostic method in this area.

The article explores the phenomenon of "digital depression" among adolescents aged 15-17—a new psychological condition associated with excessive use of social networks and digital technologies. A study conducted among 57 high school students in Kazan revealed that 29.8% of participants exhibit signs of media addiction, with 35.3% of them showing increased anxiety and 11.8% displaying symptoms of depression. A significant correlation (r=0.42, p<0.05) was established between the time spent on social media (more than 4 hours/day) and the level of anxiety. The main triggers of digital depression identified were: fear of missing out (FOMO), cyberbullying, and social comparison. The study also revealed gender differences: anxiety was more prevalent among girls, while boys tended to exhibit isolation. The authors emphasize the need to adapt psychotherapeutic assistance considering digital risks and propose specific solutions: the implementation of digital tools (chatbots, psychological applications); specialized training for school psychologists; and preventive programs on digital hygiene. Particular attention is given to the recommendation to include a module on digital well-being in the adolescent health screening program. The study confirms the relevance of the issue in Russia and the necessity of an interdisciplinary approach involving psychologists, medical professionals (psychotherapists, psychiatrists), educators, and IT specialists.

The study of the psycho-emotional health of medical students at different stages of study is of significant scientific and practical interest in the context of mental hygiene - an area aimed at maintaining mental health and preventing maladaptive conditions. Medical education is characterized by high intellectual workload, the need to assimilate a large amount of information and increased responsibility, which creates the prerequisites for chronic stress and emotional burnout. Under such requirements, anxiety becomes a key indicator of students' psychological well-being, influencing not only their academic results, but also the formation of professional competencies of future doctors. Conducting a comparative analysis of anxiety levels during exam sessions and the regular educational process allows us to identify critical points of psycho-emotional stress, which is especially important for developing preventive measures within the framework of mental hygiene. Exam periods associated with exams and assessment of knowledge are traditionally associated with peak stress, but prolonged exposure to moderate anxiety during “routine” academic months can also lead to a cumulative negative effect. Comparison of these states in junior and senior students makes it possible to trace the dynamics of adaptation mechanisms, as well as to identify the stages of learning that are most vulnerable to the development of anxiety disorders.

Diagnosis of the disorders of the temporomandibular joint (TMD) is relevant against the background of an increase in the number of such violations. Therapy with miorelaxing splint is considered an important treatment for treatment, having a comprehensive effect on the entire dentition. Target. To identify markers of TMD  and evaluate the effectiveness of splint therapy in patients. Materials and methods. The study was carried out in 25 patients with dysfunction of the temporomandibular joint. The data of the survey, palpation, photographs, plaster  models and Occlusiongram are analyzed. Results. The most common symptoms included discomfort when close, headaches (83% of patients). In 30% of patients, a restriction of the mouth (26 mm ± 1.3) with deviation was noted, and in 45% of patients the pain of the lateral poft muscle. On palpation of the joint, 33.3% of patients noted the pain in the lateral poles during rotation and 8 examiners noted soreness in the region of the temporomandibular ligament. Upon completion of therapy, 96% of patients noted a decrease in pain on the palpation of the chewing muscles, 73% - a decrease in pain of the lateral pore muscle. 84% of patients noted the normalization of the opening of the mouth. Conclusion. The disharmony of occlusal contacts initiates the development of TMD, which, in turn, compensatoryly reflects on the functioning of the chewing muscles. Splint-therapy demonstrates positive dynamics in a state of patients with temporomandibular disorders.

Аннотация на английском:

The prevalence of obesity in young people has been increasing in recent decades, which has led to an elevated cardiovascular risk. However, it is important to note that young people often exhibit what is termed "metabolically healthy obesity", in which excess weight is not accompanied by typical metabolic abnormalities, making early diagnosis difficult.

