University proceedings. Volga region. Medical sciences

Background. The purpose of the study was to identify the features of changes in the psychological state of patients after orthodontic treatment, and the impact of these changes on human life. Materials and methods. The study included 167 people of both sex es (98 women and 69 men) aged 18–38 years. An anonymous survey was conducted. The questionnaire included questions on the basis of which the main goals of correcting orthodontic defects and the expected results after the procedure in patients were identified. Two possible answers were offered to each question (“Yes” and “no”). Results and conclusions. It has been established that orthodontic treatment plays an important role in increasing a person’s self-esteem. The data obtained indicate that orthodontic treatment contributes not only to the correction of physical defects, but also to the psychological restructuring of a person.

Background. Perioperative blood loss in lower-extremity total joint arthroplasty is one of the causes of thromboembolic and infectious complications. The purpose of the research is to assess perioperative blood loss in patients who have undergone knee or hip arthroplasty for deforming osteoarthritis using a modified method for determining blood loss with Moore principle. Materials and methods. A single-center prospective study in volved 106 patients with III-IV stage osteoarthritis who underwent knee (64) or hip (42) joint replacement with intravenous tranexamic acid. Low molecular heparins are used for anticoagulant prophylaxis: 12 hours before surgery, 6 hours after it and then daily in doses as prescribed by the instructions. The number of red blood cells, platelets, hemoglobin con centration in the blood and hematocrit level were determined using an automatic hematolo gy analyzer. The volume of perioperative blood loss was calculated by Sh.V. Timerbulatov, et al.’s method and its modification. Results. One day after knee replacements, there was a statistically significant decrease in the number of red blood cells (p = 0.00000...), platelets (p = 0.02), hemoglobin (p = 0.00000...) and hematocrit value (p = 0.00000...). Similar changes were observed after hip replacement (p = 0.00000...; p = 0.039; p = 0.00000... and p = 0.00000..., respectively). According to the prototype, the perioperative blood loss dur ing knee replacement was 1322 [1008; 1718] ml, according to the original method – 1195 [973; 1591] ml (r = +0,9, p = 0.00000...); for hip replacement 871 [707; 1079] ml and 892 [638; 1238] ml (r = +0,86, p = 0.00000...), respectively. Conclusion. The suggested method for determining perioperative blood loss can be recommended for evaluating blood loss during scheduled trauma and orthopedics surgeries. 

Background. Urothelial carcinoma of the upper urinary tract is considered a rare pathology in the practice of a urologist or oncologist. This tumor is quite aggressive in na ture: for example, 60% of urothelial cancer cases at the time of diagnosis are represented by invasive forms. The diagnosis is difficult due to the absence of a specific clinical picture - the most common symptom is macro- or microhematuria. The purpose of the study is to provide an example of management tactics for a patient diagnosed with urothelial cancer of the upper urinary tract. Materials and Methods. This article presents our own clinical ob servation of a 70-year-old patient diagnosed with urothelial cancer of the ureter. Conclu sions. The gold standard of treatment of urothelial cancer is radical nephroureterectomy with pelvic lymphodissection on the side of the lesion. Indications for neoadjuvant and ad juvant therapy are determined collegially in each individual case.

The development of various somatic and psychological pathological conditions in schoolchildren due to sleep disorders is a pressing issue for public health due to its wide spread prevalence. The article reviews data from foreign and domestic literature reflecting the problems and factors of the influence of inadequate sleep on various aspects of chil dren's health. Recently published studies confirm that inadequate sleep has a comprehensive impact on the health and life of a schoolchild: it provokes metabolic disorders, psycho logical complications and causes numerous medical and social problems. Sleep disorders as a basic physiological function in adolescence also entail disorders of other physiological processes. The destructive role of sleep defects in the occurrence of cognitive impairment and behavioral disorders has been established. The two-way interdependence of sleep prob lems on the one hand and somatic deviations, as well as behavioral dysfunctions on the oth er, is confirmed. Sleep disorders affect various aspects of growth and development of chil dren and adolescents. Accordingly, screening and monitoring of school-age children for in adequate sleep helps to identify pathology at an early stage and select therapeutic and preventive measures. Due to the widespread prevalence of sleep problems in minors, negative health consequences, it is necessary to take measures of multicomponent impact and prevention.

 Somatic and neurological chronic diseases qualitatively change human life, re duce the level of his physical and psychological capabilities, which is especially important for cardiovascular diseases, which rank first among the factors of mortality and disability. The nature of nutrition, one of the important criteria and components of the somatic health of the population and therefore is an integral part of many health complexes and programs. In particular, in Russia, one of the areas of the national project “Demography” is the for mation of skills of proper, healthy nutrition in the population. The review article considers the most successfully used diet therapy in the prevention and treatment of chronic diseases of the cardiovascular system, kidneys, skin, as well as some neurological diseases, including neurodegenerative ones. The knowledge presented in this review can help in the for mation of new comprehensive programs aimed at the prevention of chronic non communicable diseases in the population or at the rehabilitation of patients already suffer ing from these diseases.

