Purpose: to evaluate the structural changes of the retina after panretinal laser coagulation of the retina in single coagulate mode, pattern and navigation technologies with lasers of different wavelengths and exposures.

Materials and methods of research. A prospective study included two main stages, 78 patients with type 2 diabetes mellitus, with the proliferative stage of diabetic retinopathy, who underwent panretinal laser coagulation (PRC). 4 groups of patients were formed. At the first stage, the quality of coagulate formation, structural changes in the surrounding retina and changes in light sensitivity before and after laser coagulation were evaluated. At the second stage, the efficacy of retinal laser coagulation was studied depending on the laser coagulation technology.

Optical coherence tomography RTVue XR Avanti (Optovue, USA), Canon was included in the diagnostic examination. The structural changes of the retina were evaluated before and after laser exposure. A study of the light sensitivity of the central parts of the retina was conducted using the Octopus 900 HAAG-STREIT perimeter (Switzerland). The severity of the pain syndrome at the time of the operation was assessed using a visual analog scale 30 minutes after the operation

Results. The formation of a full-fledged chorioretinal scar was observed with all types of laser exposure. It has been proven that a laser with a wavelength of 577 nm with an exposure of 20 ms has a minimal damaging effect, as evidenced by the absence of damage to the outer boundary membrane, outer segments of photoreceptors according to OCT data, as well as the absence of depression of average light sensitivity. According to the results of the pain perception study, it was found that patients who underwent coagulation on the Navilas 577s laser system in automatic mode (exposure of 20 msec) practically did not experience pain.

Conclusions. An assessment of the structural changes in the retina revealed the least damaging effect on the retinal tissue of laser coagulation with a wavelength of 577 nm with an exposure of 20 msec using pattern and navigation technologies, which allowed the photosensitivity of the peripheral parts of the retina to be maintained at the initial level. When using pattern and navigation technologies, the side effects of surgery (pain, glare,) are not pronounced, which makes panretinal laser coagulation comfortable and increases the patient's commitment to this type of treatment.

The aim of the research. To analyze morbidity rates by turnover, mortality of the population over the working age in the Trans-Baikal Territory.

Materials and methods. The work analyzed morbidity rates by turnover, mortality among the population older than working age. The sources of information were collections of the Ministry of Health of the region and the Russian Federation, as well as data from official sources of Rosstat. The work calculates the indicators of the dynamic range. Graphical forecasting was performed for the indicators in the Microsoft Excel program with the construction of a trend line.

Results. In 2022, the share of the population over the working age in the region was 20%. Thus, over a 10year period, the number of people in this age group increased by 11,4%. The primary morbidity rate in 2022 amounted to more than 57 thousand cases per 100 thousand population. The primary morbidity rate of the population over the working age in the region remained lower than similar indicators for the Far Eastern Federal District and the Russian Federation. The total incidence of the older generation in the region in 2022 amounted to about 220 thousand cases per 100 thousand population. The level of general morbidity in the region is lower than the same indicator in the Russian Federation. The mortality rate of the population over the working age in 2022 amounted to 43,7 cases per 100 thousand population. When comparing mortality rates in the region and the Russian Federation, higher rates were observed in the region throughout the analyzed period, on average by 8%.

Conclusions. Morbidity rates in terms of turnover among the older generation in the Trans-Baikal Territory tend to increase over the analyzed period. At the same time, these indicators remain lower than those in the Far Eastern Federal District and the Russian Federation. The mortality rate of the population of this age group remains higher than in the Russian Federation. The analysis of the health status of the older generation in the region indicates the need for managerial decisions in the regional health system.

The aim of the research. To assess the content of intercellular adhesion molecules from the immunoglobulin superfamily: ICAM-1, ICAM-2, ICAM-3, NCAM, VCAM-1, PECAM-1 in patients with COVID-19-associated lung damage and to identify the presence of a relationship between their concentration and the severity of the process.

Materials and methods. The study included 200 patients with COVID-19-associated lung damage 1 month after discharge from monohospitals in Chita. Patients were divided into groups of 50 people, depending on the degree of lung damage based on the results of computed tomography: Group 1 (CT-1); Group 2 (CT-2); Group 3 (CT-3); Group 4 (CT-4). The study included patients iwhose diagnosis of COVID-19 was confirmed by detection of SARS-CoV-2 RNA using polymerase chain reaction. The control group included 56 relatively healthy individuals who had not previously suffered from coronavirus infection or other acute respiratory diseases in the past 3 months. All study groups were comparable in terms of gender and age. The content of intercellular adhesion molecules (ICAM-1, ICAM-2, ICAM-3, NCAM, VCAM-1, PECAM-1) in blood serum was determined by immunochemical analysis.

