Orenburg State Medical Academy

Objectives: To evaluate the effectiveness of our first experience in employing transcathether arterial embolization (TAE) of popliteal artery branches in patients with knee osteoarthritis (OA). Materials and methods: The research included 80 people with knee OA grades 1-2, resistant to standard conservative treatment and without indications for surgical intervention. The patients were divided into 2 groups of 40 people each; in group 1, intra-articular injection of sodium hyaluronate (synovial fluid prosthesis) was chosen as minimally invasive therapy; in group 2, TAE of popliteal artery branches was performed. Clinical and functional characteristics of joints were assessed using WOMAC and Lysholm scales at baseline and 3 months after intervention. Results: Before surgery, in both groups 1 and 2, high levels of WOMAC scale (150 [138-184] and 162 [140-190] points, respectively) and low levels of Lysholm scale (42 [35-54] and 40 [38- 60] points, respectively) were recorded. At 3 months after treatment, patients of both groups demonstrated significant improvement in clinical and functional results in the form of decrease in WOMAC scale to 94 [84-120] for group 1, p<0.001; and 52 [40-79] points for group 2, p< 0.001. According to Lysholm scale, satisfactory results were obtained in group 1 (68 [60-85] points, p = 0.001) and good results in group 2 (91 [85-95] points, p < 0.001). On comparison of both groups, patients with TAE achieved lower values of WOMAC (p = 0.023) and higher values of Lysholm scale (p = 0.06). No complications were recorded in both groups. Conclusion: TAE of popliteal artery branches is an effective minimally invasive intervention that significantly reduces severity of pain and improves the function of knee joints. This method requires more studies with larger number of patients, development of selection criteria in order to increase accessibility in practical healthcare.

Background. Colorectal laterally spreading tumor (LST) is a large and relatively flat neoplasm more than 10 mm in diameter, growing laterally to the intestinal wall. Endoscopy plays a major role in the diagnosis and treatment of LST. Aim. To study the efficacy of endoscopic mucosal resection of colorectal laterally spreading tumors. Materials and methods. A retrospective analysis of the results of endoscopic mucosal resection of LST performed between 2020 and 2023 at the Center of Coloproctology of Orenburg Region State Hospital No. 2 was performed. Hot-snare en bloc and piecemeal endoscopic mucosal resections (EMR) were performed. Results. In the course of the study, we have analyzed 1,762 endoscopic resections of colon neoplasms, of which LST removal was performed in 99 (5.61 %) cases in 87 patients. EMR en bloc was performed in 23 (23.2 %) cases. Piecemeal EMR was performed in 76 (76.8 %) cases. There were no mortalities. Four (4) (4.04 %) complications were recorded. In 6 (12.2 %) cases out of 49 patients studied, residual lesions were detected at the control colonoscopy after 6 months. Conclusion. Endoscopic mucosal resection is an effective and accessible method of minimally invasive resection of colorectal laterally spreading tumors.

Rationale. The aim of the study is to analyze the associations of regional characteristics with the individual risk of comorbidity in the elderly population in the subjects of the Russian Federation. Materials and methods. The material of the cross-sectional study «Epidemiology of cardiovascular diseases in the regions of the Russian Federation» (ESSE-RF-3), conducted in 2020—2022, was used as individual data. The analysis included 10535 men and women aged 60—74 years. The presence of comorbid conditions was assessed using 4 methodological approaches: 1 — according to the Order of the Ministry of Health of the Russian Federation dated 07/01/2021 No. 698n.; 2 — according to the Eurasian guidelines; 3 — according to the Charlson index; 4 — in accordance with the recommendations on the organization of prioritization of patients in the framework of follow-up. To describe the regional living conditions, an integral index assessment was used, which was previously performed using the principal component method. The association of comorbidity with regional indices was assessed using logistic regression analysis, with the calculation of odds ratios (OR) and a 95% confidence interval. Results. The deterioration of economic living conditions and the shift in the age structure of the region’s population towards older age is associated with comorbidity, regardless of the method of its assessment. An increase in the industrial development of the region is associated with a decrease in the probability of comorbidity, calculated according to the «Charlson index» OR=0.93 (0.90—0.97) and according to the «Methodological Recommendations» OR=0.94 (0.90—0.97). Conclusion. The conducted study demonstrated the influence of economic, industrial and demographic regional living conditions on the individual probability of comorbidity.

