Vol 40, No 3 (2023)

Objective. Hemorrhoids is one of the most common diseases in adult coloproctological practice, the main manifestation of which is bleeding of different degree of activity and complexity. The aim of the study was to analyze the results of diagnostics and treatment of patients with different stages of hemorrhoids for 3 years.

Materials and methods. The results of diagnostics and treatment of patients with different stages of hemorrhoids treated in the coloproctological unit for 3 years (2019–2021) were analyzed.

Results. The article considers the hemorrhoidal bleeding and the possibility of classification to optimize treatment; an algorithm used for rendering medical care to this group of patients is presented. The case histories of patients with hemorrhoids, treated at the First Republican Clinical Hospital of Udmurt Republic, were analyzed.

Conclusions. Patients with profuse hemorrhoidal bleeding need hospitalization to the resuscitation unit, immediate identification and treatment of hemorrhagic shock. The offered protocol (algorithm) of managing patients permitted to work in a team, improve the quality of rendering medical care to patients with profuse hemorrhoidal bleeding and avoid lethal outcomes.

Objective. To identify the individual psychological features and forms of stress coping in volunteers, participating in one of the stages of latitudinal monitoring “Geliomed” and living in the middle latitudes depending on the presence of psychological sensitivity to the impact of geomagnetic disturbance.

Materials and methods. Fifty-seven rather healthy male and female volunteers (mean age 42.3 (39.6; 47.5) years), living in the middle latitudes (Saratov city) were examined using the Spielberger – Hanin Anxiety Test, the Haim Stress Coping Behavior Test and projective psychogeometrical test. Based on matching pick values of reactive anxiety and Kr-index (integral geomagnetic disturbance index), all volunteers were divided into two groups: group I – those having psychological sensitivity to the impact of heliogeomagnetic factors and group II – without the latter.

Results. The standard personal features of the observed persons were found to depend on the presence or absence of psychological sensitivity to the changes in geomagnetic disturbance and are reflected in the peculiar features of the stress-coping behavior formed by them. The volunteers of group I were less effective in the behavior sphere, they more often analyzed problems and suppressed their emotions compared with those of group II.

Conclusions. Thus, the persons having psychological sensitivity to the changes in geomagnetic disturbance require psychological correction of the established changes to decrease risk for the development of neuroses and psychological pathology.

Objective. To carry out the expert assessment of the facial profile esthetics with transformation of angular parameters beyond the normal values.

Materials and methods. The expert analysis enclosed 22 independent orthodontists (11 men, mean age 36.8 ± 1.2 years; 11 women, mean age 35.3 ± 2.2 years) using graphic schemes of male and female facial profiles with changed angular parameters.

Results. It was established that the changed angular parameters of the facial profile beyond the borders of the referent intervals negatively influence the assessment of attractiveness of the profile. The analysis of expert evaluation curves detected the values, with which the facial profile is perceived as an unattractive: the profile angle in men > 164° and < 182°, in women < 160° and > 178°; the convexity angle of the face in men > 16° and < 2°, in women > 14° and < 2°; the nasolabial angle in men > 120° and < 70°, in women > 115° and < 70°; the mentolabial angle in men > 150° and < 90°, in women > 150° and < 95°; the convexity angle of the lips in men > 150° and < 85°, in women > 150° and < 105°; the nasofacial angle for both sexes > 45° and < 20°. There exist also “critical” values of parameters, on reaching which the further change in the latter does not lead to the change in expert evaluation of “extremely unattractive” profile.

Conclusions. When evaluating the facial profile esthetics, it is necessary to orientate oneself to the degree of deviation of parameters from the mean values taking into account the gender dimorphism. The presence of parameter with “critical” value has an extremely negative effect on the profile esthetics, which is characterized as “extremely unattractive” irrespective of the values of other parameters.

One of the most significant problems of obstetrics are perineal injuries, in the structure of which dominate ruptures. According to Russian and world literature data, the frequency of perineal ruptures ranges from 7 to 25 % of all the childbirths. The article considers the most significant predictors of this condition, including violation of vaginal microbiocenosis, perineal injuries in the anamnesis and instrumental birth. In addition, perineal injuries lead to immediate and long-term complications that significantly reduces the quality of women's life. Among the consequences of ruptures, most often pain and discomfort in the perineum area, impaired urination and fecal incontinence, as well as the development of infectious complications are observed.

