Voronezh State Medical Academy named after N.N. Burdenko

The detection of cancer recurrences is one of the most important tasks of the healthcare system in Russia. Outpatient medical care is crucial for diagnosing tumor progression or relapses in a timely manner and referring patients to specialized treatment. Objective. To highlight the importance of an active diagnostic search for early detection of malignancies and improved prognosis for the patient in outpatient settings. Materials and methods. An outpatient clinical case is presented. Results. The patient visited her general practitioner due to periodic nausea, a fever up to 37.5 ◦C, which appeared about a month ago, and pain in the lumbar spine, which was associated with a history of osteochondrosis. In 2017, a resection of the right breast was performed for a malignancy. Blood tests showed decreased hemoglobin, increased erythrocyte sedimentation rate, and a pronounced increase in alkaline phosphatase. The general practitioner scheduled computed tomography of the pelvis, femur, and lumbar spine, which revealed multiple structural changes in the bones of the sacrum, iliac, ischial, and pubic bones, acetabulum, femur, and multiple structural changes in the ThXI, ThXII, LI—LV, vertebral arches, and spinous and articular processes. The patient was referred to an oncologist; according to the examination results, the patient was diagnosed with malignant neoplasm of the unspecified part of the breast, breast cancer on the right, T1CN0M0; Disease progression, multiple secondary bone lesions. T0N0M1; stage: IV. Conclusion. Improving the quality of medical care for patients with malignancies depends on primary healthcare professionals’ awareness of symptoms and signs indicating possible cancer, as well as on timely diagnosis and referral to appropriate specialists.

Cerebellar-type multiple system atrophy (MSA-C) presents significant challenges for early diagnosis due to the absence of specific biomarkers and its clinical similarity to other forms of ataxia. The presented clinical case highlights the importance of dynamic monitoring of magnetic resonance imaging (MRI) changes for confirming the diagnosis of MSA-C and demonstrates the characteristic temporal evolution of key neuroimaging markers.A clinical observation of a 47‑year-old patient with progressive cerebellar ataxia and autonomic failure (orthostatic hypotension, urinary incontinence) consistent with established diagnostic criteria for MSA-C is presented. Brain MRI findings obtained in follow-up with a 7‑month interval are of particular value. First detection of the highly specific “hot cross bun” sign for MSA-C – a cross-shaped area of hyperintense signal in the central pons. Progressive thinning of the middle cerebellar peduncles (by 3 mm), cerebellar vermis atrophy (by 2 mm), and enlargement of the fourth ventricle and pontine cisterns were also documented. These changes objectively correlated with the progression of cerebellar clinical symptoms in the patient.The findings of this clinical case indicate that dynamic MRI evaluation is an indispensable method in the diagnosis of MSA-C. The appearance of the pathognomonic “hot cross bun” sign and quantitatively measurable progression of atrophy in specific posterior fossa structures (the cerebellum, middle cerebellar peduncles, and pons) over a short time interval represent highly specific radiological criteria that allow reliable differentiation of MSA-C from hereditary ataxias even in the absence of definitive biomarkers. Early and sequential MRI with assessment of imaging changes over time significantly improves the accuracy of antemortem diagnosis of this severe neurodegenerative disease.

The aim of the study was to compare the electron microscopic and microscopic characteristics of the first two phases of spermiogenesis in seven mammalian species. Material and methods . For electron microscopy, testicular specimens were fixed in 2.5% glutaraldehyde and 1% osmium fixative. Sections were prepared on BS-490 and LKB-4800 ultramicrotomes. Sections were contrasted with uranyl acetate and lead citrate and examined under a Tesla BS-500 electron microscope. Results. During the first Golgi phase, the Golgi apparatus forms an acrosomal vesicle and small granules. During the second cap phase, the small granules in the acrosomal vesicle combine to form a single large granule. The acrosomal vesicle and acrosomal granule spread over the nucleus, forming a cap. In northern fur seals, silver foxes, and minks, indentations in the spermatid nuclei were found at the location of the acrosomal vesicle. In sheep, sea otters, and beavers, indentations in the spermatid nuclei at the vesicle attachment site are absent. Conclusion. During the Golgi phase, the acrosomal vesicle and acrosomal granule form. During the cap phase, the acrosomal structure spreads over the apical surface of the nucleus, forming a cap over the nucleus. In the northern fur seal, fox, and mink, the acrosomal vesicle forms a deep depression in the spermatid nucleus, which is not found in the ram, beaver, and sea otter.

