Kuban State Medical University

This article presents a Delphi consensus developed by a panel of editors-in-chief of anaesthesiology and pain medicine journals to guide the responsible use of large language models (LLMs) in academic publishing. LLMs offer potential benefits for scientific writing, including language editing, summarisation, translation, information organisation, and support for non-native English speakers, but their misuse raises concerns about accuracy, transparency, confidentiality, and research integrity. Through a three-round modified Delphi process involving 53 editors-in-chief or their delegates, 59 statements were generated and categorised into guidance for authors, editors, reviewers, and publishers with a particular attention to LLM disclosure practices and perceived risks. The consensus recognises that LLMs are useful tools in academic publishing for authors, reviewers, and editors. However, their use must be guided by ethics, legality, and principles of transparency and accountability. LLMs may assist with limited editorial and authorial tasks provided that their use is fully disclosed and all outputs are verified by humans. The consensus also emphasises the inappropriateness of using LLMs to generate original or ideative content, which should remain a strictly human responsibility. Moreover, LLMs must not generate data, references, conclusions, or entire manuscripts, nor be used for editorial decisions or peer-review reports. Editors expressed concerns about 'hallucinations', erosion of critical skills, confidentiality breaches, and the proliferation of low-quality LLM-generated manuscripts. The resulting guidance highlights transparency, human accountability, and careful verification as essential principles for integrating LLMs into scholarly workflows while preserving the integrity of scientific publishing.

Perioperative respiratory risk represents a major interdisciplinary challenge, as postoperative pulmonary complications (PPCs) are associated with increased mortality, prolonged hospital stay, and higher healthcare costs. Heterogeneity in the definitions of complications complicates the interpretation of the literature; initiatives such as Standardised Endpoints in Perioperative Medicine (StEP) and the European Society of Anaesthesiology working group on European definitions have proposed harmonised definitions and severity grading systems, thereby improving comparability across studies and clinical applicability of results. This narrative review synthesises data on the epidemiology of PPCs, patient- and procedure-related risk factors, methods of risk stratification and prevention, and presents contemporary prognostic models ranging from clinical risk scores to machine learning algorithms, with particular emphasis on validation requirements and reporting standards. Practical implications include the need to apply StEP definitions with severity grading alongside discrete registry-based outcomes according to the NSQIP (National Surgical Quality Improvement Program) classification, to perform external validation of predictive models, and to implement bundled preventive strategies throughout all phases of perioperative care in high-risk populations. Integration of standardised outcomes, validated risk models, and multistage preventive interventions, including the use of machine learning algorithms, provides a foundation for reducing the incidence of PPCs and improving long-term outcomes.

Early diagnosis of gallstones in children presents certain challenges for pediatricians. The purpose of the study. Identification of the clinical features of gallstone disease in children of different ages. Materials and methods. The study involved 71 children diagnosed with gallstone disease conditions between the ages of 0 and 18. The participants were divided into three groups based on their clinical presentation: 38 had an asymptomatic form, 20 had dyspeptic symptoms, and 13 had pain. All participants underwent a series of lab and imaging tests. Tre results of the study. A reliable relationship was found between sex and age and the clinical presentation of gallstone disease. Dyspeptic symptoms were found in both sexes in younger children and were often accompanied by pancreatic abnormalities and Helicobacter pylori infection. Painful symptoms were more common in adolescent girls and were characterized by significant changes in the esophagus, including erosive esophagitis. The asymptomatic form of gallstone disease is common in male adolescents and is associated with irregularities in the shape of the gallbladder. Conclusion. The findings emphasize the significance of considering gender and age when assessing the clinical course of gallstone disease in children, and they confirm the necessity for personalized monitoring and diagnosis.

This article examines the influence of the secretory and humoral activity of the major salivary glands on the pathogenesis of experimental periodontitis in rats with induced hyposalivation. Saliva, with its immune and cleansing properties, serves as a key factor in protecting periodontal tissues. Decreased saliva secretion (hyposalivation) is considered a significant risk factor; however, the complex impact of this condition on the pathogenesis of periodontitis requires further study. Aim: The aim of this study was to examine the role of the secretory and humoral activity of the major salivary glands in the pathogenesis of experimental periodontitis in rats with induced hyposalivation. Materials and methods: The experiment was performed on 35 Wistar rats divided into 7 groups. Hyposalivation was induced by daily subcutaneous injections of atropine sulfate at a dose of 2 mg/kg for 30 days. Periodontitis was induced by subperiosteal ligation. Morphological, biochemical, and immune changes in the salivary glands and gums were studied. Statistical data processing was performed using one-way analysis of variance (ANOVA) with Tukey's post-hoc test. Results: In the hyposalivation groups, a 55–65 % decrease in salivary gland weight and a 50 % decrease in IgA secretion were recorded. Concurrently, an increase in biochemical markers of inflammation and oxidative stress was noted: malondialdehyde (MDA) levels increased by 70–80 %, and tumor necrosis factor-alpha (TNF-α) concentrations increased by 60 %. In the combined models, worsening signs of periodontitis were observed, including increased neutrophil infiltration and destruction of the dental ligament apparatus. These changes were significant compared to the control group (p 0.05). Conclusion: It has been established that hyposalivation contributes to the progression of periodontitis by disrupting the protective functions of saliva and activating inflammatory mechanisms. This is associated with a weakening of local immunity (decreased IgA) and activation of systemic inflammation (increased TNF-α and MDA). The results confirm the key role of the salivary glands in maintaining periodontal health and indicate the need to develop strategies for correcting xerostomia to prevent periodontitis.

Relevance: The importance of this study is determined by the absence of a unified pathogenetic concept and the abundance of conflicting data regarding the nature of bladder pain syndrome/interstitial cystitis, which significantly complicates the selection of therapy for this patient population.Objective: To analyze and systematize current data on the key pathogenetic mechanisms underlying the development of bladder pain syndrome/interstitial cystitis in order to establish a comprehensive understanding of the disease, which forms the basis for the future development of targeted therapeutic strategies.Materials and methods: A search and analysis of the scientific literature was performed using PubMed, the Cochrane Library, and Elibrary. More than 40 references were selected for the review.Conclusion: Bladder pain syndrome/interstitial cystitis is a heterogeneous disorder with a complex, multifactorial pathogenesis, in which the following interrelated mechanisms play a key role: urothelial barrier damage, chronic (including neurogenic) inflammation, autoimmune responses, oxidative stress, detrusor hypoxia, and urinary microbiota dysbiosis. Numerous studies indicate that none of these mechanisms alone can fully explain the complex clinical presentation of the disease. This underscores the need to move away from monotherapy in favor of a comprehensive treatment approach simultaneously aimed at restoring urothelial barrier function, suppressing chronic inflammation, improving blood supply to the detrusor and submucosal layers of the urothelium, alleviating neurogenic pain, and correcting associated systemic disturbances. Future therapeutic prospects are associated with the development of precision methods targeting the specific pathogenetic mechanisms identified in individual patients.