Background. Assessment of the parameters of the course of cardiovascular dis eases against the background of chemotherapy for malignant neoplasms in patients with diseases such as coronary heart disease (CHD) and chronic heart failure (CHF) is an urgent task. The cardiotoxic effects of chemotherapy should be evaluated in a timely manner in order to prevent the progression of the underlying cardiac pathology. The aim of the study was to analyze the parameters of the lipidogram of patients with CHF undergoing chemo therapy for cancer, with patients with CHF without cancer, as well as to assess the 10–year risk of death using the Second manifestation of arterial disease (SMART) scale. Materials and methods. 41 patients participated in the study. Of these, 21 patients with CHF devel oped on the background of coronary heart disease and hypertension with malignant neo plasms of the larynx (14%), intestines (14%), mammary glands (22%), uterus (11%), brain (19%), lungs (5%), prostate (15%). 20 patients are a group of patients with CHF without oncological pathology. The nature of therapy for CHF had no statistically signif icant differences. The lipid spectrum was analyzed in patients with oncological pathology on the background of chemotherapy and concomitant CHF. A regression analysis of the parameters of the lipidogram and chemotherapy was performed. Statistical processing of the material was carried out using the Statistica 12 program. Results. Statistically signifi cant differences in total cholesterol levels were revealed, with values prevailing in the study group: 5.37 (4.66; 6.14) and 4.76 (3.76; 5.5) (p=0.011) mmol/L. In the group of pa tients with CHF and oncological pathology, a significant increase in the level of low density lipoprotein cholesterol was found compared with patients without oncology: 2.6 (2.4; 2.9) and 2.04 (1.85; 2.96) mmol/l (p=0.0365), respectively. Statistically significant differences in the levels of C–reactive protein (CRP) was also revealed: 18.45 (12.3; 23.6) and 2.29 (1.11; 4.45) mg/l (p=0.001), which was investigated as a marker of sys temic inflammation. The indicators of the 10-year risk of death in the studied groups had statistically significant differences: 17.6% in the group with CHF and cancer and 9.4% in the group with CHF without cancer (p=0.001). In the group of patients with CHF and on cological pathology, a statistically significant regression was found between chemothera py and CRP levels with a deterioration in lipidogram parameters (R=0.43; R2=0.2; beta=0.003; F=4.4). The p value for the model is 0.048. Conclusions. Statistically significant differences in lipidogram parameters, as well as the risk of mortality according to the SMART scale in the study group require more careful monitoring of the lipidogram. It is possible to prescribe higher dosages of statins for the duration of chemotherapy, fol lowed by dynamic monitoring. 

 The article provides an overview of foreign and domestic literature on the varia bility of the maxillary fossa of the temporomandibular joint during physiological occlusion, which is important for practitioners, dentists, maxillofacial surgeons. Based on a theoretical review and analysis of scientific sources of literature and publications, the issues of mor phological features of the mandibular fossa and other elements of the temporomandibular joint, depending on gender and age, were considered. Anatomical knowledge about the el ements of the temporomandibular joint is the basis in the practice of a dentist, gnatologist, orthopedist, orthodontist, etc., which help to understand pathological changes, correctly di agnose and identify at the early stages of the disease. The bone elements of the temporo mandibular joint require a comprehensive study, since changes in these elements lead to functional disorders of the entire body. 

Background. The increase in the number of cases of respiratory diseases, in particular chronic obstructive pulmonary disease (COPD), necessitates considering aspects of their impact on mortality, taking into account the age and gender of the deceased. The mor tality data of the population for 2021-2023 of the state budgetary healthcare institution “Regional Bureau of Forensic Medical Examination” were analyzed, the causes of death of people with COPD were studied. Materials and methods. The results were displayed using mean values and the analysis was performed using the dispersion method of statistical analysis with statistical significance determined using the p-test. Results. The results of the study show that the presence of COPD is associated with an increased risk of mortality due to distress syndrome, systemic inflammatory response syndrome, and respiratory and cardi ovascular diseases. This indicates that patients with COPD have an increased risk of mor tality associated with these syndromes, respiratory and cardiovascular diseases, which high lights the negative impact of COPD on overall mortality. COPD is a serious medical prob lem that requires a comprehensive approach to diagnosis and treatment. Conclusions. The incidence of COPD and mortality from diseases induced by it remain high and require ac tive intervention from both medical institutions and government agencies. This condition can significantly worsen the patient's quality of life and lead to serious consequences. The revealed statistics on the mortality of people with COPD can be useful for medical professionals and researchers whose goal is to prevent the development of diseases caused by chronic lung disease and reduce deaths from them. 

Background. Study of changes in biochemical and morphological parameters in rats with experimental atherosclerosis and the influence of plant complexes on them. Mate rials and methods. On a cholesterol model of atherosclerosis in rats, the hypolipidemic, hy poglycemic, cardioprotective, and hepatoprotective effects of plant complexes were stud ied: 1st – based on garlic and beetroot, 2nd – based on dioscorea, hawthorn, red clover, and beetroot, 3rd – based on thyme, blueberry, horsetail, and rose hips. Results. It was found that the most effective herbal complex for hyperlipidemia with elevated levels of low-density lipoproteins was based on blueberries, and for hypertriglyceridemia - based on garlic. All the studied herbal complexes have a hepatoprotective and cardioprotective effect, improv ing the biochemical parameters and morphological picture of liver and heart tissue in ather osclerosis, and also normalize uric acid metabolism. The herbal complex based on garlic has a pronounced sugar-lowering effect. Possible mechanisms of action of the studied herb al complexes are discussed. Conclusions. The obtained results indicate the presence of high hypolipidemic activity and pleiotropic effects in plant complexes based on garlic, blueber ries and dioscorea.