Биофизика как одна из фундаментальных дисциплин занимает особое место в медицинском образовании, развивая у будущих врачей научное понимание физико-химических принципов, лежащих в основе биологических процессов. Изучение биофизики позволяет студентам-медикам понять механизмы жизнедеятельности на молекулярном и клеточном уровнях, закладывая основу для понимания патологических явлений, а также современных диагностических и терапевтических подходов. В настоящей статье рассматриваются ключевые методологические принципы преподавания биофизики в медицинских вузах, их отличительные особенности, а также подчеркивается важнейшая роль этой науки в подготовке квалифицированных медицинских специалистов. Приводятся некоторые аспекты преподавания биофизики в Воронежском государственном медицинском университете имени Н.Н. Бурденко.

In most cases, apical periodontitis is a complication of untreated pulpitis or its unsuccessful treatment resulting from the complex anatomy of the root canals or their sclerosis. The purpose of the study is to determine the prevalence of apical periodontitis among the population of the Belgorod agglomeration. Materials and methods. During the study, we analyzed 600 tomograms of patients aged 18 to 82 years old who had dental appointments not directly related to the need for apical periodontitis treatment. Results. 47.6 % of the adult population of the Belgorod agglomeration have been diagnozed with signs of apical periodontitis. The number of teeth in the group of 18–29-year-old men is 27.37 ± 0.34, while that in the women’s group equals 28.02 ± 0.30. It consistently decreases, reaching 14.83 ± 1.97 and 16.47 ± 2.21 teeth, respectively, in the group over 70 years old. The proportion of teeth with apical periodontitis is minimal in the group of 18–29-year-olds among men, equaling 2.3 %, and 1.9 % among women. The maximum proportion of teeth with periapical changes has been found in the group of 50–59 year-olds. The indicator increases to 8.8 % in men and to 8.1 % in women. In the 70+ group of patients, the estimated proportion decreases to 5.8 % among men and 5.3 % among women. The revealed dynamics may be explained by sclerosis of the root canals.

This study addresses key limitations in tissue engineering—specifically, the inability of traditional additive bioprinting methods to fabricate complex, multi-material structures with the resolution and speed required for functional tissues. Volumetric photopolymerization methods, such as xolography and pulsed holographic photopolymerization, offer superior resolution and simultaneous whole-volume fabrication but require advanced materials. We present a prototype "liquid bioengineered tissue" matrix designed for such volumetric methods, specifically targeting bioengineered endometrium. The innovation is a biocompatible, temperature-responsive, photopolymerizable hydrogel based on Poly(N-Isopropylacrylamide) (PNIPAAm), with a Lower Critical Solution Temperature (LCST) near body temperature. This enables a phase transition from a homogeneous solution at room temperature to a precipitated state under physiological conditions. The matrix is made tissue-specific by conjugating solubilized glycoproteins and glycosaminoglycans from endometrial Extracellular Matrix (ECM) into the hydrogel. To enhance biological activity, a glycoprotein fraction from platelet lysate is chemically incorporated, extending growth factor stability. Synthesis involved radical polymerization of N-isopropylacrylamide to form PNIPAAm, enzymatic digestion of endometrial ECM, and subsequent component conjugation. The resulting hydrogels were purified and characterized. Particle size analysis confirmed nanoparticle formation suitable for a "morphogenetic matrix". The hydrogels remained optically transparent below the LCST, which is critical for volumetric photopolymerization. This PNIPAAm-based matrix, incorporating tissue-specific ECM components and platelet lysate factors, represents a foundational step towards enabling high-resolution volumetric photopolymerization for complex tissue engineering. While realizing pulsed holographic photopolymerization remains challenging, this matrix provides essential compatible materials for future volumetric bioprinting advances.

The relevance of the problem of injuries, diseases, neoplasms of the hand and the search for the least traumatic, organ-preserving and minimizing dysfunction treatment methods does not lose its importance. The article presents a clinical case of a patient with a neoplasm of the first finger of the hand. For 2 years, he was worried about pain in the distal phalanx, periodically increasing, against this background, a wound with a curdled discharge opened, after which the pain practically stopped. At the outpatient stage, the patient underwent laboratory (general and biochemical blood tests, coagulogram, urine analysis) and instrumental research methods (X-ray, MSCT), as well as a biopsy of the neoplasm. Morphologically, the picture of an epidermal cyst with resorption has been established. Intraosseous resection (curettage) of the neoplasm was performed on the basis of the outpatient surgery center of the Hospital No. 1. According to the histological examination of the obtained intraoperative material, the formation corresponded to an epidermal cyst with chronic inflammation. 3 weeks after the surgical treatment, the patient began the duties of a musician (playing the piano), without noting the discomfort in his finger. The analysis of the demonstrated clinical case, as well asliterature data, emphasizes the role and importance of outpatient surgeons, the need for the correct choice of minimally invasive surgical tactics in order to preserve the functional activity of the hand and shorten the patient’s rehabilitation time.

