Municipal Budgetary Health care Institution "Clinical and Diagnostic Center" Health

BackgroundMedical text summarization using large language models (LLMs) has reached an inflection point in 2024–2025, with adapted models demonstrating capability to match or exceed human expert performance in specific tasks. However, critical gaps persist in safety validation, evaluation frameworks, and clinical deployment readiness. A comprehensive review revealed that only 7% of studies conducted external validation and 3% performed patient safety assessments, with hallucination rates ranging from 1.47% to 61.6%. Existing reporting guidelines, including CONSORT-AI, SPIRIT-AI, TRIPOD-LLM, and DEAL, do not adequately address the specific requirements of medical text summarization tasks.Objectiveto develop MEDAI-LLM-SUMM, the first specialized reporting checklist for research on medical text summarization using LLMs, addressing critical gaps in existing reporting standards.MethodsA modified iterative consensus approach was employed, comprising three sequential stages: (1) a systematic literature review of 216 publications from PubMed and eLibrary (2023–2025) following PRISMA guidelines and an analysis of existing reporting standards (TRIPOD-LLM, DEAL, CONSORT-AI, SPIRIT-AI, TRIPOD + AI, CLAIM, STARD-AI); (2) development of an initial 44-item, 7-section checklist by a supervisory group; (3) three rounds of face-to-face consensus discussions with a multidisciplinary expert panel of 11 specialists (3 radiologists, 2 clinicians, 3 medical informatics experts, 1 biostatistician, and 2 medical LLM developers). The consensus criterion required unanimous agreement from all panel members.ResultsThe final MEDAI-LLM-SUMM checklist comprises 24 items organized into six sections: (A) Clinical validity (4 items addressing clinical task definition, expert involvement, hypothesis formulation, and medical expertise requirements); (B) Model Selection (5 items covering model justification, system requirements, deployment environment, LLM-as-judge approach, and prompt documentation); (C) Data (3 items on datasets, reference summaries with expert consensus, and data stratification); (D) Quality Assessment (8 items including evaluation metrics, clinical metrics, expert evaluation, hallucination detection, LLM-judge assessment, sample size justification, pilot testing, and limitations documentation); (E) Safety (2 items on ethical approval and data anonymization); and (F) Data Availability (2 items on code and dataset accessibility). Comparative analysis with six existing reporting standards demonstrated that MEDAI-LLM-SUMM uniquely addresses hallucination assessment requirements, reference summary creation methodology, LLM-as-judge validation protocols, and detailed pilot testing specifications.

The implementation of the medical decision support system (MDSS) in clinical practice requires careful monitoring to ensure patient safety and track the performance of artificial intelligence technologies.Goal: To assess the effectiveness of the TOP-3 MDSS in outpatient clinics of the Moscow Heath Care Department.Materials and methods: The Moscow Heath Care Department monitored the TOP-3 operation between October 1, 2020 and March 03, 2024 (n = 63,809,360 people). The Hit-3 metric was used to determine if the MDSS needs retraining. An additional study involving medical experts included a retrospective analysis of data from 3,000 patients and calculation of the diagnostic agreement rate among the MDSS, doctors and the experts.Results: The monitoring demonstrated mean Hit-3 of 63.5, 64.5 and 67.7 for MDSS ver. 1, 2, and 3, respectively. In cases where the clinicians disagreed with the MDSS (n = 2000), based on the patient complaints, experts agreed with the MDSS in 80.2% of cases, with clinicians in 11.5% of cases, and established a different diagnosis in 8.3% of cases. In cases where the clinicians’ and the MDSS’s conclusions matched (n = 1000), experts approved the diagnosis in 50.4% of cases, selected an alternative diagnosis suggested by the MDSS in 37.9% of cases, and established a different diagnosis for 11.7% of patients. Conclusion: The described monitoring methodology, supplemented by expert review, allowed for a comprehensive assessment of the MDSS to be implemented in the health care system. Based on the results of the TOP-3 effectiveness assessment, it was decided that the analyzed list of data from electronic health records should be expanded, which will be implemented in the upcoming version TOP-3+.

