Vol 42, No 5 (2025)

The objective of this review was to systematize the methods and techniques aimed at reducing the impact of residual monomer from polymer dentures on oral tissues and organs. Residual monomer of polymeric materials contributes to the development of allergic and toxico-chemical reactions in the oral cavity. To achieve this aim, we conducted a meta-analysis of modern literary scientific studies of researchers published in both domestic and foreign publications posted on the electronic resources eLIBRARY and PubMed. To provide summarized data on the stated issues, 207 sources were processed, from which 47 publications were selected that were of the greatest interest according to modern concepts. Based on the results of processing the research data of domestic and foreign authors, the following scientific directions were formed: 1) improvement of hygiene products that help to reduce microbial contamination that exposes the surface of orthopaedic dental structures to destructive changes; 2) development of adhesive creams and gels; 3) creation of soft linings; 4) the use of ultrahigh frequency energy, ultraviolet radiation and ultrasound waves to improve the polymerization of the material; 5) the use of supercritical carbon monoxide media to remove soluble substances, residual monomer in particular; 6) modification of the components of polymeric materials; 7) the development of biological coatings that prevent the release of residual monomer. The combination of methods related to the areas mentioned above helps to minimize the concentration of unreacted monomer, improve adaptation, increase the service life of prostheses, which in turn improves the quality of life of this category of people.

The oral microbiota includes more than 700 species of microorganisms, the bulk of which are opportunistic pathogens, and the relationships between them are characterized by wide variability, which is manifested by both antagonism and mutualism. At the same time, it has not been established yet how the symbiotic relationships of microorganisms that are of clinical importance, are reflected in the virulence of certain species. Moreover, the issues of microbial syntrophy are hardly studied in medical microbiology. It is of interest to study the accumulated information on changes in the functional and metabolic activity of oral microorganisms, taking into account their symbiotic relationships. Currently, in the study of the oral microbiome, a rejection of a culture-based approach in favor of nucleic acid analysis methods is observed due to some reasons. However, the widespread use of such technologies has led to a number of new questions, concerning, for example, the interpretation of the obtained results on the composition of microorganisms, since the methods of nucleic acid analysis allow the identification of taxa represented by almost a few cells. The review article shows that when conducting microbiological studies, it is important to take into account the symbiotic relationships between individual microorganisms, since they can change the functional and metabolic activity of associates, and hence the severity of the pathological process. The existing technologies of molecular genetic analysis do not allow one to evaluate either the orientation of symbiotic relationships or the functional activity of microorganisms. On the other hand, the possibilities of the cultural methods are also limited by the exactingness of most clinically significant taxa to the conditions of cultivation, and the data on the functional activity of isolated strains do not allow us to evaluate its manifestations in real conditions of microsymbiocenosis. It seems appropriate to search and/or develop approaches to assessing the functional and metabolic activity of the total microflora, taking into account the clinical picture of the disease. Moreover, the use and creation of new probiotics, which will allow regulating the composition of the microbial community, and hence its functional activity should be recognized as a promising direction for the search for drug treatment.

Objective. To conduct a comparative study of efficacy and safety of treatment with nucleoside reverse transcriptase inhibitors (NRTIs) – phosphazide and tenofovir in patients with acute HIV infection.

Materials and methods. A comparative study to evaluate the efficacy and safety of domestic drugs phosphazide and tenofovir in combination antiretroviral therapy regimens for acute HIV infection was conducted for 48 weeks in Perm Regional Center for AIDS and Infectious Diseases in 2017-2019. A total of 28 patients, divided into 2 groups, were included into the study. All patients underwent early diagnosis of HIV infection using enzyme immunoassay, immunoblotting, detection of HIV DNA and RNA by polymerase chain reaction (PCR); indicators of cellular immunity were determined – the level of CD4 + lymphocytes, assessment of clinical status before the start of the prescribed combination antiretroviral treatment and after 2, 4, 12, 24, 36 and 48 weeks.

Results. High virological, immunological, clinical efficacy and safety of the use of antiretroviral therapy (ART) regimens containing phosphazide or tenofovir in combination with lamivudine and efavirenz in the treatment of the acute stage of HIV infection have been demonstrated. These drugs can be recommended for use in the first-line therapy.

