Vol 26, No 2 (2026)

Aim: to identify factors that increase the risk of recurrence after POP surgical correction.

Material and methods. This study included 160 patients who underwent surgery for POP correction from 2015 to 2020. The following surgical techniques were used: a combined technique (laparoscopic MESH promontopexy + precision posterior pelvic grafting with the patient’s own tissues), precision vaginal pelvic grafting, anterior Kelly colporrhaphy and posterior colporrhaphy with levator plasty.

Results. Varicose veins of the lower extremities and chronic hemorrhoid in the analyzed sample of patients with POP, statistically significantly increased the risk of recurrence after surgery by 1.8 times.

Conclusion. The obtained data will allow the physician to predict the risk of POP recurrence after surgery, taking into account comorbidities, plan the necessary surgical intervention, and determine a dynamic monitoring program for the early detection of recurrence.

Aim: assessing the severity of asthenic and somatovegetative manifestations in patients with anxiety spectrum disorders who initially consult a neurologist.

Material and methods. 41 patients with anxiety spectrum disorders were examined: Group 1 – patients with generalized anxiety disorder (GAD, n = 19), Group 2 – patients with post-traumatic stress disorder (PTSD, n = 22). The Visual Analogue Scale (VAS) for asthenia, the Wayne Vegetative Change Scale, and the Beck Anxiety Inventory were used. Statistical processing was performed using Student’s t-test for independent samples and Pearson correlation coefficient. The distribution was assessed using the Shapiro – Wilk test. The statistical significance of the findings was determined at a 5% significance level.

Results. It was found that the indices of subjective asthenia according to the VAS (6.0 ± 2.3) and the level of vegetative dysfunction according to the Wayne scale (27.4 ± 11.2) were comparable in both groups (p >0.05). A significant increase in the level of anxiety disorders was revealed in the GAD group (41.5 ± 6.9) compared to the PTSD group (35.5 ± 9.0; p = 0.022). A strong direct correlation was found between asthenia and vegetative disorders (r = 0.921; p < 0.001).

Conclusion. Asthenia and vegetative dysfunction are universal components of anxiety disorders, the intensity of which does not directly depend on the nosological form, while the affective component is more pronounced in GAD.

Aim: to evaluate the clinical outcomes and complications of primary vitrectomy compared with encircling operation in phakic patients with rhegmatogenous retinal detachment, taking into account the localization and number of ruptures.

Material and methods. A prospective study involving twenty-three patients was conducted at the Multidisciplinary Hospital No. 2 in St. Petersburg from October 2024 to May 2025. The patients were randomly divided into two groups: the primary vitrectomy group (twelve patients) and the scleral filling group (eleven patients). All operations were performed according to modern standards of surgical treatment, followed by follow-up for nine months.

Results. The primary indicator of anatomical retinal fit was 83.3% in the vitrectomy group and 81.8% in the encircling operation group, while the differences did not reach statistical significance. After nine months, the final retinal fit was achieved in all cases in both groups. Visual acuity improved significantly in both groups, but faster recovery was noted in patients after scleral filling. At the same time, cataract development was more often detected in patients after vitrectomy, whereas cases of residual subretinal fluid and infection in the buckle area were observed after the encircling operation.

Conclusion. Both methods provide high efficiency in the treatment of rhegmatogenous retinal detachment in phakic patients. The choice of surgical tactics should take into account the location and number of ruptures, which increases the likelihood of a successful outcome and minimizes complications. The significance of the study lies in the fact that it helps doctors to choose a reasoned treatment method, taking into account the risks of complications and the features of the clinical picture.

Aim: to evaluate the effectiveness of a comprehensive diagnostic and treatment algorithm for the treatment of temporomandibular joint (TMJ) arthrosis based on digital methods.

Material and methods. 96 patients with various TMJ diseases were examined. The diagnostic algorithm included a clinical examination, analysis of diagnostic models, wax and digital occlusiography, cone-beam computed tomography, electromyography, axiography. The treatment was carried out in a differentiated manner.

Results. The use of digital methods allowed for the detection of minimal disorders that were not identified during standard examinations.

Conclusion. The developed diagnostic and treatment algorithm using digital methods ensures the early detection of the initial stage of TMJ arthrosis, allows for substantiated treatment, and prevents the progression of the disease.

