Aim: to establish reference characteristics of blood flow in the retrobulbar vessels and angular artery of the eye based on ultrasound Doppler imaging data in healthy people. Material and methods. A study of the retrobulbar vessels in a group of healthy volunteers was performed. Thirty-six subjects (36 pairs of eyes) were examined. Blood flow parameters were measured in the ophthalmic artery (OA), central retinal artery (CRA), short posterior ciliary arteries (PCA) on the temporal side, angular artery (AngA), and central retinal vein (CRV). The following parameters were obtained: peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), resistance index (RI), maximum average weighted blood flow velocity in one cycle (TAMAX), pulsatility index (PI), and systolic acceleration time (AccT). For CRV, maximum and minimum blood flow velocities (Vmax and Vmin) were determined instead of PSV and EDV. Results. During ultrasound Doppler imaging, the blood flow characteristics (M ± σ) in the studied vessels were as follows: for OA PSV, 23.7 ± 7.0 cm/s; EDV, 6.3 ± 2.9 cm/s; RI, 0.73 ± 0.09; TAMAX, 11.1 ± 4.0 cm/s; PI, 1.63 ± 0.53; AccT, 0.055 ± 0.008 s; for CRA PSV, 10.3 ± 2.9 cm/s; EDV, 2.5 ± 1.2 cm/s; RI, 0.76 ± 0.08; TAMAX, 4.9 ± 1.6 cm/s; PI, 1.64 ± 0.48; AccT, 0.054 ± 0.008 s; for CRV Vmax, 4.5 ± 1.8 cm/s; Vmin, 2.5 ± 1.2 cm/s; RI, 0.45 ± 0.11; for PCA: PSV, 13.3 ± 5.7 cm/s; EDV, 4.0 ± 2.5 cm/s; RI, 0.70 ± 0.10, TAMAX, 7.3 ± 3.7 cm/s; PI, 1.30 ± 0.34; AccT, 0.056 ± 0.007 s; for AngA: PSV, 17.2 ± 5.8 cm/s; EDV, 4.6 ± 2.0 cm/s; RI, 0.73 ± 0.09; TAMAX, 7.8 ± 2.9 cm/s; PI, 1.71 ± 0.60; AccT, 0.055 ± 0.007 s. Conclusion. The combined use of spectral and numerical characteristics has the potential to improve diagnostic accuracy, thereby enhancing the method’s informative value. Reference parameters for AngA blood flow are presented.
Despite the functioning of a multi-stage medical selection system and continuous aeromedical monitoring, diseases of the cardiovascular system remain the leading cause of occupational disqualification among aviation specialists. Contemporary studies indicate that the formation of cardiovascular risk in pilots and air traffic controllers is associated with a complex interaction between universal metabolic risk factors and specific occupational conditions, including shift work, circadian rhythm disruption, chronic stress, and forced physical inactivity. The aim of this study was to analyze current scientific data on modifiable risk factors for circulatory system diseases in aviation and to assess the prospects for their preventive correction. The study was conducted as an analytical review of contemporary scientific literature. The search for sources was performed in the international databases PubMed/MEDLINE, Scopus, Web of Science, and the national database eLIBRARY.RU for the period of 2010–2025, with additional inclusion of key earlier methodological publications. The analysis included epidemiological, cohort, and clinical-metabolic studies containing quantitative estimates of associations between risk factors and cardiovascular diseases. The literature analysis demonstrated that the structure of cardiovascular risk in aviation specialists largely corresponds to patterns observed in the general population and is primarily determined by classical modifiable risk factors, including arterial hypertension, dyslipidemia, obesity, disorders of carbohydrate metabolism, and smoking. At the same time, occupational conditions, e.g. work in shifts, circadian rhythm disruption, chronic stress, and physical inactivity, act as additional modifying influences that intensify metabolic dysregulation and contribute to the development of insulin resistance, visceral obesity, and subclinical atherosclerosis. The synthesis of data on the mechanisms of circadian disruption, metabolic abnormalities, and early vascular changes allowed the authors to propose an integrative model of the pathogenetic continuum of cardiometabolic risk formation in aviation specialists. Within this model, the sequence of metabolic and structural alterations was systematized, and key diagnostic markers were identified with reference to different age stages of professional activity. The proposed scheme reflects the staged development of cardiovascular pathology and highlights a "therapeutic window" for early preventive intervention. This approach may serve as a theoretical basis for the development of screening algorithms and preventive management strategies for cardiometabolic risk in aviation medicine.