Arterial stiffness, as measured by the CAVI (Cardio-Ankle Vascular Index), has been identified as an independent marker of vascular ageing, with a reduced reliance on blood pressure compared to other methodologies. The present study involved 51 students (mean age: 21.7 ± 3.0 years). Their body composition was assessed by means of the bioelectrical impedance method (Tanita MC-780 MAN), and arterial stiffness was measured by volumetric sphygmography (Vasera VS-2000) and expressed as CAVI (Cardio-Ankle Vascular Index).

The results revealed a negative association of CAVI with BMI (P=0.003), fat (P=0.009), and skeletal muscle mass (P=0.022). These findings contradict traditional views of the negative effects of obesity on the vascular system and are consistent with the concept of the "obesity paradox". Potential explanations for these findings include compensatory mechanisms in young adults, the influence of physical activity, and the protective role of muscle mass.

The findings emphasise the limitations of BMI as a marker of cardiovascular risk in young age and underscore the necessity of employing integrated measures such as CAVI for early diagnosis.

Breast cancer is one of the key problems of modern oncology, and the prognosis of overall and event-free survival of patients depends on its early diagnosis. The vastness and heterogeneity of sources of information about this disease in the modern information field creates a contradictory opinion about the risk factors affecting the development of breast cancer, symptoms and diagnostic methods. Therefore, the aim of the study was to investigate the sources of information about breast cancer and the degree of trust in them among students of the Vitebsk State Medical University and participants without medical education. As a result, it was found that both medical students and respondents with non-medical specialties have a fairly high trust in unofficial sources of information, such as family, friends and social networks. Also, an insignificant number of respondents receive information about breast cancer from medical information campaigns, such as "pink October" and others, which may indicate an insufficient number and quality of activities.

Progression of joint hypermobility into joint hypermobility syndrome without timely diagnosis can lead to patient disability. The aim of the study was to use the ordinal logistic regression technique for more effective identification of joint hypermobility syndrome severity predictors. Materials and methods. A database analysis was performed with a sample of patients aged 18 to 50 years with signs of joint hypermobility, divided into 3 groups according to the severity of the Beighton scale. Using descriptive statistics, as well as the ordinal logistic regression method, 52 potential predictors were assessed on their impact on the severity of joint hypermobility. Results. The following signs were statistically significant in the progression of the severity of hypermobility (p < 0.05, OR > 1) according to the results of two analysis methods: velvety skin, blue tint of the sclera, winged scapulae. Conclusion. The revealed signs can be potential predictors of the severity of joint hypermobility along with the classic "minor" criteria, which is important for preventing disability. The ordinal logistic regression method used to identify them is promising in further studies of phenotypic features of progressive hypermobility.

Introduction. The issue is concerned with the labor outcomes for mother and fetus in case of burdened gynecological anamnesis. The goal of this study is to learn the influence of burdened gynecological anamnesis on fetus and women from Voronezh. Materials and methods. From June 2024 to February 2025 it was analyzed 442 birth histories at the Maternity hospital Emergency medical Hospital №10. Results. It was stidied 442 cases of labor, 265 of them were primiparas (59,9%) and multiparas (3 and more) – 177 (40,1%). Among primiparas there are 205 women with burdened gynecological anamnesis (77,3%), burdened somatic anamnesis - 242 (91,3%). While among multiparas - 25 (14,2%) and 29 (16,5%). Complications among primiparas: fetal growth retardation - 37 (13,9%), acute fetal hypoxia – 5 (1,8%), CNS depression – 14 (5,2%), prematurity - 8 (3%), retention of secundines - 8 (3%), hemorrhaging - 5 (1,8%). Among multiparas there are fetal growth retardation - 4 (2,2%), CNS depression 2 (1,1%), hemorrhaging 2 (1,1%). Primiparas have 110 operative occasions (41,5%) and natural labour - 155 (58,5%). Multiparas have 30 (17,1%) и 145 (82,9%). Conclusions. Primiparas with burdened gynecological anamnesis have higher morbidity than multiparas - 28,7% и 4,4%.

