Vol 25, No 3 (2025)

Aim – to evaluate the effectiveness of first trimester screening in predicting major obstetric syndromes: preeclampsia (PE), intrauterine growth restriction (IGR) and preterm birth (PB).

Material and methods. We analyzed the results of first trimester screening and pregnancy outcomes in 992 patients included in the risk groups for PE, IGR and PB according to the Astrae program.

Results. Preeclampsia leads in the number of calculated risks, both isolated, 47.4%, and in combination with IGR, 27.6%. 75.4% of women did not realize the probability of one or another pregnancy complication despite the fact that they were assigned to the risk group based on the screening results. The incidence rate of preeclampsia was 3.6%, and that of IGR was 9%. Preeclampsia occurred in 4.3% of patients in the corresponding risk group, IGR, in 11.6%, respectively. In 31.2% of women with IGR, low risks were calculated for IGR, and high risks for PE. However, the established risk of IGR is associated with an increase in the frequency of spontaneous miscarriage in the observed group. In the group of calculated high risk for PR, this complication did not occur in any case, while in other risk groups (IGR and PE), premature births were observed in 5.3% of cases.

Conclusion. The first trimester screening generally accepted in the Russian Federation is quite inaccurate in terms of risk prediction. The obtained characteristics of the effectiveness of this study suggest the inevitability of revising approaches to first trimester screening and replacing the studied biomarkers. In the group we observed, patients who subsequently experienced spontaneous miscarriage had significantly increased risks of IGR. This fact should be verified on a larger sample of patients with such an unfavorable pregnancy outcome, which requires further research in this area.

The development of drugs for effective antiviral therapy of hemorrhagic fever with renal syndrome remains a highly important problem still unresolved today, since drugs with non-specific effects on the infectious process are still used in widespread clinical practice. At the same time, presence of concomitant diseases and a burdened medical history make certain adjustments to therapeutic tactics.

The article presents a clinical case of treatment of a comorbid patient with severe hemorrhagic fever with renal syndrome, acute kidney injury caused by acute tubulointerstitial nephritis in the presence of a number of concomitant diseases.

Today, a promising direction for determining the prognosis of chronic heart failure (CHF) and its further clinical course is the study of predictors that reflect the pathogenesis of heart failure.

Endothelial dysfunction is an independent predictor of the risk of cardiovascular events. Today, it is becoming more obvious that myocardial fibrosis plays a significant role in the pathogenesis of CHF in patients with myocardial infarction. Myocardial fibrosis is correlated with increased arrhythmias, hospitalization, and mortality in heart failure.

The author searched for publications in the electronic databases PubMed, Web of Science, Google Scholar and ELibrary. The review article analyzes the prognostic value of endothelial dysfunction and myocardial fibrosis in patients with CHF who have had a myocardial infarction.

There are two main histological forms of reactive fibrosis, interstitial and perivascular, which often coexist. Interstitial fibrosis is associated with chronic stressors. Perivascular fibrotic tissue is rich in inflammatory cell infiltrate and is more pronounced in conditions with predominant endothelial damage. Differentiating the effects of interstitial and perivascular fibrosis is difficult because these processes usually coexist.

Aim – optimization of rehabilitation results for patients with ischemic stroke with clinical features of sensory impairment and neglect syndrome.

Material and methods. The research involved 136 patients in the acute period of ischemic stroke in the carotid basin with sensory and motor disorders, who were divided into two groups depending on the rehabilitation methods used. The study group included 70 patients who underwent training on a multisensory virtual reality simulator in addition to basic stroke therapy, and the comparison group included 66 patients who received only standardized therapy. Sensory disorders were assessed from the moment of inclusion in the study until discharge from the hospital using the NIHSS and FMA scales, motor disorders, using the FMA and BBS, and the dynamics of the modified Rivermead mobility index, the presence of neglect, according to the NIHSS scale: partial or complete disregard were additionally assessed.