Purpose of the study: to analyze the data of domestic and foreign literature on the use of computed tomographic perfusion (CTP) in the diagnosis of kidney diseases, including patients with benign and malignant kidney tumors. To evaluate the prospects of using this technique to determine the effectiveness of various minimally invasive interventions (cryotherapy, various types of thermoablation, arterial embolization) for the treatment of patients with renal tumors, as well as for follow-up of patients in these groups.Material and methods. A search of scientific papers published in the electronic databases PubMed, Google Scholar, E-library using the key words “angiomyolipoma”, “kidney”, “transarterial embolization of tumors”, “CT-perfusion of the kidneys” was carried out. In the article the materials of 40 literature sources for the last 10 years, including 25 articles - for the last 5 years, devoted to the mentioned subject are considered. The authors present their own clinical cases demonstrating the CTP application usefulness to assess the therapeutic effect of renal angiomyolipomas (rAML) transarterial embolization (TAE).Results. The conducted literature review showed that renal CTP is a noninvasive technique that allows differential diagnostics between benign tumors (low-fat rAML and oncocytoma), as well as with malignant renal neoplasms, to reveal features of different histological variants of renal cell cancer. In addition, there are works devoted to the application of CTP in the evaluation of the efficacy of minimally invasive techniques such as cryoablation, TAE (in the treatment of renal cell cancer (RCC) and rAML, respectively), as well as target therapy for RCC. According to the preliminary results of our clinical cases, the main CTP parameters allowed to detail the structure of rAML (before and after TAE), blood flow features of its microcirculatory level and to detect recurrence on the basis of progressive growth of perfusion values with simultaneous reduction of tumor volume, which demonstrates the possibilities of using CTP as an additional monitoring technic after surgical treatment.Conclusion. Despite the availability of papers analyzing the use of CTP as a technique to assess renal tumor angiogenesis, many gaps remain in its use as a clinical potential in the evaluation of early and subsequent follow-up in the cases of renal tumors surgical treatment. To date, there is no evident and thoroughly validated imaging method for embolized tumors. There are no works on studying the possibilities of CTP in assessing the therapeutic effect of rAML embolization. The results of our own clinical cases allowed us to suggest that CTP can be used as an additional technique for monitoring rAML after surgical treatment such as TAE and detecting disease recurrence by assessing tumor neoangiogenesis.

The article presents the results of a gender characteristics research in the expression of anxiety levels students aged from 15 to 17 years old. Research methodology: a method for multidimensional assessment of children's anxiety (authors: E.E. Romitsyna, L.I. Wasserman), for children and adolescents from 8 to 18 years old. Mathematical and statistical processing of the results was carried out using the nonparametric Mann-Whitney U-test method. The existence of significant differences in the severity of anxiety levels in boys and girls was revealed, and the features of the distribution of data on the scale «Anxiety in Relationships with Parents» were also identified. EDN: UZTGOM

At present, an important task in the system of Russian education is the modernization of the educational process, aimed at developing the educational component of teaching the younger generation and youth, where the constructive interaction of all its subjects is of the greatest importance. The article pays special attention to the formation of the readiness of all subjects of an educational institution to interact with each other, which results not only in the personal development of students, but also in the harmonization of interpersonal relations, mutual understanding of the parties interacting in the educational environment and the improvement of society. As part of the production (pedagogical) practice, students of the Samara State Socio-Pedagogical University developed and implemented activities aimed at developing fruitful cooperation between all its participants in the educational process of the educational institution. The constructive interaction of the participants in the educational organization was built taking into account the creation of the necessary conditions (regulatory, informational, stimulating, prognostic-activity) and including its main components (motivational, cognitive-activity, evaluative) aimed at obtaining the desired result. To solve the identified tasks, a number of activities were carried out aimed at increasing the interest of the subjects of the educational process in the education of the spiritual and moral personality of the student, the formation of responsibility to the family in particular and society in general.

The article presents the results of analysis of primary and secondary disability due to malignant neoplasms among young people in Moscow in 2016-2018. The study established that in the structure of young patients recognized as disabled for the first time made up the smallest percentage with tendency of increasing the level of primary disability. The study established the predominance of people with disabilities of group II with high level of primary disability. The second position is taken by patients with disabilities of group III with tendency of increasing their specific severity. The number of patients repeatedly recognized as disabled is much higher than patients recognized as disabled for with the first time. The study established prevalence of disabled patients of group III with tendency of increasing level of repeated disability.

Background. In the last decade, the relationship between arterial hypertension and the risk of developing kidney cancer (KC) has been pointed out. Some studies have shown that the metabolic imbalance of the components of the renal renin-angiotensin system (RAS) is associated with the development and progression of KC.Objective: to study the state of RAS in tumor and peritumoral tissues in patients with KC on the background of arterial hypertension. Materials and methods. In patients with localized KC T1N0M0 and grade I–II arterial hypertension without special treatment (n = 40) in the samples of tumor, peritumoral and histologically unchanged tissue, the levels of angiotensins 1, 2, 1–7 (AT1, AT2, AT(1–7)) of angiotensin-converting enzymes (ACE, ACE2) were determined by ELISA. The comparison group consisted of patients with RC without impaired blood pressure (n = 55).Results. In patients with KC, the level of AT1 is 1.5 times higher (p <0.05), and AT2 is 1.6 times higher (p <0.05) in tumor tissue against the background of unchanged content in peritumoral tissue compared with histologically unchanged tissue. The level of ACE is higher than histologically unchanged tissue by 2.7 times, ACE2 – by 1.6 times (in all cases p <0.05), and in peritumoral tissue it is identical in histologically unchanged tissue.In patients with KC and arterial hypertension, the level of AT1 and AT2 in the tumor tissue is 1.8 times higher (p <0.05) and 2.1 times (p <0.01), respectively, the content of AT(1–7) is 1.6 times (p <0.01). In peritumoral tissue, AT1 is 1.6 times higher (p <0.01) and AT2 is 1.9 times higher (p <0.05). The level of AT(1–7) in the peritumoral tissue is identical to the values in the histologically unchanged tissue. The content of ACE and ACE2 in tumor tissue is 3.6 and 2.9 times higher, respectively, and in peritumoral tissue is identical to that in tumor tissue. Correlation analysis revealed a reliable direct relationship in the studied groups for all parameters, while in the peritumoral tissue of hypertensive patients, the relationship between the average blood pressure and the RAS peptide and enzymes content had a higher tightness.Conclusion. An increase in the levels of AT1 and AT2, ACE and ACE2 in the tumor tissues and peritumoral tissue in patients with localized KC, regardless of the presence of arterial hypertension at initially higher values in hypertensive patients, was shown. The presence of arterial hypertension in patients with KC changes the metabolism of local RAS in peritumoral tissue and is associated with an increase in the correlation between changes in the components of RAS and arterial hypertension.

