Science and Innovations in Medicine

Aim – to study the dynamics of ovarian parameters in women from the first period of adulthood to early old age measured by sonography.

Material and methods. The study used the results of an ultrasound examination of 81 women with normal pelvic dimensions, without reproductive organ pathology, having maximum two pregnancies in life history more than one year before the study. All participants gave their consent to routine examination. The procedure consisted of measuring the length, width, anteroposterior size and volume of the ovaries by transvaginal access according to standard protocols. The subjects were divided into three groups according to anatomical age classification. The first group consisted of 29 early adulthood women (22 to 35 years); the second group included 23 women in middle adulthood (36 to 56 years) and 29 early old age women (57 to 73 years).

Results. All the ovarian parameters decreased by early old age (p < 0.01). At the same time, a trend towards macroanatomic asymmetry of the ovaries with larger dimensions in the right side was revealed in each of the studied age periods (p > 0.05).

Conclusion. The results of a lifetime comparative analysis of the anatomical dimensions of the ovaries in women contribute to the knowledge of their age-specific structure and requires a future detailed study. A new knowledge is required to develop modern methods for preventing pathologies of the female reproductive system and to provide timely, high-quality medical care.

Aim – to develop an in vitro method for assessing the activity of the inflammasome under conditions of hyperuricemic stimulation of inflammatory interleukins.

Material and methods. Whole blood cells of donors and patients with hyperuricemia and exacerbation of gouty arthritis diluted with RPMI were cultured in vitro in the presence of different concentrations of uric acid. The production of cytokines in the cell growth media of hematopoietic cells stimulated with uric acid was evaluated using an enzyme-linked immunosorbent assay (ELISA).

Results. By simulating the hyperuricemia in vivo, an in vitro cell-based bioassay was developed to stimulate blood cells of individual donors with uric acid. Using the developed in vitro Hyperuricemia-hemotest bioassay, quantitative differences were found in the production of inflammatory cytokines by the blood cells of potentially healthy donors and patients with hyperuricemia and gouty arthritis.

Conclusion. As a new approach in personalized diagnostics, a hyperuricemic (HU)-hemotest system was developed, which can serve as an in vitro cell model for studying the activation of inflammasome by inflammatory signaling molecules in gouty arthritis.

Aim – to study the ethyl alcohol 70% of the Lux brand in respect to its chemical and analytical quality, toxicological safety, microbial effectiveness and to assess its use in skin antiseptics.

Material and methods. The studies were performed using organoleptic, physical, chemical, toxicological and microbial analysis in accordance with standard modern methods.

Results. Ethyl alcohol 70% has chemical, analytical and microbial quality indicators that meet the requirements of the State Pharmacopeia of the Republic of Belarus. According to toxicological indicators, it belongs to class IV – lowhazard substances, with no irritating effect, which corresponds to the regulatory toxicological indicators of the safety of skin antiseptics. During the primary epicutaneous application on volunteers, it does not cause subjective and objective symptoms of sensitization; it belongs to substances that do not have an irritating effect and sensitizing ability. Standard test cultures and clinical strains of microorganisms are highly sensitive to ethyl alcohol 70% in a qualitative suspension test tube and micromethod without protein load and moderately sensitive in the diskdiffusion method with an exposure of 1 min. In relation to these microorganisms, the antimicrobial activity of ethyl alcohol 70% is above 99.999% and a reduction factor above 5 lg at exposure of 1 min in a quantitative suspension method without a protein load. Ethyl alcohol 70% is also characterized by a high efficiency of normal skin disinfection and E.coli contaminated skin of volunteers over 99% and a reduction factor above 2 lg and 4 lg, respectively.

Conclusion. Ethyl alcohol 70% of the brand "Lux" is a highquality, toxicologically safe and microbial effective drug. It can be recommended for skin antisepsis of the injection field (class A), as well as hygienic hand antisepsis (class B) and antiseptic sanitization of the skin in the Republic of Belarus and Russian Federation.

Aim – to evaluate the effectiveness of vaccination when using various vaccines against COVID-19 approved for use in Russia among medical staff and faculty of medical higher educational institutions according to online questionnaires.

Material and methods. A cross-sectional study was conducted online from January to March 2022 (circulation period of the omicron genovariant). The survey was completed by 6032 respondents, 2114 respondents were excluded from the study. The remaining 3918 respondents were included in the the analysis.

Results. 47 (0.1%) medical workers reported COVID-19 incidence within 21 days after the second dose of the vaccine. 616 (16.8%) medical workers reported COVID-19 incidence within 5 months after two vaccinations. 116 (46.4%) unvaccinated respondents reported a laboratory-confirmed new coronavirus infection within 5 months prior to the survey. Lack of vaccination increased the risk of SARS-CoV-2, OR 1.78 ± 0.14 (95% CI 1.34-2.36). It was found that gender and age were not a risk factor for the onset of the disease in the post-vaccination period. The presence of SARS-CoV-2 in medical history increased the risk of developing the disease in the post-vaccination period.

Conclusion. The analysis revealed that vaccination had significantly higher protection effect for 1.5 months after vaccination and significantly reduced in 5 months after vaccination.

Aim – to study the features of the ECG records received by 24-hour ECG monitoring in patients with paroxysmal atrial fibrillation (AF) and, based on the data obtained, to determine the main predictors of the development of this arrhythmia.

Material and methods. A single-center, cross-control study was conducted. Of all 6630 protocols analyzed, according to 24-hour ECG monitoring, AF paroxysm was detected in 97 people as an accidental finding. These patients were included in the main study group. The control group consisted of 99 patients from the same cohort without paroxysmal AF, having the anthropometric and comorbidity parameters similar to the patients of the main group.

