Vol 39, No 3 (2022)

Objective. To conduct a comparative analysis of metabolic and hormonal changes in patients with seborrheic dermatitis depending on age. Seborrheic dermatitis is a common chronic inflammatory skin disease that occurs as a result of impaired sebum production and the addition of the yeast fungus Malassezia furfur. Disorders of the endocrine, immune and nervous systems of the body can contribute to the development of dermatosis; sexual and age characteristics are also important. Malassezia furfur influences changes in the biochemical composition of sebum and supports the inflammatory response, exacerbating pathogenetic changes.

Materials and methods. The study involved 62 patients with seborrheic dermatitis, who formed two groups: group I consisted of 32 patients aged 20–30 years; group II – 30 patients aged 40–50 years. The groups were comparable by gender (men) and social status; all were residents of the Perm Region. The exclusion criteria were the presence of proved cardiovascular and endocrine pathology, malignant neoplasms, liver and kidney failure, HIV infection, autoimmune diseases. The study consisted of an assessment of the general condition and dermatological status as well as laboratory methods, including general blood and urine tests and biochemical blood analysis with indicators of the lipid spectrum, carbohydrate metabolism, liver enzymes and male sex hormones.

Results. In patients with seborrheic dermatitis aged 20–30 years, the level of blood lipids was within physiological values. In patients with seborrheic dermatitis older than 40 years, the lipid metabolism disorders were noted, especially an increase in cholesterol, LDL and atherogenicity index. No significant changes in carbohydrate metabolism, liver enzymes, hyperandrogenemia were observed in both groups, no significant difference between the studied groups according to these criteria was revealed.

Conclusions. At young age, seborrheic dermatitis in men develops without significant metabolic disorders. Seborrheic dermatitis in men over 40, is mainly accompanied by hyperlipidemia; such patients need additional examinations and observation by a cardiologist.

The purpose: To analyze the possibilities of usage and the dynamics of such metabolic parameters as physical rating, basal metabolism and metabolic age, in evaluating the results of liposuction.

Materials and methods. The following body composition indicators were measured: physical rating, basal metabolism, and metabolic age. The study included 26 relatively healthy women before liposuction, immediately after the surgery and on the 7^th day after it, which were measured with Tanita BC-542 two-electrode body composition analyzer. The significance of differences was assessed using the Wilcoxon test with an error value of p <0.05.

Results. The physique rating immediately after liposuction in 3 (11%) patients improved, remaining on the 7th day, in one (4%) woman it has deteriorated. In 22 (85%) women it has not changed. The basal metabolic rate in patients on admission was 1333 (1265-1407) kcal. After liposuction it increased to 1340 (1289-1394) kcal (p = 0.02), on the 7th day - 1357 (1319-1482) kcal (p = 0.04). Metabolic age on admission in 14 (54%) patients was less than actual, in 1 (4%) woman in matched, in the remaining 11 (42%) it was more than the actual. Immediately after liposuction, the metabolic age corresponded to the actual in 6 (23%) patients, in 13 (50%) it was less than the actual age, in the remaining 7 (27%) it increased. On the 7th day the metabolic age in 16 (89%) decreased, while in the remaining 2 (11%) it did not change. On the 7^th day it neither increased.

Conclusions. In most patients, metabolic rates improved after liposuction, but in one case, the "deterioration" of physique rate was recorded. The procedure for measuring metabolic parameters in estimating the results of liposuction requires improvement.

The literature data on the connection between type 2 diabetes mellitus (DM) and pancreatic cancer (PC) were analyzed. Early detection of pancreatic cancer remains an unsolved problem of oncology because of absence of pathognomonic symptoms for this disease at the early stages, difficulties in visualizing changes in the pancreas as well as difficulties in differential diagnosis with benign tumors. Fifty nine articles in Russian and English were studied, and the data presented in literature regarding the connection between type 2 diabetes mellitus and early stages of pancreaticic cancer have been analyzed.Resectable pancreatic cancer makes up less than 15 % of the cases during initial medical examination. Currently, the existing methods of diagnostics do not allow solving the problem of early detection of pancreatic cancer – it dictates the need to search for a new marker that will improve the early diagnosis of this tumor. According to the results of many studies, there has been detected a connection between the new-onset type 2 diabetes mellitus and early stages of pancreatic cancer. Based on the data published by a number of authors, manifestation of the new-onset type 2 diabetes mellitus in patients over fifty (fasting blood glucose level ≥ 7 mmol/L, or a blood glucose sugar level ≥ 11,1 mmol/L after performing oral glucose tolerance test, or random blood glucose level ≥ 11,1 mmol/L with a typical hyperglycemia signs and symptoms) can serve as an early symptom of pancreatic cancer.