Aim: to analyze the incidence and prevalence of complex hip joint pathology in the Samara region for the period 2015–2024 and the outcomes of endoprosthetics at the V.D. Seredavin Joint Surgery Center in the period 2006–2025. from the standpoint of evidence-based medicine.

Material and methods. 9472 patients with hip joint pathology who underwent primary hospital surgery and 721 (7.6%) who underwent revision were studied. The statistical analysis was carried out using standard statistical processing methods by using the Data Analysis add-on in Microsoft Office Excel 2021.

Results. The prevalence of dysplastic coxarthrosis (CA) at the end of 2024 in Samara was 43.95 per 100,000 population. Among the patients who required re-hospitalization (n=721), 53.7% were diagnosed with dysplastic CA. After hip joint replacement, complications were detected in 5/1% (35 cases), including 9 dislocations (1.2%) and 5 deaths (0.7%). Our approach in endoprosthetics allows us to achieve better results compared to the control group: reduce the risk of death by 23.7% and reduce the chances of death by 2.2 times.

Conclusion. Our research has proved the need to form a unified register of patients with hip joint pathology and with surgical interventions at the level of the Ministry of Health of the Samara Region, which will make it possible to update the lists of patients in need of endoprosthetics and improve the system of organization of high-tech treatment methods.

Aim: to identify the features of PET/CT metabolism of the energy-intensive molecule ¹⁸F-FDG in the brain and the bladder wall in the normal state and in neurogenic lower urinary tract dysfunction.

Material and methods. This pilot study describes clinical observations of two patients, focusing on the features of cerebral and bladder ¹⁸F-FDG metabolism under normal conditions (filling phase, voiding phase) and in neurogenic dysfunction, based on whole-body PET/CT data. The standardized uptake values (SUVmax) of ¹⁸F-FDG in the anterior and posterior parts of the cingulate gyrus, as well as in the bladder wall during different functional phases, were calculated.

Results. The study showed that during the bladder filling phase, increased metabolic activity was observed in the posterior part of the cingulate gyrus (SUVmax 4.2), whereas during the voiding phase, increased activity was noted in its anterior part (SUVmax 4.9). An increase in ¹⁸F-FDG metabolism was observed in the bladder wall during the voiding phase (SUVmax 13.59), indicating the high energy demands of the micturition act. In the patient with neurogenic bladder dysfunction during the filling phase, simultaneous activation of both parts of the cingulate gyrus occurred, coinciding with increased ¹⁸F-FDG accumulation in the bladder wall (SUVmax 20.44).

Conclusion. Metabolic synchrony was demonstrated between the parts of the cingulate gyrus and the detrusor in a patient with no urological history during the filling and voiding phases, as well as during the filling phase in neurogenic lower urinary tract dysfunction. A synchronous increase in the ¹⁸F-FDG standardized uptake value was observed, which could serve as an additional functional neuroimaging tool in the diagnosis of neurogenic disorders. Despite limitations associated with the small sample size and the pilot nature of the work, the obtained data indicate the need for further research.

Aim: evaluation of the metrological characteristics of the method for the quantitative determination of ademethionine in tablets by IR-spectrometry in the attenuated total internal reflection mode using the independent component analysis.

Material and methods. IR-spectra were recorded using an Agilent Cary 630 FTIR spectrometer in the attenuated total internal reflection mode (crystal - diamond) in the wavenumber range from 4000 to 650 cm^-¹ with a resolution of 4 cm^-¹. The processing of IR-spectra was performed using Agilent Microlab Expert 1.0.0.7 software (IR-spectra registration, ATR correction) and KNIME 5.3.2 with pre-installed Python 3.9.7 libraries. To conduct the study, we used the drug “Heptral”, enteric-coated tablets, 500 mg, the pharmaceutical substance ademethionine 1,4-butanedisulfonate and excipients.

Results. A chemometric model based on independent component analysis is proposed. The model includes an optimization procedure for selecting the optimal number of independent components and accounts for the effect of spectral transformations on the predictive performance of the mathematical model. The metrological characterization methodology was assessed and all independent components and their relationship to characteristic frequencies were interpreted.

Conclusions. The possibility of using the independent component analysis in the quantitative ratio of ademethionine in tablets using IR-spectrometry in the total internal reflection distortion mode with preliminary chemometric processing of the analytical signal has been shown. The optimal parameters of the mathematical model were selected (number of components, type of coordinate line correction). The relative error of the resulting model is less than 1%.