Iron deficiency anemia (IDA) is often noted in women of childbearing age, according to the authors [1,2] from 50 to 85% of cases. This is due to a number of reasons, namely, the presence of various gynecological diseases: menstrual disorders, manifested in the form of heavy menstruation, the volume of which exceeds 80 ml3 per cycle, pelvic inflammatory diseases, uterine fibroids, endometrial hyperplastic processes, and others [3]. The symptoms of IDA can resemble many diseases and its diagnosis can be difficult, which requires additional research methods. We have noted that in women of childbearing age, the diagnosis of somatoform dysfunction of the autonomic nervous system (ADHD) is most often observed in concomitant pathology. The purpose of our work was to evaluate the nature of the activity of the autonomic nervous system (ANS) using the Kerdo and Hildebrant indices in women of childbearing age with anemia in chronic pelvic inflammatory diseases. Research methods. 39 women (from 19 to 45 years old) with normal and abundant menstruation were examined, a detailed history of somatic and gynecological diseases was collected, clinical and biochemical blood tests were analyzed, blood pressure (blood pressure), heart rate (heart rate), BH (respiratory rate), Hildebrantz and Kerdo indices were assessed.. Results. In the group of patients with heavy menstruation, IDA was diagnosed, while the Kerdo index and the Hildebrandt index were within the physiological range, the Kerdo index was shifted towards sympathicotonia, the Hildebrandt index was closer to the upper limit of the norm outside of exacerbation, heavy menstruation and verified IDA, the Kerdo index and the Hildebrandt index are within physiological norms. At the same time, the symptom complex of IDA took on the "mask" of ADHD.

Heartburn is one of the most common complaints encountered in the practice of a general practitioner. Its main cause is gastroesophageal reflux disease (GERD). Numerous studies have been devoted to the study of the prevalence and clinical manifestations of the disease, as well as uniform recommendations regarding the timing and regimens of drug therapy against the background of unsatisfactory treatment results. The issue of the comparative effectiveness of antisecretory therapy in patients with gastroesophageal reflux disease in the age aspect remains unexplored.

Despite medical advances in the diagnosis and treatment of pelvic floor dysfunction, the problem of pelvic organ prolapse remains relevant today. The share of this pathology in the structure of gynecological diseases accounts for up to 28% [1]. With increasing life expectancy, the incidence of the disease increases, 41% of women aged 50-79 years suffer from pelvic organ prolapse, and the prevalence of the disease increases by 40% with each subsequent decade of life [2]. The main purpose of this study is to conduct a comprehensive epidemiological analysis to determine the age characteristics of patients suffering from pelvic organ prolapses, as well as to assess the severity of this pathological condition in the study sample. Materials and methods. To solve these tasks, we used the analysis of data obtained as a result of a study of 249 medical histories of patients who received surgical care for pelvic organ prolapse of varying degrees in the Department of Gynecology No. 2 of the M.N.Sadykov State Medical University No. 7 in Kazan in 2024. Results. Surgical correction of the pelvic floor was performed in patients aged 32 to 92 years. The largest number of patients are in the age group from 60 to 70 years (98 people, 39%), the smallest number of patients in the age group from 30 to 40 years (15 people, 6%). There were approximately the same number of women in the age groups of 50-60 and over 70 years (50 people, 20% and 58 people, 23%, respectively). The largest number of operations were performed for third-degree pelvic organ prolapse (148 cases, 59%). Conclusions. The results of the analysis of our data prove the worldwide statistics that the prevalence of pelvic organ prolapse increases with age. We also note that surgical treatment is already provided for the third degree of pathology, which may indicate the lack of timely diagnosis, treatment and prevention of disease progression.