Aim – to study the prevalence and structure of glaucoma pathology using the example of the Orenburg region in 2013-2024. Material and methods. Statistical data on glaucoma pathology in the population of the Orenburg region, the Volga Federal District (VFD) and Russia for 2013-2024 were analyzed. Statistical data on morbidity in the Orenburg region, the Volga Federal District and Russia were obtained with the assistance of the State budget-funded healthcare institution “Medical Information and Analytical Center”. Data on the structure and dispensary supervision are calculated according to the federal statistical observation form No. 12 “Information on the number of diseases registered in patients living in the service area of the medical organization” (“Form No. 12”) and based on data from the Territorial Fund of Compulsory Medical Insurance for the Orenburg Region (hereinafter referred to as TF Compulsory Medical Insurance). The data is presented in the form of absolute and relative indicators (%). The statistical analysis was carried out using Microsoft Excel 2016 software. Results. Glaucoma ranks 4th (6.9%) in the structure of general ophthalmological pathology in the Orenburg region in 2013-2024, following refractive disorders (46.4%), cataracts (20%) and conjunctivitis (11.1%). The overall incidence of glaucoma does not have a clear pattern; however, an increase of 3.41% was noted during the study period. Primary morbidity decreased dramatically during the study period (by 54.1%). The Covid-19 pandemic had a significant impact on the indicators for 2020-2021. By 2024, there was a positive trend in primary morbidity, but the indicators are significantly lower than the national ones. In the post-Covid period, the primary incidence among the working-age population continues to decrease, which indicates the problems of early detection of glaucoma. The work of ophthalmologists in the dispensary registration of patients with glaucoma is characterized by positive dynamics. By 2024, patient follow-up coverage has reached a decent level, equal to the national indicators - 80.8%. The detection of glaucoma patients during preventive examinations over the years under study remains at an extremely low level.

Background. Diffuse cutaneous systemic sclerosis is a multisystem disease of connective tissue characterized by symmetrical thickening of the skin and subcutaneous tissue, combined with fibrous and degenerative changes in the synovial membrane of joints, digital arteries and internal organs (esophagus, intestines, heart, lungs, kidneys). The key factor in systemic scleroderma is a violation of microcirculation, covering the entire body on a global level. This deviation occurs due to excessive synthesis of antibodies in combination with intense reactions of cellular immunity, which leads to significant damage to the vascular endothelium, a fundamental stage in the development of pathology. Damage to the microcirculatory bed provokes the formation of microthrombi due to increased thrombotic activation and proliferation of the inner lining (intima) of small arteries, which causes vasoconstriction and the occurrence of local hypoxic conditions. In the long term, this leads to chronic insufficiency of blood supply to the affected organs. There is a tendency towards an increase in connective tissue diseases, including scleroderma. Thus, in the Russian Federation in 2021, the number of reported cases among adults amounted to 17,667.7 thousand people, which is an increase compared to 2020, when there were 17,360.5 thousand people. In 2022, this number increased to 18,864.1 thousand people. The primary incidence of systemic scleroderma in children is 0.27 per 1 million children per year. Among patients with systemic scleroderma, the proportion of children under the age of 10 does not exceed 2%, and among all patients aged 10 to 20 years varies from 1.2% to 9%. The average age of morbidity is 8.1 years, the peak of the disease is observed in the period from 10 to 16 years. Among the cases, girls account for a significantly higher number, the ratio with boys is 4:1. Objective. The aim of the study was to present a clinical case of mixed systemic scleroderma in a 16-year-old teenager. Materials and methods. Patient R., born in 2008, was examined in June 2024 at the State Autonomous Healthcare Institution Regional Children's Clinical Hospital. The child was examined using the clinical and genealogical method, functional research methods (ultrasound examination of the abdominal cavity and retroperitoneal space, ECHO-CS + Doppler, CT of the chest, EGDS), clinical and biochemical blood tests, ENA profile: RNP/Sm, Scl-70, ANF; coagulogram: APTT (APTT), the percentage of prothrombin by Quick, ferritin. Conclusion. Systemic scleroderma in children is a complex and polysystemic disease that requires a deep understanding of its pathogenesis, clinical manifestations, and treatment approaches. To date, the urgency of the problem is confirmed by an increase in morbidity among both adults and children.

Aim. Analysis of the results of using laparoscopic technologies in the city clinical hospital named after N.I. Pirogov in Orenburg Materials and methods. A retrospective analysis of all elective of emergency laparoscopic surgeries performed in the city clinical hospital named after N.I. Pirogov in Orenburg for 2020-2024 years. Results. During the period 2020-2024, 3,541 laparoscopic surgeries were performed, of which 1240 were elective (35.1%), and 2,301 were emergency (64.9%). Laparoscopic operations accounted for 67.3% of all performed surgical procedures. Emergency operations accounted for the majority of the interventions. There is an annual increase in the percentage of laparoscopic surgeries performed, and new techniques and equipment are being explored, such as bariatric and anti-reflux surgery. Conclusion. Laparoscopy in general surgery has proven to be an advantage over open surgery in planned and emergency operations. There is a decrease in the number of postoperative complications and mortality as a result of an increase in the proportion of laparoscopy.