Results. As a result of the work, an increased content of intercellular adhesion molecules (ICAM-1, ICAM2, ICAM-3, NCAM, VCAM-1, PECAM-1) was revealed in the studied groups of patients with COVID-19associated lung damage compared to the control group. Significant differences were also found between groups of patients with different levels of lung damage according to CT data, when studying some intercellular adhesion molecules.

Conclusion. The levels of intercellular adhesion molecules of the immunoglobulin superfamily in the blood, which are markers of pathological activation of the endothelium, reflect the severity of lung tissue damage against the background of coronavirus infection, including during the convalescence period.

The aim: to evaluate the dynamics of changes in the level of biomarkers of acute kidney injury – lipocalin and cystatin C in blood serum in patients with thermal skin burns.

Materials and methods. The study included 74 patients with thermal skin burns of I-III degree with a skin lesion area of more than 25%, of which at least 15% are deep burns. Serum creatinine levels were determined using the kinetic Jaffe method. Lidocaine and cystatin C concentrations were studied by multiplex analysis on a flow cytofluorimeter.

Results. It was found that the concentration of cystatin C in the blood serum during burn shock increases by 1,9 times, with burn toxemia and septicotoxemia - by 1,5 times in relation to the control group. The level of lipocalin in the blood serum of patients with thermal skin burns during the shock period increases by 5,5 times compared to the control group. During the period of burn toxemia and septicotoxemia, lidocaine concentration remained at a high level and exceeded the control values by 4,4 and 3,6 times, respectively.

Conclusion. Lipocaine and cystatin C can be considered as early biomarkers of acute kidney injury in patients with thermal skin burns.

The article presents the results of an empirical study on the characteristics of the material and information flows of the process of servicing diagnostic medical equipment. The insufficient quantitative and qualitative efficiency of the process of identifying malfunctions of medical equipment and creating a request for its service has been established. The current state map allowed us to identify all unproductive activities and operations in the value stream. The analysis determined the level, period and conditions of occurrence of each problem, its localization, as well as the amount of information sufficient in depth and completeness to make a management decision and develop an improvement plan.

Objective: to analyze the time intervals of medical care for patients with acute coronary syndrome with STsegment elevation on an electrocardiogram at different stages of care.

Materials and methods. The study included 189 patients of both genders hospitalized with a diagnosis of acute coronary syndrome with ST-segment elevation, 3 age groups were formed, according to WHO criteria: 1 group (up to 59 years old) – 72 patients, 2 group (60–75 years old) – 69 patients and 3 group (over 76 years old) – 48 patients. The analysis of the time intervals of care at different stages was carried out, the intervals were compared in the group of men and women, as well as in different age groups.

Results. The time interval from PMC to hospitalization in cPCI was 33 minutes, the interval from PMC to the start of PCI was 90 minutes, which corresponds to the standards of care. The median time to seek care from the onset of symptoms in our study was 191,65 ± 142,49 min. No gender differences were identified in seeking care. Younger patients (group under 60 years) sought care reliably earlier from the onset of symptoms than older patients, which is probably due to a more erased clinical picture in older patients.

Conclusion. The main delay occurs at the symptom-PMC stage, which is the main problem. This indicator depends on the awareness of the population about the symptoms and danger of ACS. To improve this indicator, it is necessary to carry out educational work. The result of this activity should be an earlier recognition of ACS symptoms by patients and a reduction in the time from the onset of symptoms to the call of the NSR.

Objective: we aimed to study antiepileptic drug efficacy in achieving seizure remission in certain genetic types of childhood epilepsy.

Materials and methods. The authors studied 240 patients aged from 1 month to 18 years with epilepsy between 2019 and 2023. Children with genetic forms of epilepsy accounted for 69 (28,8%). In this group, remission was achieved in 13 (18,8%) of patients. Among them, there were 13 children (%) with certain forms of genetic epilepsy aged 5 to 4 (average 10 ± years), with 7 (53,8%) being girls and 6 (46,2%) being boys. There were 7 (53,8%) children with generalized epilepsy, including 5 (30,8%) cases of childhood absentee epilepsy. 5 (38,5%) patients had focal epilepsy, all of them had self-controlling epilepsy with central temporal adhesions. The study included one patient with an unspecified type of epilepsy (7.7%).