Conclusions. The conducted study allows us to recommend the scheme of using phosphazide in combination with lamivudine and efavirenz for the first-line therapy in HIV-infected patients. Further optimization of antiretroviral therapy of HIV infection based on phosphazide involves creation of a combination of fixed doses with a frequency of use once a day for the treatment of HIV/AIDS as new dosage forms.

Objective. To analyze the long-term average values of the birch and cereal pollination periods.

Relevance. Fluctuations in the concentration of pollen grains from allergenic plants in the air significantly affect allergy symptoms in sensitive patients, that is why aeropalynological monitoring is so important.

Materials and methods. An analysis of aeropallinological monitoring data for the city of Perm from 2010 to 2019 and in 2023 was carried out. For the birch and cereals, an assessment of the main pollination period was made based on 98% of the total annual number of pollen grains (MPP 98) and the pollination season (PS) according to the method of the European Academy of Allergy & Clinical Immunology (EAACI). Statistical processing of the obtained data was carried out using the following programs: Microsoft Excel® 2016 was applied for the calculation of the median total pollen grains concentration (p. g.) of the birch and cereals, the duration of pollination of these plants, Statistica 6 was used to determine the differences between median values based on the Mann-Whitney U-criterion.

Results. The median total pollen grains concentration of the birch per season was 19,478 [3,024; 32,094] p.g./m³, cereals – 522 [238; 916] p.g./m³, the median duration of the pollination period of the birch was 31 [22; 36] days, cereals – 35 [31; 49] days according to the EAACI method. Statistically significant differences were detected between the duration of cereal pollination when calculated using the MPP 98 and PS methods (p = 0.01).

Conclusions. High inter-seasonal variability in the total pollen grains concentration of allergenic plants was determined, the intensity of birch pollination per season in 2013 and 2014 differed by 35 times, that of cereals in 2015, 2016 – by 9 times.

Objective. To present, on the basis of the dataset, the medical and social profile of patients with hypertensive disease (hypertension) with predominant renal involvement and to consider the diagnostic significance of some biomarkers of this disease.

Materials and methods. The analysis of the medical and social profile of 436 patients diagnosed with hypertensive disease (hypertension) with predominant renal involvement was conducted according to the dataset. In our research, combined features by age (18–76 years), sex (male, female), anthropometric (height, weight status, body mass index) and clinical (heart rate, blood pressure, blood creatinine, urinalysis (glomerular filtration rate, protein, density, pH)) characteristics were evaluated.

Results. The medical and social profile of patients with hypertensive disease (hypertension) with predominant renal involvement is presented by age groups and sex, including anthropometric, clinical and social characteristics according to the dataset (male and female, respectively: aged 18–34 (25.9 %; 5.7 %), 35–54 (17.2 %;14.9 %), 55–76 (25.7 %; 10.6 %)). The average duration of treatment was 13.8 ± 5.8 days. In our opinion, biomarkers developed on small samples without taking into account the sex and age of patients with this combined pathology require additional research using datasets and artificial intelligence.

Conclusions. Large amounts of datasets form the medical and social profile of a patient with a combined pathology, combining the necessary anthropometric and clinical characteristics for the analysis, which allows to integrate information about the patient into artificial intelligence for machine learning and contributes to improving medical care.

Objective. To analyze the changes in the key indicators of oncological care for the population in a big industrial region for a 35-year period from 1990 till 2024.

Materials and methods. A total of 309,885 patients with malignant neoplasms were registered in Perm Krai over a 35-year period. Due to the extended timeframe and considerable year-to-year variation in most indicators (range: 6–26 %), median values for five-year intervals were used for the analysis.

Results. The analysis shows that the incidence of malignant neoplasms increased by 74 % based on median values (average for each five-year period). According to median figures, mortality increased by 6.8 %. over the same period.