Results. In the absolute majority (97.9%) of patients in the main group in whom paroxysmal AF was detected, a special variant of extrasystole was revealed – early atrial “P on T” type (versus 4.0% in patients in the control group) [OR 8461.648 (382.1983;187336)]. The number of supraventricular single, paired and group extrasystoles was significantly higher in the main group, but the number of ventricular extrasystoles did not differ significantly.

Conclusion. One of the main ECG predictors for the development of paroxysmal AF in asymptomatic patients is the appearance of supraventricular extrasystole of the “P on T” type. In the mechanism of formation of AF paroxysm during supraventricular extrasystole of the “P on T” type, not only electrophysiological mechanisms play a role, but also the heart biomechanics.

The Kimmerle anomaly is one of the varieties of craniovertebral junction anomalies. Currently, it is one of the main causes of vertebrobasilar insufficiency, vertebral pain and vegetative syndromes. Despite a sufficient number of publications on this problem, the Kimmerle anomaly still remains not fully understood. Insufficient awareness of primary care physicians about this pathology, a wide variety of clinical manifestations, the absence of pathognomonic neurological syndromes, the complexity of the analysis of imaging data cause difficulties in identifying this anomaly. The article describes the epidemiology, pathogenesis, and clinical picture of Kimmerle anomaly. Further, the paper presents modern methods of its diagnosis (spondylography, ultrasound, MRI, MSCT, etc.) and treatment. In conclusion, the authors present ways to optimize the diagnosis and treatment of Kimmerle anomaly.

Aim – to study the practice of use of the cosmetology services nomenclature in medical organizations.

Material and methods. The Clinic of beauty and health "New Life" (Samara, Russia) was the base of the study. We analyzed its business practices and made a review of regulatory documents and scientific literature on the use of cosmetology services nomenclature. The analytical method and the content analysis method were applied.

Results. Currently, there is a situation when one medical cosmetology service is called differently in various documents related to medical care provision: in medical documentation, in the contract for the provision of medical services, in informed voluntary consent to medical intervention and other documents, defining medical services in different terms.

Conclusion. For responsible professional communication and awareness of generally accepted methods of diagnosis, treatment and prevention in the provision of medical care in the "cosmetology" profile, it is necessary to unify the terminology of cosmetology services within the current nomenclature of medical services.

Introduction. Post-traumatic stress disorder (PTSD) encompasses a wide spectrum of psychopathological manifestations that arise after exposure to a severe or life-threatening event. The increasing relevance of PTSD issues is associated with the escalation of military conflicts worldwide. Complex biological mechanisms also play a significant role in the pathogenesis of PTSD, including those changes observed in the hippocampus and other brain structures.

Aim – to identify the most significant genetic markers predisposing the risk of PTSD manifestation, which could contribute to the development of targeted interventions focusing on the preventive measures and treatment strategies of this disorder.

A literature search was conducted in the PubMed database using keywords related to the genetics of PTSD, with a publication time restriction from 2018 to 2023. Out of 623 papers, 20 articles met the inclusion criteria, describing molecular-genetic and statistical data, and the sample size of at least 60 patients with a verified PTSD diagnosis, were reviewed and analyzed in detail.

The studies revealed significant associations between PTSD occurrence and single nucleotide variants (SNVs) in the FKBP5 and CRHR1 genes. Particular attention was paid to the interactions between SNVs of different genes and their association with the severity of PTSD clinical manifestations.

Conclusions. Genetic markers, in particular, SNVs in the FKBP5 (rs9470080) and CRHR1 (rs1724402) genes, may play a key role as the risk factors for biological predisposition and the PTSD development. These findings would underlie the targeted interventions integrated into PTSD-related prevention measures and treatment strategies. However, further multicenter and consortium studies with unified design are required to confirm the significance of the identified associations and to specify the epigenetic aspects contributing to the PTSD manifestation and development.

Aim – to conduct a comparative assessment of the accuracy of the developed method of preoperative planning for primary hip arthroplasty.

Material and methods. The "Method of preoperative planning in hip arthroplasty" and special device were developed to improve the accuracy of preoperative planning and reduce the number of complications. A clinical study was conducted in the comparison groups. In the main group (50 patients), we used the proposed method in the pre-operative planning; in the control group the patients were prepared for the operation using a standard planning method. The accuracy of evaluation of implant sizes, limb length and offset were registered in the post-operative period. The preoperative planning data were compared with the results obtained.

Results. The accuracy of offset estimation in the main group was higher than in the control group (T-criterion = -2.6; p = 0.01). The average difference between the estimated offset and the one obtained in the main group was 1.4±1.5 mm, in the control group it was 2.2±1.7 mm. The error in head size estimation in the main group was less than in the control group (odds ratio = 3.02). No significant differences were registered in determining the size of components of the endoprosthesis, and there were no differences in the leg length in the study groups.

Conclusion. The developed method allows for improving the accuracy of preoperative planning in hip arthroplasty. The proposed device ensures the correct placement of patients when performing pelvic radiography, and also makes it easy to change it when performing this procedure.

The article observes a clinical case – intraoperative use of anterior mediastinal plastic surgery with a mesh implant for transsternal occlusion of the main bro

nchus in a patient with widespread destructive pulmonary tuberculosis complicated by pleuralempyema with bronchopleural fistula.

A control examination after 1.5 years showed a clinical cure of tuberculosis of a single lung. When comparing functional indicators, there was a slight increase in vital capacity (VC) and forced expiratory volume in the first second (FEV₁). There were no changes in the indicators of pO₂, pCO₂. Also, unchanged left ventricular ejection fraction and a substantial decrease in pulmonary artery pressure positively affected the patient's general condition.