Aim: study of the influence of various technological factors on the extraction of biologically active substances from powdered plant materials packaged in sachets.

Material and methods. The content of biologically active substances in sachet extracts containing black alder and gray alder leaf powders was assessed depending on the infusion time and temperature, raw material:extractant ratio (g:mL), and primary packaging material, according to the articles of the State Pharmacopoeia of the Republic of Belarus, Volume 2, “Black Alder Leaves” and “Grey Alder Leaves”. Spectrophotometric determination was performed on a Solar RV 2201 spectrophotometer, and quantitative HPLC analysis was performed on a Dionex UltiMate 3000 macrometer (Thermo Fisher Scientific, USA), equipped with a diode array detector, using the Chromeleon 7 software.

Results. It was found that infusion in a thermos (60-70°C) provides a higher yield of biologically active substances compared to infusion at room temperature (20-22°C) in a glass beaker over the same time interval. When determining the optimal exposure time, an increase in the content of substances in the extracts was observed up to 30 minutes of infusion, while no statistically significant changes occurred from 30 to 60 minutes. Infusion of 1 sachet (1.2 g) with 50 mL of water provides the maximum extraction of biologically active substances, while an increase in the extractant volume to 100 mL leads to a decrease in the content of biologically active substances in 1 mL of extract by approximately 2 times. The content of PC, ellagic acid and hyperoside in the extracts of BA leaves and GA leaves obtained by infusion of filter bags with a density of 23 g/m2 for 30 minutes in a thermos is statistically not different from the extracts from nylon bags, filter bags with a density of 11 g/m² and 21 g/m².

Conclusion. Technological methods have been established that ensure maximum extraction of biologically active substances from black alder and grey alder leaf powders packaged in sachets made of filter paper and nylon: infusing one sachet (1.2 g) with 50 mL of hot water in a thermos (60-70°C) for 30 minutes. Filter paper of varying densities (11 g/m², 21 g/m², 23 g/m²) and nylon can be used to make dosed sachets.

Aim: to analyze laboratory and instrumental data in patients with type 1 and type 2 diabetes who have sensorimotor DN and neuropathic form of diabetic foot syndrome.

Material and methods. The study group included 150 people aged 18 to 70 years, men and women with type 1 and type 2 diabetes, with sensorimotor DN and neuropathic form of diabetic foot syndrome, and 20 healthy people. Research methods: 1) clinical objective research (questionnaire, case history analysis, height and weight measurement with BMI calculation, blood pressure measurement, evaluation of skin condition and condition of nerves of the lower limbs); 2) laboratory tests (glucose, creatinine levels, LDLs, HDLs, triglycerides, total and active B12 level, glycolyzed hemoglobin in total blood, total urine test (albuminuria)) and instrumental tests (electromyography).

Results. One year later, the subjects recorded a decrease in HbA1c by 1% in the group with type 1 and type 2 diabetes with sensorimotor DN (from 9.0% to 8.0%) (p < 0.001), and by 1.5% in the group with type 1 and type 2 diabetes, having the sensorimotor and neuropathic form of diabetic foot syndrome with trophic ulcer (from 9.0% to 7.5%) (p < 0.001). There was also a decrease in BMI by 0.5–1.0 kg/m² (p < 0.001), a decrease in LDL by 0.5–0.6 mmol/l, and an increase in HDL by 0.1 mmol/l, especially in the group with type 1 and type 2 diabetes, with sensorimotor DN and neuropathic form of diabetic foot syndrome with trophic ulcer, where 73% received statins. A significant decrease in neurological symptoms was observed in patients with type 1 and type 2 diabetes with sensorimotor DN (by 51% on the TSS scale (p=0.00005), by 46% on the NIS-LL scale (p=0.00003) and in patients with type 1 and type 2 diabetes with sensorimotor DN and the neuropathic form of diabetic foot syndrome with trophic ulcer (TSS increased by 68% (p=0.00007), on the NIS-LL scale by 45% (p=0.00004)).

Conclusion. Glycemic control, lipid-lowering and antihypertensive drugs, and timely treatment led to improved metabolic, neurological, and anthropometric parameters and faster healing of leg ulcers in patients with type 1 and type 2 diabetes.