Conclusions. A decrease in the rate of advanced-stage disease and one-year case fatality was established, alongside an increase in early and active detection rates and a rise in five-year survival. The cancer patient registry (prevalence) has grown by 92.5 % over the last 20 years, from 1,664.6 per 100,000 population in 2005 to 3,165.5 in 2024, compared to the national indicator of 2,887.6 in Russia in 2023.

Objective. To assess the readiness of the healthcare and social protection systems, non-governmental institutions to implement an integrated approach to the provision of medical care, including medico-social and palliative care, and social services to people in need.

Materials and methods. Sociological (questionnaire) and statistical methods were used while conducting the study. The questionnaire “Scaling integrated care in context, SCIROCCO”, developed within the framework of the project “SCIROCCO Exchange EU Capacity Action for integrated care” was used as a research tool. This questionnaire is used in European countries to assess the readiness of the healthcare and social protection systems and non-governmental organizations to implement integrated care. The study involved 325 (79.1 %) employees of healthcare agencies and organizations, 78 (19.0 %) employees of social service institutions, 8 (1.9 %) employees of the Red Cross Medico-Social Service "Dapamoha" of the Belarus Red Cross.

Results. There was a statistically significant difference in the average level of assessment of readiness of the healthcare and social protection systems to implement an integrated approach to providing medico-social and palliative care and social services to the citizens in need, depending on the category of workers (Kruskal-Wallis test: H = 22.3; p₃ = 0.0001). The highest assessment of readiness to implement an integrated approach was demonstrated by employees of social service institutions, with the median value (Me) reaching 3.2 points (Q₂₅ = 1.6; Q₇₅ = 4.0), the lowest one was shown by healthcare workers (Me = 1.9 points (Q₂₅ = 1; Q₇₅ = 3)). The assessment done by the employees of the medical and social service of the Red Cross was higher than that of the healthcare workers, but lower than that of the employees of social service institutions, and amounted to Me = 2.7 points (Q₂₅ = 1.7; Q₇₅ = 3).

Conclusions. The respondents' assessment of the level of readiness of the healthcare and social protection systems to implement an integrated approach to providing medicо-social and palliative care and social services to citizens in need is low and statistically significantly differs depending on the category of workers, which must be taken into account when organizing these types of assistance.

Morbid obesity is a significant current medico-social problem, and bariatric surgery is a highly effective method for losing weight in individuals with severe obesity. Laparoscopic sleeve gastrectomy is the most commonly performed bariatric procedure. The most formidable complication of this operation is gastric leak. Our report demonstrates the diagnosis and management of early staple line leakage after laparoscopic sleeve gastrectomy.

A 34-year-old female patient (BMI 40 kg/m²) underwent laparoscopic sleeve gastrectomy using a calibration bougie 36 F. The failure was suspected on the 2^nd day after the operation, but the X-ray examination of the stomach failed to reveal a water-soluble contrast leak outside the gastric wall. The gastric leak was detected on the 3^rd day after the procedure on abdominal CT-scan. The abscess was drained on re-laparoscopy. No closure of the insolvency zone and endoluminal stenting of the stomach were performed. The patient maintained fluid intake. On the 7^th day after the re-laparoscopy, she was discharged from the hospital in a satisfactory condition with drainage installed in the abscess. On the follow-up examination in 2 weeks, the general condition was satisfactory, the patients got food following the dietary recommendations; fistulography showed a slight leakage of contrast material into the gastric remnant. After another 2 weeks, no contrast material in the gastric lumen was detected on fistulography. In 1 month, no defect of staple line was revealed on esophagogastroduodenoscopy, including insufflation.

The used approach allowed us to eliminate the early staple line leakage after laparoscopic sleeve gastrectomy in a relatively short period.

The article is dedicated to Maria Yakovlevna Podluzhnaya, an outstanding scientist and healthcare administrator, the founder of a public health scientific school, doctor of medical sciences, professor, and teacher. For more than 30 years, she was heading the Department of Social Hygiene and Healthcare Organization at Ye.A. Vagner Perm State Medical University, having trained multiple generations of leaders for medical institutions in the Perm Region and, throughout Russia. 42 dissertations were defended under Professor Maria Yakovlevna Podluzhnaya’s supervision.