Thus, the new-onset type 2 diabetes mellitus in persons aged 50 years or older can potentially be used to identify a group of patients requiring a directional examination for the purpose of early detection of pancreatic cancer. Further studies on this problem could allow us to formulate a special program of early diagnostics of pancreatic cancer.

Objective. To assess the efficiency of using polypositional skin thermometry of high resolution with wavelet-analysis of the obtained curve as a screening noninvasive method for diagnostics and correction of microcirculatory disorders and endothelial dysfunction in complex therapy of acute pancreatitis using antioxidant drugs.

Materials and methods. A prospective open randomized study of 30 patients with acute pancreatitis was carried out. The polypositional skin thermometry of high resolution with wavelet-analysis of the obtained curve was chosen as a screening method of diagnostics of microcirculatory disorders and endothelial dysfunction. Measurement of temperature oscillation amplitude with an accuracy to 0,001 °С was performed in conditions of skin heating with index finger. The study was implemented before and after calf blood deproteinized hemoderivative infusion.

Results. Reliable changes in skin temperature oscillation of the microcirculatory bed of the skin in the endothelial range on the days 1, 2 and 3 of drug infusion were detected. In the investigated group of patients, the phenomena of transitory organ dysfunction were arrested during 48 hours that proves the presence of pancreatitis of a moderate degree of severity. The temperature oscillation amplitudes of skin in neurogenic range significantly differed by the moment of arresting organ dysfunction.

Conclusions. The method of polypositional skin thermometry of high resolution with wavelet-analysis of the obtained curve can be offered as an instrument for assessment of endothelial dysfunction prior to appearance of clinical manifestations of acute pancreatitis. The calf blood deproteinized hemoderivative infusions applied as a metabolic therapy positively influence the endothelial dysfunction in acute pancreatitis of a moderate degree of severity.

Objective. To develop a standard determination of a clinical case of measles in conditions of its elimination.

Materials and methods. The study included 28 patients with measles (main group) and 30 with infectious mononucleosis (comparison group). By means of correlation analysis, among clinicolaboratory indicators there was determined a list of clinical signs, which statistically significantly were more often identified in patients with measles compared to patients with infectious mononucleosis. The mathematical model was developed using the method of logistic regression, which helped to single out the most qualitative binary classifiers directly connected with diagnostic probability of measles. Sensitivity and specificity of the obtained model were calculated. For statistical processing IBM SPSS Statistics 26 was used.

Results. To carry out a standard determination of a clinical case of measles with the presence of combined clinicolaboratory symptoms, the mathematical model was developed, described by the following equation: р=1/(1+е^-z) · 100, where z=71,7+36,8 · Х _{dry cough} +53,5 · Х _{maculo-papular rash} +17,6 · Х _{damages of eyes in the form of conjunctivitis and/or sclerite.} Taking into account the regression coefficient values, such clinicolaboratory symptoms as maculo-papular rash, damages of eyes in the form of conjunctivitis and/or sclerite were directly connected with diagnostic probability of the diagnosis “Measles”. The determination coefficient of the obtained model was R² = 0,97, p < 0,001. The sensitivity of the model was 96.4 %, specificity – 100 %, efficiency – 98 %.

Conclusions. In conditions of measles elimination, the combination of maculo-papular rash, damages of eyes in the form of conjunctivitis and/or sclerite allows confirming the clinical diagnosis of measles with the probability of 98 %.

Objective. To determine the trends in the structure and assess medical, social and clinical aspects of the consumption of tobacco and nicotine-containing products among adolescents aged 14–17.

Material and methods. During the study, 352 adolescents aged 14 to 18 years studying in urban (n = 202) and rural (n = 150) schools of Yaroslavl region were surveyed in 2020–2021. Statistical processing of the data was carried out using computer programs "Statistica" v.10.0.