Results. The duration of remission ranged from 6 months to 7 years 2 months (me – 3 years 8 months). 11 children (84,6%) were in stable remission for 1 year or longer. Complete clinical electroencephalographic remission was observed in 7 (53,9%) cases. In other cases, regional and diffuse epileptiform activity was recorded in 3 (75,0%) and 1 (25,0%) case, respectively. Remission was achieved in 5 children (38,5%) who were taking levetiracetam, 6 subjects (46,1%) – valproic acid, 1 person – carbamazepine (7,7%). Persistent remission was registered in 4 children (36,3%) who were prescribed levetiracetam, 5 children (45,4%) taking valproic acid and 1 person (9 %) who was administered carbamazepine. 1 person (7,7%) was in stable remission after discontinuation of the antiepileptic drug.

Conclusion. Most of the children with certain types of genetic epilepsy under the treatment with antiepileptic drugs were in stable seizure remission. More than half of those observed were in a complete clinical electroencephalographic remission. Predominantly, seizure remission occurred with the administration of valproic acid and levetiracetam, with the same frequency in generalized and focal types of genetic epilepsy.

The aim of the research was to study the direct and platelet-mediated intercellular adhesion of blood-derived lymphocytes, as well as the influence of interleukin-2 and interferon-α on it.

Materials and methods. Whole blood samples from 34 apparently healthy individuals were collected using vacuum tubes containing sodium citrate (3,8%). A suspension of lymphocytes and platelets was isolated on a Ficoll-Urografin gradient. Light microscopy was used to determine the percentage of lymphocyte-platelet aggregates. The effect of cytokines was studied by adding human recombinant interleukin-2 and interferon-α to whole blood, and incubating for 4 hours in a thermostat at 37 °C. After incubation the necessary parameters were counted using the method described above. The results were expressed as mean values and standard deviations (± SD). Statistical processing of the data was performed using the Mann-Whitney U-test and the Kolmogorov criterion (Statistica 10), with differences considered significant at p < 0.05.

Results. The study showed that in addition to lymphocyte-platelet aggregates (11 ± 3.6%), the total pool of lymphocytes also contained intercellular aggregates of lymphocytes (3 ± 3,8 per 100 cells) and lymphocyteplatelet clusters (2 ± 0,6 per 100 cells). It was found that the addition of interleukin-2 (IL-2) led to an increase in lymphocyte-platelet aggregates (LPA) and lymphocyte-platelet clusters by 1,8 times (p < 0,001) and 3,3 times (p < 0,001), respectively, compared to the control group. In contrast, incubation of blood samples with interferon-α (IFN-α) led to a decrease in the number of LPA (by 5.5 times compared to the control, p < 0,001) and almost prevented the ability of lymphocytes and platelets to form clusters. The presence of the abovementioned cytokines in the incubated blood did not affect the ability of lymphocytes to form aggregates with each other.

Сonclusion. It was found that IL-2 increases the ability of lymphocytes and platelets to form clusters, while IFN-α significantly reduces this ability and has an inhibitory effect on the ability of these cells to form LPA. In our opinion, it is important that the effects of these cytokines were manifested only upon contact of lymphocytes with platelets.

The aim of the research. to analyze the incidence of acute intestinal infections in the Omsk region, identifying the proportion of viral diarrhea in individuals under 17 years of age.

Materials and methods. The main reporting forms of Rospotrebnadzor for the period from 2017 to 2023 were used. Descriptive statistics methods and dynamic series analysis were applied. A forecast was built.

Results. In the region, acute intestinal infections often remain of unknown origin. Among acute intestinal infections with an established cause, persons under 17 years of age accounted for more than 70,0%. When building a forecast, it was revealed that the situation will not change for 2024.