Liver cirrhosis (LC) remains a significant socio-economic problem of healthcare worldwide and has the highest mortality rate among nonneoplastic diseases of the digestive system. The most common etiological factors are alcoholic liver disease, chronic viral hepatitis, and non-alcoholic fatty liver disease. General pathological mechanisms are involved in the pathogenesis of cirrhosis: damage, necrosis and steatosis of hepatocytes, inflammation with the production of pro-inflammatory cytokines, endothelial dysfunction, oxidative stress, metabolic disorders, fibrosis activation, pathological regeneration, neoangiogenesis, impaired organ architectonics with the development of portal hypertension and hemostasis disorders. At the present stage, the diagnosis of cirrhosis is based on laboratory, instrumental, morphological research methods and calculated indices. In the diagnosis of liver cirrhosis, combinations of various tests can be used, which reflect the pathogenetic mechanisms of liver damage. Optimization of known and creation of new approaches to the differential diagnostics of the severity of cirrhosis makes it possible to carry out timely therapeutic measures aimed at preventing the progression of this disease.

Objective. To evaluate the possibilities of transmural endoscopic drainage in the treatment of post–necrotic pancreatic pseudocysts in the immediate and long-term periods.

Materials and methods. From 2018 to 2022, a transmural endoscopic drainage method was used in the treatment of 36 patients with pancreatic pseudocysts at Perm Regional Clinical Hospital. The results were evaluated in the immediate postoperative period, 4–7 months before the removal of the stent and 1–4 years by the complaints of patients, blood amylase content, the results of ultrasound and CT examination of the abdominal cavity.

Results. Two-three days after the endoscopic intervention, the cyst completely disappeared in 30.56 % of patients, decreased by half or more of the diameter in 63.89 % and only in 5.56 % – decreased slightly. After 1–4 years, the absence of cysts was registered in 80 %, small diameter (from 15 to 24 mm) – in 10 %. Pancreatic cysts persisted in three patients (10 %). Statistical analysis showed that the wider was the main pancreatic duct and the higher the blood amylase level before transmural endoscopic drainage, the poorer was the treatment result.

Conclusions. Transmural endoscopic drainage of pancreatic pseudocysts makes it possible to achieve complete disappearance or significant reduction in the size of pancreatic cysts a year or more after the intervention in 90 % of cases. The clinical result of transmural endoscopic drainage in the treatment of pancreatic pseudocysts depended on the initial width of the main pancreatic duct and the level of blood amylase.

Objective. To describe and characterize the curriculum regarding a new coronavirus infection in the educational process of students of the Pediatric Faculty of Astrakhan State Medical University.

Materials and methods. The working program "Epidemiology and Prevention of New Coronavirus Infection COVID-19" (hereinafter referred to as the Program) was developed by the staff of the Department of Infectious Diseases and Epidemiology of Astrakhan State Medical University in 2021 and introduced into the curriculum of fourth-year students (8^th semester) in the specialty 31.05.02 "Pediatrics" as an optional discipline.

Results. Seventy-two academic hours are assigned for the study of the discipline, of which 50 % (36 hours) – for classroom work of the teacher with students including 33.3 % (12 hours) – for lectures, and the remaining 66.7 % – for practical classes. Independent work of students with the educational literature, educational portal of Astrakhan State Medical University and electronic resources takes the remaining 50 % (36 hours). At the last lesson, students take a test in the form of a final test (100 test tasks).

Conclusions. Thus, summing up all of the above, we can note that those students, who have attended a full course of lectures and practical classes on epidemiology and prevention of a new coronavirus infection, at the senior courses (5th and 6th courses) much better orientate themselves in epidemiology, clinic, diagnostics and prevention of not only infections with an aerogenic transmission mechanism, but also other infections with different mechanisms and transmission routes than students who have not studied this discipline.