Results. The survey of teenagers revealed a fairly high prevalence not only of active tobacco smoking (tried 37 %, actively smoked 30 % of adolescents), but also the use of "new" nicotine-containing products (vape, hookah, electronic cigarettes, snus, snuff) (tried 38 %, actively used 7 % of teenagers). The structure of active tobacco use and NRTI use was found to differ by the place of residence. Active tobacco use accounted for 46.7 % of rural adolescents and 19.8 % of urban residents (p < 0,01).

Conclusions. In modern adolescents, along with tobacco smoking, a negative trend has been detected to increase the use of nicotine-containing products, especially hookah. This substantiates the need to improve educational anti-nicotine programs, to introduce a system of regular regional monitoring of the prevalence of traditional and new nicotine-containing products use among children and adolescents in order to make quick and effective decisions.

Objective. To conduct epidemiological studies of the long-term dynamics of maternal mortality (MM) and failed maternal mortality, development of trends and territorial distribution.

Materials and methods. The data of official statistics on maternal mortality calculated for

100 000 live births and a long-term dynamics of unrealized maternal mortality according to the data of the Ministry of Healthcare of PK "Unified Information System of Healthcare of Perm Krai" are presented. The number of cases of complicated pregnancy, childbirth and the postpartum period with the formation of multiple organ dysfunction or insufficiency requiring intensive therapy, blood transfusion and emergency surgical interventions was calculated. The epidemiological descriptive and evaluative method was used when performing the studies. The long-term dynamics of MM was calculated, the rectilinear epidemic trend for the function of the parabola y1 = a + bx and the curvilinear tendency for the function of the parabola y2 = a + bx + c2, its upper and lower confidence bounds (Me ± 0.95) were determined. The rate of growth and increment were investigated and the research cyclical fluctuations were determined.

Results. The maximum level of maternal losses (ML) in Perm Krai established in 2003 was 44.2 per 100 thousand live births. The minimum figure in 2015 was 5.2 per 100 thousand live births. The average long-term indicator of MM is 19.3. A feature of the long-term dynamics of the studied period was a steady decline in MM with an average annual rate of 5.7 %. Cyclical fluctuations were initially regular in nature, and subsequently had a lengthened rhythm of 13 years. Failed maternal mortality in Perm Krai had a pronounced downward trend; the decrease rate was 518.9 %. The annual loss rate was 69.8 %.

Conclusions. The long-term dynamics of MM in Perm Krai was characterized by an average degree of intensity, an epidemic tendency to decrease, the presence of cyclical fluctuations, the formation of internal causes testifying to the possible activation of maternal losses. The long-term dynamics of failed maternal mortality had a pronounced downward trend.

Objective. To identify the features of connective tissue dysplasia in patients undergoing treatment in the Surgical Unit of the First Republican Clinical Hospital of Izhevsk.

Materials and methods. The study of connective tissue pathology was conducted in patients with surgical diseases on the basis of the Surgical Unit of the "First Republican Clinical Hospital of the Ministry of Healthcare of the Udmurt Republic".

Results. The following phenotypic manifestations of connective tissue dysplasia were revealed in the examined patients: asthenic type of constitution; body weight deficiency; dolichostenomelia; arachnodactyly; deformities of the chest and spine; joint mobility; atrophic striae, skin hyperextension; longitudinal and transverse flat feet; ventral and inguinal hernias; varicose veins.

Conclusions. Thus, the variety of clinical symptoms in connective tissue pathology indicates the systemic nature of the lesion since connective tissue is located in almost all organs and systems and has a number of important functions. In its turn, underestimating the importance of connective tissue dysplasia leads to the development of severe complications, which require early diagnosis, timely prevention, and, if necessary, adequate complex therapy and rehabilitation of patients with this syndrome.

Objective. To develop an accessible, easily reproducible, functional method for modeling bleeding from varicose veins of the esophagus based on the body of a laboratory animal.

Materials and methods. The work is based on an experiment carried out in the operating room of the vivarium of Ryazan State Medical University using laboratory animals – 12 domestic pigs of the Large White breed.

Results. In 10 cases out of 12, it was possible to successfully form changes in the animal's body, allowing to provoke bleeding from the dilated veins of the esophagus, damaging them with biopsy forceps during fibroesophagoscopy.

Conclusions. Creation of an experimental model of bleeding from varicose veins of the esophagus in the body of a domestic pig by dosed clamping of the hepato-duodenal ligament with a plastic clamp, which was followed by subsequent damage of the esophageal veins with biopsy forceps during fibroesophagoscopy, is technically feasible, reliable, and the model itself is quite functional.