Aim: to evaluate the role of HGF, CEA, IL-8, and prolactin in progression of colorectal cancer, their diagnostic potential, and as therapeutic targets. Material and methods. In this cross-sectional study, Luminex xMAP 200 was used to determine serum cytokine profiles in 91 CRC stages I–IV patients and 100 healthy controls, identifying diagnostic indicators. Mann-Whitney U and Kruskal-Wallis H tests were used to compare groups; heatmap and receiver operating characteristic (ROC) were used to analyze cytokine-CRC relationships. Results. Significant variations in prolactin (p = 0.004), hepatocyte growth factor (HGF) (p = 0.01), interleukin-8 (IL-8) (p = 0.01), and carcinoembryonic antigen (CEA) (p = 0.01) indicated that the inflammatory milieu was favorable for malignancies. There was a substantial correlation between CEA and CRC staging. For HGF (AUC = 0.780), CEA (AUC = 0.733), IL-8 (AUC = 0.729), and prolactin (AUC = 0.708), ROC analysis demonstrated good diagnostic performance. The findings suggest that a systemic inflammatory environment is encouraging angiogenesis and tumor formation. The study has highlighted potential diagnostic indicators for CRC. Conclusion. HGF, IL-8, CEA, and prolactin are potential diagnostic markers linked to colorectal cancer progression and staging in patients who may benefit from serum HGF, IL-8, CEA, and prolactin monitoring and the therapeutic target of their genes.
Aim: to conduct a comparative analysis of primary breast cancer (BC) incidence dynamics (2015–2024) across the Tomsk Region, the Siberian Federal District (SFD), and the Russian Federation (RF), and to develop a medium-term, evidence-based forecast for the Tomsk Region. Material and methods. A retrospective analysis of federal statistical data was performed. Absolute numbers, crude, and age-standardized incidence rates were calculated and compared. Trends were analyzed using descriptive statistics. To create a medium-term forecast for the Tomsk Region, an extended time series (2007–2024) was utilized. A linear regression model was selected and validated, with its accuracy confirmed by standard statistical criteria (R², RMSE, AIC). Results. A steady nationwide increase in BC incidence was observed (26.8% in absolute numbers). The growth accelerated in 2020–2024, being more intensive in the SFD and Tomsk Region (34.4% and 40.7%, respectively) compared to the RF. While age-standardized rates increased significantly in the SFD (19.9%) and RF (17.1%), the 10-year increase in the Tomsk Region (13.5%) was not statistically significant. The analysis focused on the female population, as male incidence showed no significant trend. The predictive model forecasts a rise in the age-standardized incidence rate in the Tomsk Region to 76.4 per 100.000 population by 2029 (95% CI: 64.1–88.6). Conclusion. The study confirms a consistent upward trend in BC incidence with distinct regional variations. The forecast for the Tomsk Region underscores the necessity of enhancing screening programs and adapting regional oncology services to manage the projected increase in patient load effectively.
Aim: to develop, implement, and evaluate the effectiveness of a differentiated approach to the treatment and rehabilitation of children with GP, based on the assessment of intra-abdominal hypertension (IAH) and the abdominal cavity index (ACI) according to V.S. Saveliev, concerning the incidence of long-term complications and QoL indicators. Material and methods. A single-center interventional non-randomized retrospective-prospective controlled study was conducted. The analysis included 339 patients aged 1-14 years with GP (2006-2022). Patients were divided into a differentiated approach group (DG, n = 237) and a standard therapy group (SG, n = 102). The differentiated approach included: 1) stratification by the degree of intra-abdominal hypertension (IAH) and the intraoperative abdominal cavity index (ACI) to choose the surgical access (laparoscopy/laparotomy); 2) infusion therapy with succinate (Reamberin®); 3) a multi-stage outpatient rehabilitation program aimed at preventing adhesive disease and the development of vascular endothelial damage. QoL assessment using the SF-36 questionnaire was performed in 69 patients 5-7 years after treatment. The carotid and femoral artery intima-media thickness (IMT) was also assessed in the long-term period. Results. The application of the differentiated approach led to a significant reduction in the rate of postoperative complications according to Clavien-Dindo (8.8% in DG vs. 46.0% in SG, p 0.001). In the long-term period (1-5 years), ‘good’ results were recorded in 64.2% of DG patients versus 23.0% in SG (p 0.001). Unlike in SG, the IMT in DG patients 5-7 years later corresponded to the age norm. DG patients demonstrated statistically significantly higher scores across all domains of the SF-36 questionnaire, particularly in Physical Functioning (90 vs. 75, p 0.001), Bodily Pain (84 vs. 62, p 0.001), and Vitality (75 vs. 60, p 0.001). Conclusion. A differentiated approach to the treatment and rehabilitation of children with GP, based on monitoring IAH and ACI, not only improves immediate surgical outcomes but also significantly reduces the risk of long-term adhesive and vascular complications, leading to a meaningful increase in long-term quality of life. Integration of this algorithm into clinical guidelines seems warranted.