This article examines the impact of office printer operation on air pollution caused by fine particulate matter (PM2.5 and PM10) in various departments of the Federal Budgetary Healthcare Institution "Center for Hygiene and Epidemiology in the Voronezh Region." The study aims to assess the concentration of fine dust during standard and intensive printing, as well as to develop recommendations for reducing its levels. Measurements revealed that under standard printing conditions, PM2.5 and PM10 concentrations do not exceed sanitary limits. However, during intensive printing, a short-term increase in particle concentrations was observed, especially in rooms with insufficient ventilation. The highest levels of pollution were recorded in the Sample Reception and Coding Department (PM2.5 – 0.015±0.002 mg/m³, PM10 – 0.025±0.002 mg/m³), which is associated with high printing intensity and the simultaneous use of multiple printers.

The article proposes measures to improve ventilation, evenly distribute printer workload, and ensure regular maintenance of printing equipment, all of which can help reduce fine particulate concentrations in workplace air.

Preserving the health of the younger generation is a priority area of national public health policy. One of the most pressing threats to adolescent health remains exposure to tobacco smoke and, in recent years, to nicotine vapor produced by the use of electronic cigarettes and vapes. According to the WHO, vaping is rapidly spreading among young people, while the risks associated with its use are still insufficiently studied, especially in comparison with traditional tobacco smoking. This situation requires a systematic approach to assessing and managing these risks.

The aim of this study is to assess the probability of adverse health effects in students exposed to tobacco smoke and nicotine vapor, and to analyze the potential for managing the identified risks.

Materials and Methods: The study involved 100 senior school students from Voronezh. Methods included a questionnaire survey, self-assessment of health, and a software tool based on the guidelines MR 2.1.10.0033-11 for assessing lifestyle-related health risks.

Results showed a high prevalence of both tobacco smoking (41%) and vaping (27%) among adolescents. A significant proportion of students reported dual use. Reliable correlations were established between the use of nicotine products and respiratory symptoms, as well as the expected age of onset of chronic diseases. The nicotine load among vapers was comparable to that of smokers (6–14 mg versus 12–18 mg per day). Dual users exhibited the most pronounced symptoms, such as bronchospasm, dry cough, tachycardia, and reduced physical endurance. Tobacco smoke and nicotine vapor are considered manageable health risk factors. Their impact can be mitigated through preventive programs that include education, individual support, and social restrictions.

The problem of postoperative ventral hernias (POVH) in herniology still remains relevant. According to the literature, the formation of a postoperative ventral hernia after a planned surgical intervention in the volume of laparotomy occurs in 10% of patients, while in emergency cases, in at least 30% of cases [1,2]. Installation of a mesh implant in the retromuscular space in the sublay position, both in the open version (Rives-Stoppa operation, TAR, etc.) and in the minimally invasive (laparoscopic, robotic eTEP RS) is currently the most preferable in the surgical treatment of POVH due to the lower risk of recurrence [3,4].

Gestational diabetes mellitus is a common pathology of pregnancy and poses a serious problem, increasing the frequency of undesirable pregnancy outcomes for both mother and fetus. According to the International Diabetes Federation, the prevalence of hyperglycemia in pregnant women is about 15.8%, of which 83.6% of cases were associated with GDM. Early diagnosis in order to adequately correct glycemia plays a significant role in maintaining the health of mother and child, but the initial manifestations of GDM are mostly latent and can only be detected through targeted screening, so the issue of optimizing diagnosis is very relevant at the present time.