Of the identified causes of diarrheal syndrome, viruses such as rotavirus, Norwalk, and enterovirus were most often recorded. Over seven years, the share of rotavirus infection was 82,6%, noravirus infection – 8,7%, enterovirus infection – 6,9%. In persons under 17 years of age, rotavirus gastrointestinal tract lesions were observed in 74,8%, norovirus disease in 59,9%, and enterovirus intestinal manifestation in 98,6% of children. In general, during the study period, the share of viral intestinal infections in persons under 17 years of age was 75,0% of all confirmed cases among the population. Outbreaks of intestinal infection in the region were analyzed. The average value of outbreak incidence over 7 years was 0,64 ± 0,003 % of all registered cases of acute intestinal infection. Foci of infection were mainly located in preschool institutions, where the source was people, and the route of transmission was contact-household. In all cases, viral intestinal infection was confirmed. The leading cause of foci of intestinal infection was the Norwalk virus (54,1%). An outbreak of isolated rotavirus infection was detected in 35.1%, and in combination with norovirus – 2,7%. Enterovirus was the cause of group morbidity in 8,1% of cases. Norovirus infection foci in 100% of cases were found in preschool institutions.

Conclusion. In the Omsk region, there is a tendency for low verification of diarrheal syndrome in the population, which affects the under-detection of patients or carriers of acute intestinal pathogens. Viral diarrhea prevails among the population, among which people under 17 years of age make up the majority.

The aim of the research. To identify changes in tryptophan and cytokine metabolism in synovial joint tissue in rheumatoid arthritis.

Research materials and methods. The experiments were performed on 40 WISTAR rats. At the beginning of the study, each animal of the experimental groups received an intraperitoneal injection of collagen type 2 solution (Chondrex, Inc., USA) in Freund's incomplete adjuvant. The content of tryptophan, kynurenine, 3-hydroxykinurinine, L-5-hydrotryptophan by HPLC with fluorimetric and spectrophotometric detection, and the concentration of cytokines: IL1b, IL6, IL10, IL17, IL18, TNFa were determined in the tissues of the synovial membrane of the knee joint. They were determined using Rat Inflammation Panel V02 multiplex assay kits (Biolegend, USA) on a Cytomics FC500 flow cytofluorimeter (Beckman Coulter, USA). Statistical analysis was performed using the Jamovi program version 2.3.

Results. The concentration of cytokines: IL1b, IL6, IL10, IL17, IL18, TNFa was found to be high during the acute development of rheumatoid arthritis. With experimental rheumatoid arthritis, the content of tryptophan metabolites along the kynurenine pathway increases and the concentration of metabolites along the serotonin pathway decreases. Direct positive correlations of IL1b, IL6, IL10, IL17, IL18, TNFa with the content of tryptophan metabolites along the kynurenine pathway have been established.

Conclusions. Tryptophan metabolism and IL1b, IL6, IL10, IL17, IL18, and TNFa content are altered in rheumotoid arthritis.

Background. Long-term resorption of cephalohematoma may be accompanied by the formation of surgical complications. The rate of resorption of cephalohematoma has uncertain dynamics and may depend on the characteristics of hemostasis in newborns.

Aim. To define the level of thrombus formation and fibrinolysis in venous blood plasma in newborns with cephalohematomas.

Methods. There were 90 newborns under observation, 30 – with medium and large-sized cephalohematomas (the cephalohematoma was punctured), 30 – with small-sized cephalohematomas (the cephalohematoma was not punctured). The control group – 30 healthy newborns. The level of thrombosis and fibrinolysis indicators was determined by flow cytometry on a Cytoflex LX device using multiplex analysis kits.

Results. On the 10th day, the level of prothrombin in newborns of the first group was 1,33 times higher than in the control group, and 1,47 times higher than in the second group of the study. On the 10th day, the concentration of antithrombin III in the first and second groups exceeded the control group by 5.28 and 8,82 times, and on the 28th day of the study by 6,9 and 7,.28 times. The concentration of type 1 plasminogen activation inhibitor in the first and second groups was higher than in the control group by 3,11 and 5,25 times on the 10th day, and on the 28th day of the study by 2,88 and 3,93 times. The level of D-dimer on the 10th day in the first and second groups was 1,43 and 1,71 times higher, and on the 28th day in both groups it was 1,6 times higher than the control group.

Conclusion. Reparation for cephalohematomas is associated with mechanisms of resorption of subperiosteal hemorrhage and depends on the fibrinolytic activity of the hemostatic system. It is likely that the isolation of the cephalohematoma from the systemic circulation under conditions of inhibition of plasminogen activity may be the cause of long-term persistence of subperiosteal hemorrhage.