In preparation for the annual self-assessment (education quality assessment), the goal was to analyze practical training at the Nursing Department of the Faculty of Higher Nursing Education of OrSMU. Materials and methods. The practices implemented at the Nursing Department of OrSMU and their educational and methodological support, practice control, and electronic educational environment were analyzed. The study used social-hygienic and statistical research methods. Results. The Nursing Department implements two practices in the 2nd year of full-time and part-time education and 4 practices in the 3rd year of full-time education using distance learning technologies. The work programs of the practices corresponded to the Federal State Educational Standard of Higher Education 3++ in the direction of training 34.03.01. "Nursing" and professional standards "Nurse / Nurse". Students entered into agreements on practical training on the basis of medical organizations, taking into account and maintaining the profile of the practice. The assessment tool funds have been completely updated. All practice materials are posted in 1c University. Practice management is carried out by the head of practical training from the Orenburg State Medical University and the medical organization. Difficulties in developing work programs were associated with the lack of a professional standard in the field of training 34.03.01. Nursing, academic bachelor. Analysis of the academic performance of 2nd year students with different forms of education revealed an increase in the number of unsuccessful students with full-time and part-time education. Conclusions. To establish the reasons for the increase in the number of unsuccessful students with full-time and part-time education, it is necessary to conduct additional research.

The aim of the work is to determine new data on the intravital anatomy of the spleen using computed tomography in patients depending on gender. The computed tomographic anatomy and topography of the spleen were studied based on the analysis of computed tomograms in 110 patients. The morphometric parameters of the spleen were assessed: thickness, diameter, craniocaudal length, splenic index, volume. The shortest distances from the spleen to the midline of the body were determined. It was found that the morphometric parameters of the spleen in men prevailed, compared with similar parameters in women, as well as the average value of the distance from the spleen to the midline of the body. The new data obtained on the intravital anatomy and topography of the spleen can be useful for choosing the optimal approach in operations on the spleen.

Chronic kidney disease is the outcome of progressive chronic kidney diseases. Chronic kidney disease has a special social significance, affecting the quality of life and life expectancy and life expectancy. Early detection of children and adolescents with chronic kidney diseases and early stages of chronic kidney disease will not only slow down the progression, but also prevent the loss of kidney function. The article presents the main pathogenetic factors influencing the formation and progression of tubulointerstitial fibrosis — arterial hypertension with impaired general and local renal hemodynamics, proteinuria, ischemia, impaired normal functioning of the endothelial barrier, molecular genetic markers; the role of mast cells in the pathogenesis of renal fibrosis, nephrosclerosis.

. Increasing the efficiency of industrial poultry farming depends on the level of functional activity of poultry organism, conditions of keeping, balanced feeding, timely and qualitative veterinary and sanitary measures. Stress-factors and other unfavorable environmental influences lead to weakening of resistance of poultry organism and, as a consequence, to decrease of productive potential, level of profitability of egg and meat production. To optimize metabolic processes, improve feed conversion, adaptive capabilities of poultry, feed additives with high biological activity are widely used in production. The effect of selenium-containing feed additive selenium on growth, development and exterior features of broiler chickens was studied. Three groups of day-old chickens were formed: control and two experimental groups. Poultry of the I experimental group together with feed received the drug in the amount of 30 g/t feed, broilers of the II experimental group - 50 g/t. Chickens of the control group were not given the preparation. It was found that the use of seleniumcontaining preparation in the diet of broiler chickens promoted a reliable increase in live weight by the end of growing. Indicators of absolute and average daily weight gain were higher in birds of experimental groups by 165.10-181.30 g and by 8.15-8.98 %. Maximum values of measurements were recorded in birds receiving selenium: body length increased by 1.99-2.25 %, keel length - by 2.14-2.31 %, breast girth - by 8.32-8.72 %, breast width - by 1.21-1.87 %, breast depth - by 11.33-11.62 %, pelvic width in maclocks - by 2.96-3.46 %, tibia and tarsal length - by 1.42-2.23 % and 0.87-1.12 %. The broilers of the experimental groups had an advantage in most of the exterior parameters.