The problem of health preservation among students is multifaceted and requires a comprehensive solution by various specialists. Objective. To assess the factors influencing students' health preservation. Materials and methods. The factors were studied using survey data from 800 second- and fifth-year students of VSMU and VSPU. The respondents were 100 young men and women from each year and university. The questionnaire included 49 questions covering specific categories with assigned points, according to which each group was divided into three subgroups. For a comprehensive assessment of health preservation factors, the indicator of which was BMI, statistical processing of the results was carried out. Graphs were constructed illustrating the pairwise correlation of two categories on the BMI of young men and women from both universities. Results. The factors influencing students' health preservation can be divided into several key categories. Each of them plays an important role in shaping the physical, mental and social well-being of respondents. Comparing the obtained data, we can note a significant difference in the relationship between BMI and the characteristics of the two categories for respondents from VSMU and VSPU. The type of response surface (convex and concave) depends on the data of the average risk group - for VSPU students they are more strongly associated with BMI - it is in the "green" zone, and for doctors the situation is the opposite: the data of respondents from the average risk group - negatively correlate with BMI, which tends to "red", unacceptable values. Conclusion. The data of all four categories correlate with BMI: the positive is in the green area of ​​the response surfaces, and the negative is in the red.

Resume. Introduction. Statistics and relevance. The state in Russia. In 2023, cervical cancer ranked 9th among all tumors in men and women (4.5%). In women, it has become the 3rd most common among tumors of the reproductive system, second only to breast cancer and cancer of the uterine body. The average age of the patients over the last decade was 52 years. In the age group under 35, breast cancer was first detected in 46.88% of women. At the age of 35-44 years - 35.25%, in the perimenopausal period (45-54 years) — 18.49%, and in the postmenopausal period (after 55 years) — 18.59%. Mortality from cervical cancer is 12.7%, ovarian cancer — 16.7%, uterine body - 7.0%, breast — 4.4%. Goal. To investigate specific genes regulating the process of cervical cancer. To consider the epigenetic mechanisms influencing the occurrence and development of cervical cancer.Materials and methods of research. Search for scientific articles in the PubMed database.Results. The presence of genetic risks of developing this disease significantly increases the likelihood of its occurrence compared to those who do not have such risks. Without infection with the human papillomavirus (HPV), these risks are not realized. Conclusions. Breast cancer is a serious disease that can be fatal in young women. Identifying genetic factors that affect the likelihood of developing cervical cancer plays an important role in maintaining the health and life of many women.

The introduction to the problem of managing patients with polytrauma complicated by massive bleeding highlights the relevance of the concept of resuscitation damage control (RDC) as a set of strategies aimed at improving outcomes. The aim of this systematic literature review was to systematize current understanding of the principles and key components of RDC based on an analysis of scientific publications over the past five years (2017-2022). The study included a search and analysis of 82 relevant sources from 309 initially found in the PubMed, Cochrane Library, Google Scholar, eLIBRARY.ru, and Cyberleninka databases. The results showed that massive crystalloid infusion is not optimal, giving way to a strategy of small volumes and controlled hypotension. The importance of early balanced blood component transfusion and the expediency of using tranexamic acid (TXA) at the prehospital stage were confirmed. The significance of viscoelastic methods such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for the diagnosis of trauma-induced coagulopathy (TIC) was noted. In conclusion, it is emphasized that RDC is a multicomponent approach requiring further research to optimize individual elements.

Introduction. The management of patients with polytrauma complicated by massive bleeding remains one of the most critical challenges in modern disaster and emergency medicine. The concept of damage control resuscitation (DCR) was developed to improve survival rates in this severely injured patient population. DCR encompasses a set of interrelated strategies aimed at rapidly addressing life-threatening conditions, such as ongoing hemorrhage and coagulopathy, followed by definitive surgical correction. However, given the dynamic evolution of medical knowledge and technologies, the components and tactical approaches of DCR require regular revision and updates based on current scientific evidence. This systematic literature review analyzes recent studies on DCR published over the past five years. The objective is to synthesize current knowledge on the key principles and components of DCR to optimize treatment approaches for polytrauma patients with massive bleeding. The findings of this review may contribute to refining clinical guidelines and protocols for managing such patients across various stages of care.Aim: To evaluate the structure of recent literature on "damage control resuscitation" and conduct a qualitative analysis of publications across its key themes.Materials and Methods. A systematic scoping review was conducted following PRISMA-ScR guidelines. Relevant publications were searched in electronic databases (PubMed, Cochrane Library, Google Scholar, eLIBRARY.ru, Cyberleninka) from 2017 to 2022. Inclusion criteria covered studies addressing various aspects of DCR in polytrauma patients. Out of 309 identified sources, 82 publications met the inclusion criteria and were further analyzed.