The problem of cerebrovascular diseases, in particular acute cerebrovascular accident, does not lose its relevance. Despite the primary and secondary prevention of cardiovascular diseases, the incidence of ischemic stroke among the population of the Russian Federation remains high. A well-established system of routing patients with acute vascular accidents and a multidisciplinary approach to treatment do not always guarantee a satisfactory result. The widespread prevalence of the disease, a high degree of disability and mortality, a decrease in the age of patients, economic losses associated with the rehabilitation of patients and their long-term disability dictate the need to find new and effective approaches to the diagnosis and treatment of this condition.

Currently conducted studies are aimed at studying the pathogenetic cascade of reactions that occur at the time of acute cerebral ischemia, in order to develop adjuvant therapy. Based on the results obtained, additional options are being developed in the treatment and further rehabilitation of patients. The presented literature review collects and analyzes current data on the problem of ischemic stroke. The role of individual molecules of the tumor necrosis factor family, which are directly involved in the development and course of cerebral infarction, but also affect the further prognosis of survival and recovery of patients, is considered.

Preeclampsia is a multisystem disease that can include cardiovascular changes, hematological disorders, liver and kidney failure, cerebral and visual symptoms. Currently, the presence of papilledema in preeclampsia characterizes the disease as severe. However, it is likely that the presence of papilledema does not always characterize vasogenic cerebral edema with increased intracranial pressure. The formation of blurred borders and papilledema may also be associated with impaired autoregulation in the head of the optic disc due to increased blood pressure and the presence of endothelial dysfunction in preeclampsia. It is also important to differentiate the true papilledema from the pseudopapilledema. The study carried out a detailed systematic analysis of modern domestic and foreign literature, devoted to the pathogenetic mechanisms of papilledema development in preeclampsia. The study used such information databases as: eLibrary, PubMed, Scopus, Cochrane Library, MEDLINE for the period from 2015 to May 2024. This literature review presents possible pathogenetic mechanisms of the development of papilledema against on preeclampsia, as well as modern approaches to the differential diagnosis of papilledema from pseudopapilledema. Further study of the pathogenetic mechanisms of papilledema development in hypertensive pregnancy disorders is necessary to identify high-risk patients and optimize their management and treatment tactics.

This review article presents current information on the pathogenetic features of hemostasis in cerebral ischemic stroke based on the analysis of scientific articles indexed in PubMed and Web of Science databases. Ischemic stroke is a sudden neurological failure due to acute focal cerebral ischemia leading to cerebral infarction. The role of hemostasis disorders in the pathogenesis of ischemic stroke has been much less publicized in scientific circles, and the dynamics of disorders and early signs of activation of the blood coagulation system, including the development of hemorrhagic transformation and secondary vasospasm, have not been sufficiently studied.

Relevance. The relevance of the problem of the volemic status (VS) correction in patients with sepsis, especially with septic shock and multiple organ failure is beyond doubt, because in this condition there are always significant and life-threatening changes in homeostasis, especially in the circulatory system. At the same time, the percent of deaths remains high, and uncertainty in the pathophysiological mechanisms and an erased clinical picture can lead to untimely diagnosis and delayed correction of circulating blood volume (CBV).

Aim of research. To analyze and summarize current concepts about the assessment of CBV in sepsis and septic shock. To identify current approaches to infusion therapy in this pathology in order to increase the efficiency of treatment and knowledge of specialists.

Materials and methods. During writing the article, the search for literary sources was carried out in the databases: PubMed, eLibrary, CyberLeninka over the past 5 years, as well as from earlier sources that have not lost their relevance. At the same time, free access to the full content of publications was used in accordance with the subject of the review.

Conclusion. The choice of infusion therapy tactics for patients with sepsis and polymorbidity may present significant difficulties due to the limited number of methods for monitoring and correcting volemic status. At the same time, the difficulty of making a decision is due to the multifactorial nature of the parameters and the inconsistency of the results obtained. In this situation, the result of treatment can be improved by using a combined analysis of parameters, prioritizing dynamic rather than static indicators. Methods of research and control of VS based on ultrasound technologies are more accessible and preferable in use for most medical preventive institutions (MPI) to determine the strategy of infusion therapy in the treatment of sepsis. The topic of control and correction of volemic status needs further research.

The article provides a contemporary literature review on the causes, clinical features, laboratory criteria, and management strategies for children with a rare condition – TAR-syndrome. The review is supported by a clinical case of a disease in an infant girl born with thrombocytopenia and a bilateral absence of the radial bones. The diagnosis was confirmed by a specific cytogenetic and molecular study.