Sphingolipids are bioactive lipids that regulate cell proliferation, differentiation, apoptosis, angiogenesis, and inflammation. In recent years, their role in maintaining the ovarian reserve and developing of female reproductive disorders has gained increasing attention. Ceramides (CERs) and sphingosine-1-phosphate (S1P) form a dynamic balance between pro-apoptotic and pro-survival signals, determining the fate of follicles and oocytes. Dysregulation of sphingolipid metabolism has been identified in ovarian cancer, polycystic ovary syndrome, endometriosis, obesity, diminished ovarian reserve, and premature ovarian insufficiency. These conditions are accompanied by a shift in the CERs/S1P ratio, which affects oocyte quality and their susceptibility to oxidative stress, chemotherapy, and inflammation. Emerging evidence indicates that targeted modulation of the sphingolipid pathway — including enzymes such as sphingosine kinases, ceramide synthases, sphingomyelinases, and ceramide transfer protein, as well as S1P receptors may represent a promising approach for preserving ovarian reserve, preventing infertility, and overcoming chemoresistance in ovarian cancer. S1P exhibits protective properties toward oocytes, whereas ceramide analogues and inhibitors of sphingolipid-metabolizing enzymes offer new opportunities for personalized therapy. Summarizing current data on sphingolipid metabolism in reproductive tissues highlights these molecules not only as biomarkers of pathology but also as potential therapeutic targets, which is particularly relevant for developing fertility-preserving strategies and improving the outcomes of gynecological disease treatment.

BACKGROUND: Temporomandibular joint (TMJ) dysfunction, involving both the joint and the muscles, develops as a result of unbalanced loading of the joint produced by an incorrect orientation of the occlusal plane, even with optimal position of the articular structures. Favorable therapeutic outcomes can be achieved by establishing proper alignment of the vertical, orbital, occlusal, and auricular planes. Myogymnastics—synchronous, well-coordinated anterior and lateral mandibular excursions—plays a critical role in the comprehensive management of TMJ dysfunction. AIM: This work aimed to evaluate the effectiveness of a combined protocol of masseter and temporalis muscle relaxation using a deprogramming device together with Mariano Rocabado’s myogymnastic regimen in patients with occlusal disturbances and TMJ dysfunction. METHODS: Muscle relaxation was assessed using electromyography. In the intervention group, mandibular deprogramming and registration of a new mandibular position were performed using a Lucia Jig device in combination with Rocabado’s myogymnastic protocol. The control group did not use deprogramming devices, subsequent splint therapy in the new mandibular position, or preliminary relaxation of the masseter and temporalis muscles. Electromyographic activity of the temporalis and masseter muscles on the right and left sides was recorded, and symmetry and synergy were compared at physiologic rest (absence of load) and during maximal voluntary clenching (maximum load). Data in each group were obtained at three time points: baseline (diagnostic stage), after registration of the new mandibular position, and 3 months after completion of prosthodontic treatment. RESULTS: Outcomes in the intervention group, where the Lucia Jig and Rocabado’s myogymnastics were used to register a new mandibular position, were more favorable than in the control group. The difference in bioelectrical activity of the temporalis muscle at rest between groups was 3.83 μV on the right and 6.6 μV on the left. For the masseter muscle, the difference was 13.3 μV. Electromyography assessment of the masseter muscle during the maximum load test demonstrated between-group differences of 83.8 μV (right) and 150.6 μV (left). Additionally, the temporalis muscle values differed by 87.4 μV (right) and 114.3 μV (left) between the groups. CONCLUSION: This study is the first to employ a method for registering centric relation using a deprogramming device combined with Rocabado’s myogymnastic exercises in patients with occlusal disorders complicated by TMJ dysfunction. The effectiveness of this approach has been demonstrated and is supported by favorable long-term outcomes after placement of definitive prosthodontic restorations. Performing myogymnastic exercises in patients with TMJ dysfunction promotes a stable myostatic reflex, reduces the load on the TMJ capsuloligamentous apparatus, alleviates pain, and positively influences the patient’s psychoemotional state.

Ulcerative colitis is a chronic recurrent disease with an autoimmune type of lesion of the mucous membrane of the colon. Its prevalence in the population is increasing every year and, according to the latest data, amounts to 6.8 million people worldwide. This pathological condition requires clinicians to be more vigilant about timely diagnostic and therapeutic tactics at the outpatient stage. The article demonstrates a clinical case of UC in a young patient with an atypically acute onset of the disease for his age. The described case draws attention to the role of external factors in the onset of the disease, the importance of timely diagnosis, a rational approach to treatment, and patient compliance with medical recommendations.