Results. The literature analysis revealed key directions in the evolution of DCR strategies. It was established that massive crystalloid infusion is not optimal for initial fluid resuscitation due to the potential risks of dilutional coagulopathy and hyperchloremic acidosis. Modern guidelines favor low-volume infusion and controlled hypotension to maintain perfusion of vital organs without excessive dilution of clotting factors [1]. Strong evidence supports early balanced transfusion of blood components (plasma:platelets:red blood cells in a 1:1:1 ratio) to correct trauma-induced coagulopathy. Whole blood transfusion is considered a promising alternative, particularly in resource-limited settings or military medicine [2]. Significant emphasis is placed on the early administration of tranexamic acid (TXA) within the first three hours post-injury, including the prehospital phase, to reduce blood loss and transfusion requirements [3]. Viscoelastic hemostatic assays, such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM), play a critical role in diagnosing trauma-induced coagulopathy (TIC) phenotypes and monitoring hemostatic therapy efficacy [4]. Additionally, the analysis highlighted hypocalcemia as a significant yet often underestimated risk factor for adverse outcomes in severe trauma, warranting further investigation [5].Conclusion. Damage control resuscitation represents a comprehensive and dynamically evolving strategy for managing polytrauma patients with massive bleeding. Modern DCR approaches include restricted crystalloid infusion, controlled hypotension principles, early balanced blood component (or whole blood) transfusion, mandatory use of tranexamic acid, monitoring and correction of TIC using viscoelastic assays (TEG/ROTEM), and management of metabolic disturbances, including hypocalcemia. Further research is required to optimize individual DCR components and improve outcomes in polytrauma patients.

The study of molecular mechanisms underlying aging and the action of geroprotective agents represents a highly relevant area of biomedical research. This work investigates the effects of intragastric administration of metformin (35 and 70 mg/kg) on the expression of the Eda2r gene in various tissues of aged Wistar rats of both sexes. Gene expression analysis was performed using real-time PCR in 10 tissue types (brain, muscle, adipose tissue, liver, heart) and whole blood following 30-days of treatment. In male rats, metformin at a dose of 35 mg/kg induced a 30-fold increase in Eda2r expression in the quadriceps femoris muscle, whereas in females a 7-fold decrease was observed at a dose of 70 mg/kg. Additionally, a significant reduction in Eda2r expression was detected in the cardiac tissue of females. Sex-specific differences in Eda2r expression were observed both in control groups and in response to metformin, along with distinct tissue-specific coexpression patterns. These findings suggest that Eda2r is involved in tissue- and sex-specific regulation under aging conditions and highlight its potential as a molecular marker in gerontological research.

The study is important because of the high rate of children seeking emergency care. Parents facing emergency situations should know how to provide first aid, which affects the outcome of injuries and acute conditions. The aim is to study the frequency of calls for children under 5 years of age and to assess the literacy level of the parents of these children in providing them with first aid. Materials and methods. A survey of 68 parents of children under 5 in the Moscow region using 18 questions. Methods of survey and statistical data processing were used. The results obtained. In 11 months of 2024, the ambulance service performed 54,449 visits to children under 5 years of age. Almost half of them are for infants, one third for young children, and one in five calls are for children aged 4-5 years. The main reasons for the complaints were high fever, digestive and respiratory disorders, as well as injuries. The most frequent calls came from parents of newborns and infants with fever and dyspepsia, from young children with respiratory disorders, and from children 4-5 years old with dyspepsia. Injuries, impaired consciousness, and seizures were observed equally in all age groups. Respondents: 80.9% of women, aged 18-40, with children under 5 years old. 75% consider themselves well-informed about first aid. However, only 22.1% know how to deal with a cut wound. At high temperatures, 69.1% are antipyretic, but only 16.1% are analgesic. More than half act incorrectly with nosebleeds and fainting, incorrectly assessing the importance of information about the consequences of an error (53.9%). Conclusions. Parents underestimate their own awareness in the field of first aid and need reliable information. The need to develop a booklet on first aid for parents before the ambulance arrives increases the relevance of the topic.