Results. After the treatment, sensory impairments persisted in 64.3% of patients in the study group and in 89.4% in the comparison group, with the dynamics of sensory deficit, according to the “H” section of the FMA scale, being statistically significant in both groups with some prevalence in the study group. The number of patients with neglect syndrome in the first group decreased from 15 to 6; in the second, from 28 to 20. At the same time, positive dynamics were observed in relation to motor functions according to all scales used, more significant in patients with less pronounced sensory impairments.

Conclusion. The use of modern methods of multisensory impact on patients with ischemic stroke in combination with basic therapy leads to better results in the rehabilitation of sensory disorders and neglect syndrome.

Swallowing is a complex physiological process, which is ensured by the coordinated actions of the oral cavity, pharynx, larynx and esophagus muscles under the control of the nervous system. As reported earlier, dysfunction and tongue posture disorder are one of the main reasons for the change in the myodynamic balance between the tongue muscle from the inside and the muscles of the maxillofacial region from the outside. Persistent muscle imbalance can contribute to the disruption of the formation and growth of the upper jaw in postnatal period, vital functions, body posture, and as a result, affect the overall health and psychoemotional development of growing patients. However, the question of the role of tongue dysfunction in the occurrence of malocclusion in growing patients remains open. The article presents modern data from the analysis of specialized literature over the past 7 years on the prevalence of infantile swallowing in children with mixed dentition, issues of etiopathogenesis and known classifications from the Researchgate, PubMed and E-library databases. The article describes influence of the studied functional disorder on the growing patients and considers preventive measures aimed at normalizing the swallowing function as one of the main factors for harmonious development of dentofacial structures in children.

Aim. This study investigated the clinical efficacy of combined platelet-rich plasma (PRP) therapy and hyaluronic acid in treating post-traumatic hand joint contractures. The relevance of this research stems from the high prevalence of such injuries and the need for more effective treatment approaches.

Material and methods. A prospective randomized study was conducted involving 147 patients with post-traumatic hand contractures, divided into three groups. The main group received combined therapy, while the other two groups were treated with either PRP or hyaluronic acid as monotherapy. Outcome measures included pain assessment (VAS), range of motion measurements, and functional indicators (DASH questionnaire). Statistical analysis incorporated calculation of arithmetic means (M), standard errors of the mean (m), and Student’s t-test. Statistical significance was determined using critical values of the t-test with a 95% confidence level (p<0.05). Data processing was performed using Microsoft Excel (Microsoft, USA).

Results. The study demonstrated the effectiveness of combined therapy, showing significant improvements across all evaluated parameters. The most pronounced analgesic effect was observed in the combination therapy group, with pain scores on the VAS decreasing from 6.1±0.9 to 1.8±0.2 points. The monotherapy groups showed less dramatic improvements: PRP alone reduced pain to 3.1±0.4 points, while hyaluronic acid alone achieved 2.7±0.3 points.

Functional recovery, as measured by goniometry, was superior in the combination therapy group, with a 22.0±3.8° improvement in range of motion (45.7% of baseline). In contrast, the PRP and hyaluronic acid monotherapy groups showed improvements of only 10.5±4.1° and 15.7±3.6° respectively. The reduction in pain and improvement in joint mobility directly correlated with enhanced functional outcomes on the DASH scale, which improved by more than 50% in the combination group compared to less than 45% in the monotherapy groups.

Conclusion. The combined PRP and hyaluronic acid therapy represents an effective treatment for post-traumatic hand contractures, demonstrating superiority over monotherapy across all key parameters. These findings confirm that this combined approach offers a promising direction in regenerative medicine, providing significant improvement in functional outcomes. The results suggest that the synergistic effect of PRP and hyaluronic acid may establish a new standard of care for this challenging condition.

Aim – to conduct a comparative quantitative analysis of diterpene compounds in the leaves of some species of the genus Salvia L. native to the Samara region.