Corynebacteria non-diphtheria and, in particular, C. pseudodiphtheriticum species that are closely related to C. propinquum and C. striatum form a group of new respiratory pathogens leading to the development of bronchitis, tracheitis, exacerbation of chronic obstructive pulmonary diseases, nosocomial pneumonia and other pathology. The goal is to analyze the frequency of the release of Сorynebacteria non-diphtheria from the upper respiratory tract of patients with various inflammatory diseases of the respiratory tract. Strains of Сorynebacteria non-diphtheria (C. pseudodiphtheriticum, C. propinquum, C. accolens, et al.), isolated from patients with inflammatory diseases of the respiratory tract (60 pcs.) and practically healthy individuals (31 pcs.) were studied. Identification of Сorynebacteria was performed using the method of mass spectrometry (MALDI-ToFMS). Сorynebacteria nondiphtheria in the amount of 105 and higher were more frequently detected with the development of chronic tonsillitis (60.0%) and nasopharyngitis (30%). The strains of C. pseudodiphtheriticum (40.0±6.4%) and the closely related species C. propinquum (21.7±5.3%) were mainly found; much less often - C. accolens (8.3±3.6%), C. afermentans (6.7±3.3%), et al. In 86.7% of cases, Corynebacteria non-diphtheria were isolated from children. In chronic tonsillitis, C. pseudodiphtheriticum and the closely related species of C. propinquum were isolated more often; in nasopharyngitis and bronchitis - С. pseudodiphtheriticum. Isolation of Corynebacteria non-diphtheria and, especially, C. pseudodiphtheriticum, C. propinquum, C. accolens species from patients with inflammatory diseases of the respiratory tract in the amount of 105 and above, if there are no other pathogenic microorganisms in the role of microbial associates, of clinical importance.

To evaluate the efficacy and safety of the antibacterial drug fosfomycin trometamol (Fosfomycin Esparma) in women of reproductive age with acute uncomplicated cystitis. In order to assess the efficacy and safety of using fosfomycin trometamol (Fosfomycin Esparma), a prospective, non-randomized, uncontrolled study involving 32 women with acute uncomplicated cystitis was carried out. The average patients age was 27.3+/-3.1 years. Before the study, all women underwent a general clinical, bacteriological, and ultrasound examination. Inclusion criteria was the presence of pathognomonic symptoms of acute uncomplicated cystitis. Exclusion criteria were as following: complicated urinary tract infection, anatomical and functional disorders of the urinary tract, comorbidities. All patients were prescribed a study drug at a dose of 3 g, once. The efficiency of therapy was evaluated on days 3 and 14 after administration of Fosfomycin Esparma based on clinical and microbiological cure and safety. The only bacterial pathogen isolated from the urine was E. coli. In 4 cases (12.5%) strains produced extended-spectrum -lactamase. The sensitivity of E. coli to fosfomycin, piperacillin/tazobactam, amikacin and meropenem was 100%. A resistance to ampicillin was 15.6%, compared to 9.4% for levofloxacin and norfloxacin and 12% for cefotaxime, ceftazidime, cefpoxin. By the 3rd day after receiving fosfomycin, the symptoms of cystitis were resolved in all patients. On day 14, according to the results of the urine culture, there was no growth of bacteria. During the follow-up period, no significant side effects was detected. Our study showed that antibacterial drug Fosfomycin Esparma in women of reproductive age with acute uncomplicated cystitis is effective and safe. Maintaining a high sensitivity to fosfomycin allows us to recommend this drug as an empirical antibiotic therapy in this cohort of patients.

Antiphospholipid syndrome (APS) is an immune-mediated violation of coagulation, the diagnosis of which requires mandatory laboratory confirmation. Since the clinical manifestations of APS are extremely diverse, various specialists are involved in the diagnostic process – neurology, cardiologists, surgeons, hematologists, endocrinologists, laboratory medicine specialists, etc. So far, it remains an open question what specialist exactly should make the final diagnosis and supervise patient with APS. The experience of a separate diagnostic center shows the distribution of prescriptions and their compliance with the international recommendations. This study also provides data on the frequency of prescribing laboratory tests to confirm APS, which is 1.2% of all coagulation tests. Among the patients with suspected APS on the basis of clinical signs, only 12.2% of the diagnosis was confirmed. Presents the dangers of obtaining false-positive results that should be taken into account when prescribing laboratory tests.