Adherence to psychopharmacotherapy is a key factor in determining the effectiveness of treatment for patients with their first episode of psychosis. Low levels of compliance are associated with an increased risk of relapse, hospitalization, and chronicity of the disorder. This emphasizes the need for systematic monitoring throughout all stages of care. In the context of psychotic disorders, it is becoming more relevant to take a differentiated approach to assessing and maintaining adherence in both inpatient and outpatient settings, considering the specific clinical, psychosocial, and organizational factors involved. The first episode of psychosis, such as the onset of schizophrenia, bipolar disorder, or other psychotic conditions, presents a unique opportunity for intervention due to the high plasticity of neurobiological and psychological processes. This creates a "therapeutic window" in which remission can be achieved.. However, up to 50% of patients discontinue taking antipsychotic medications within the first year following diagnosis, due to various reasons, including a lack of understanding about the disease (anosognosia) and the occurrence of adverse events. Therefore, adherence monitoring should be incorporated into clinical practice as an ongoing process tailored to the different stages of treatment.

Traumatic brain injury (TBI) in children has its own characteristics related to the anatomical and physiological properties of the child's body. The incompleteness of the ontogenetic formation of the brain determines the difference in the clinical manifestation of closed trauma in children in the acute and long-term periods. The consequences and outcomes of TBI can have different outcomes and impact on the quality of later life. Diagnosis of traumatic brain injuries helps to determine the degree of brain damage and choose the appropriate treatment method. This can improve treatment and rehabilitation outcomes, reduce the risk of complications, and ensure timely medical care and a better prognosis

The aim of the work is to evaluate the relationship between the overall survival of patients with colorectal cancer and markers of inflammation.Materials and methods of research. Based on the materials of the cancer registry of the Ministry of Health of the Republic of Tatarstan, the data of 232 patients with histologically verified colorectal cancer were retrospectively studied. The sample was carried out in 2017 to further study the 5- and 10-year survival rates of these patients. The criteria for inclusion in the study were: patients with intestinal adenocarcinoma T=>1N any M any. Exclusion criteria are the presence of acute inflammatory processes (abscesses, phlegmon), active bleeding in the last 6 months, congenital and acquired immunodeficiency (including HIV/AIDS). Indices of systemic inflammatory response were collected, calculated, and evaluated. Further, the data obtained were compared with each other. The research process included collecting, calculating, and evaluating indices of systemic inflammatory response in patients. The data obtained were analyzed and compared with each other to identify statistically significant relationships with overall survival rates. Statistical analysis was performed using the MedCalc v.20.104 program.The results of the study. There was a statistically significant inverse correlation of the NLR neutrophil-lymphocyte ratio (P <0.0001, rho= -0.34, 95% CI: -0.450; -0.221) and the SII systemic inflammation index (P <0.0001, rho=-0.347 [-0.455; -0.228]) with the overall 5-year survival rate of patients with colorectal cancer. Thus, indicators of the systemic inflammatory response are parameters applicable in assessing the prognosis in patients with CRC. The study showed that changes in hematological parameters reflecting the severity of systemic immune inflammation and systemic inflammatory response in patients with colorectal cancer correlate with the prognosis of the disease.Conclusions. Despite the small number of patients, our study showed that elevated SII and NLR values are potential predictors of disease outcome in patients with colorectal cancer.