Material and methods. The studied samples are the leaves of Salvia officinalis L., leaves of Salvia nemorosa L., leaves of Salvia verticillata L., leaves of Salvia nutans L. and leaves of Salvia dumetorum Andrz. ex Besser. Quantitative determination of diterpene compounds was carried out according to the method of RAS Professor I.N. Zilfiqarov using a working standard sample of carnosolic acid purchased from the pharmaceutical company Wuhan HengHeDa Pharm Co (Wuhan, People’s Republic of China). The content of the sum of diterpenic acids in terms of carnosolic acid was determined by the spectral method using the specific absorption index of the standard sample equal to 49.84.

Results. A quantitative analysis was performed to determine the amount of diterpenic acids in terms of carnosolic acid in the leaves of Salvia officinalis L., leaves of Salvia nemorosa L., leaves of Salvia verticillata L., leaves of Salvia nutans L. and leaves of Salvia dumetorum Andrz. ex Besser. The maximum value of diterpenes was found in the leaves of Salvia officinalis L. (1.38±0.02%).

Conclusion. The results obtained during the study will contribute to the improvement of the “Quantitative determination” section of the pharmacopoeial article of the FS.2.5.0051.15 Salviae officinalis folia, as well as the development of regulatory documentation for the raw materials of the studied species of the genus Salvia L.

Aim – to study the amount of phenolic compounds in cinnamon rosehip fruits as part of optimizing approaches to the quantitative analysis of raw materials and preparations based on it.

Material and methods. We studied the fruits of the cinnamon rosehip (Rosa cinnamomea L. fam. Rosaceae) harvested in the Samara region and the Republic of Mari El, as well as industrial samples of “Sirupus fructis Rosae” and “Cholosas” preparations, solutions of standard samples of gallus acid, ascorbic acid and catechin. The research methods involved direct spectrophotometry at 282 nm for quantitative determination of total flavonoids expressed as catechin equivalents and differential spectrophotometry at 412 nm expressed as rutin equivalents.

Results. The analysis of the nature of absorption curves during direct spectrophotometry for extraction from cinnamon rosehip fruits and preparations based on them showed the presence of a manifested maximum at 276±2 nm, which is characteristic of catechin derivatives and gallic acid. The amount of reduced flavonoids expressed as catechin equivalents in fresh cinnamon rosehip fruits and in the preparations of “Sirupus fructis Rosae” and “Сholosas” based on them significantly exceeds the amount of oxidized flavonoids expressed as rutin equivalents.

Conclusion. It seems most appropriate to conduct a quantitative analysis of cinnamon rosehip fruits, as well as preparations of “Sirupus fructis Rosae” and “Сholosas” derived from them, based on the amount of flavonoids expressed as catechin equivalents by direct spectrophotometry at 282 nm.

Aim – study of the leaf petiole features of Althaea officinalis L. for the selective diagnosis of medicinal plant raw materials.

Material and methods. The objects of the study were samples of Althaea officinalis L. leaves. The sections for the study were prepared on the REF 901140 rotary microtome, SN S19112191. Anatomical and histological examination of Althaea officinalis L. plant materials were performed using polarizing microscope (PLM-213), light microscopes with a digital accessory in transmitted and reflected light with the ability to measure objects (Motic DM-1802, Motic DM-39) on a white field with x40, x100, x400 magnification. Sample preparation of raw materials and micro-preparations was carried out in accordance with the requirements of OFS.1.5.3.0003 State Pharmacopoeia of the Russian Federation, XV edition. Reagents were used to ensure histochemical reactions, which are regulated by the relevant GOST standards.

Results. The anatomical and morphological study identified and confirmed new diagnostic features of the structure of the petioles of the leaves of Althaea officinalis L. consisting of a complex of the following features: variability of the outlines of cross-sections in the basal, medial and apical parts of the petiole; the characteristic structure and arrangement of conductive bundles and angular-lamellar collenchymes; the presence of idioblast cells with mucous lumps, calcium oxalate druses, trichomes on the epidermis, represented by simple unicellular hairs assembled into bundles of two or four cells and glands with a multicellular double-row head.

Conclusion. The results obtained during the study can be used later in the revision of the section “Microscopic features” of the draft pharmacopoeial article “Althaea officinalis L. herb”, as well as in fundamental botany aimed at studying species of the Malvaceae family.