Diabetes insipidus belongs to the group of rare heterogeneous diseases, it can manifest at any age and is distinguished by a variety of etiological factors, pathogenetic mechanisms and clinical variants of the debut and course. A significant water-electrolyte imbalance in this type of diabetes is its "calling card". The article presents a description of a clinical case of a preschool patient with early verification and late diagnosis of hereditary nephrogenic diabetes insipidus as a result of the lack of alertness of primary care specialists. Low awareness of parents about the essence of the pathology, insufficient sanitary and cultural level of the family and, as a result, a low level of parental compliance create additional risks for achieving a long-term remission. This case reflects the importance of a thorough history taking, which makes it possible to suspect the hereditary nature of the disease from the first days of a child's life at the outpatient stage. Carrying out timely diagnostics both at the regional and federal levels for further development of treatment tactics, recommendations and a follow-up plan is a necessary step towards improving the patient's quality of life.

To show the features of the clinical picture of this orphan disease and demonstrate the effectiveness of a long-term pathogenetic treatment of this disease using the case history of a patient with paroxysmal nocturnal hemoglobinuria (PNH) as an example. Complaints, anamnesis, physical status, as well as laboratory and instrumental studies used for a patient with PNH were presented. Modern literature data on the diagnosis and treatment of PNH have been studied.

Complaints, anamnesis, physical status as well as laboratory and instrumental studies used for PNH patient were analyzed in comparison with the world literature data on this pathology.

A conclusion was made regarding the need for a wide coverage of the clinical picture and diagnosis of PNH. The effectiveness of a long-term (for 13 years) pathogenetic treatment of the classical form of PNH with eculizumab was shown.

Objective. To study the neuropsychotropic activity of 2,4-dioxobutanoic acid derivatives containing a fragment of benzimidazole as well as to determine the relationship between the structure of substances and their biological effects.

Materials and methods. The spectrum of neuropsychotropic activity of 2,4-dioxobutanoic acid derivatives with benzimidazole was studied on experimental animals using the «open field», «black-and-white camera», and «extrapolation deliverance» tests.

Results. A compound with potential anxiolytic properties has been identified. The dependence of the manifestation of anxiogenic or anxiolytic properties in the presence of mono- or bicyclic arenes in the structure, respectively, is shown.

Conclusions. 2,4-Dioxobutane acids containing a fragment of benzimidazole are of interest for the search for substances with neuropsychotropic activity. The results of the “structure-activity” analysis should be used in further targeted synthesis.

Irina Vladimirovna Tereshchenko is a Doctor of Medical Sciences, an Honoured Professor of Academician E.A. Vagner Perm State Medical University, Correspondent Member of the Russian Academy of Natural Science, founder of Perm School of Endocrinology. More than 60 years of her life, she devoted to medicine including 47 of them – to Perm Medical University. Irina Vladimirovna is a remarkable person, doctor, scientist, researcher and a talented teacher, founder of Perm School of Endocrinology.

Having graduated from school with a silver medal, she entered the Medical Faculty of Nizhny Novgorod Medical Institute. Since that time, medicine became her fate. After graduating from medical institute, Irina Vladimirovna worked as a therapeutist at the hospitals and polyclinics of the city of Gorky and in 1960 began to work in the Unit of Endocrinology of Gorky Regional Hospital. In 1968 Irina Vladimirovna defended her candidate thesis, and in 1987 – doctoral thesis. Both theses concerned the issue of pubertal dispituitarism. The etiology, pathogenesis, clinical picture, treatment and prevention of this disease were studied in details and the developed method of bitemporal inductothermy is very effictive. In 1970, Irina Vladimirovna came to Perm and began to work as an Assistant and since 1974 – an Associate Professor at the Department of Hospital Therapy of Perm Medical Institute. From 1976 to 1988, she worked at the Department of Hospital Therapy № 2 and then she headed the Department of Therapy of Medicoprophylactic Faculty. Afterwards, Irina Vladimirovna worked at the Department of Endocrinology and Clinical Pharmacology of Perm Medical Academy.

Irina Vladimirovna is the author of 4 monographs and more than 550 papers. Professor Tereshchenko is a Correspondent Member of the Russian Academy of Natural Science. All her scientific works greatly contribute to theoretical and practical endocrinology.