Aim: to assess and compare anthropometric growth data of boys from the indigenous small-numbered peoples of the North and the newcomer population of the Middle Ob region. Material and methods. Anthropometric measurements of body length/height were taken from boys of two population groups: representatives of the indigenous small-numbered Khanty people and children from newcomer families (of European origin who have lived in the region for 2–3 generations). The total sample size analyzed comprised 20,051 males aged 0 to 17 years. Results. During the infancy period, at birth and throughout the first year of life, no significant interpopulation differences in body length were observed. From 21 months onwards, the differences become statistically significant, reaching a gap of 5 cm by 33 months. In the newcomer group, annual growth rates remained higher, whereas in the Khanty group they gradually declined. At the age of 3–7 years, the height gap increases from 5.6 cm to 7.7 cm. At 8–12 years, interpopulation differences are maximal: the gap grows from 8.2 cm at 8 years to 14.5 cm at 12 years. In adolescence and youth, the difference remains significant and equals 10.3 cm at 17 years. Thus, from 21 months up to 17 years, boys from the newcomer population are consistently taller than their peers from the indigenous small-numbered peoples of the North. Conclusion. Stable differences were revealed in boys from the newcomer population compared to the indigenous small-numbered population. The interpopulation height gap forms as early as the second year of life and tends to increase. The maximum absolute difference is reached during the period of second childhood and puberty and decreases by the age of 17 years. The identified differences may be the result of a complex interaction between ethnogenetic adaptations and environmental factors.
Background. Endometrial cancer is a common oncological disease of the female reproductive system. Treatment is based on a comprehensive analysis of FIGO staging, degree of differentiation, invasion, and molecular genetic profile of the tumor. Aim: comparative analysis of the metabolic characteristics of the primary tumor based on PET/CT results with [18F]FDG and key prognostic factors of endometrial cancer according to morphological and immunohistochemical studies. Material and methods. A retrospective analysis of 34 patients with morphologically verified endometrial cancer who underwent PET/CT prior to surgical treatment with [18F]FDG. The relationship between the quantitative metabolic characteristics of the primary tumor: the standardized accumulation level (SUVmax), the metabolic volume of the tumor (MTV) and the total glycolytic index (TLG) of the primary tumor with the histological type, degree of differentiation (Grade), the depth of invasion into the myometrium, the presence of lymphovascular invasion and damage to the lymph nodes was investigated. Results. A statistically significant strong positive correlation was found between SUVmax and the degree of neoplasm anaplasia (ρ = 0.68, p 0.001). The SUVmax values significantly differed between the Grade groups: Grade 1, 7.25, Grade 2, 7.22 and Grade 3, 12.80 (p 0.001). Non-endometrioid histological types and the presence of LVI were also associated with higher values of SUVmax, MTV, and TLG. A moderate positive correlation of SUVmax with the depth of tumor invasion into the myometrium was found (ρ = 0.58, p = 0.001). Conclusion: quantitative metabolic characteristics of the primary tumor obtained by PET/CT scans with [18F]FDG can be used for predictive risk stratification as part of a personalized approach to endometrial cancer treatment, as they are closely related to the main histopathological prognostic factors of biological tumor aggressiveness.
Background. In modern gastric cancer surgery, the assessment of quality of life (QoL) through Patient-Reported Outcomes (PRO) is becoming a key criterion for treatment effectiveness. Of particular interest is the differentiated assessment of the impact of surgical access and reconstruction technique on the dynamics of various aspects of QoL in the postoperative period. Aim: to conduct a comparative analysis of the dynamics of QoL, functional, and oncological outcomes after laparoscopic and open extended gastrectomy, with special attention to the recovery timeline of specific parameters depending on the surgical technique. Material and methods. This prospective comparative study included patients who underwent laparoscopic extended gastrectomy (LEG, n = 63) with an original intracorporeal anastomosis technique and open extended gastrectomy (OEG, n = 114) for gastric adenocarcinoma. Intra- and postoperative parameters, complications (Clavien – Dindo), post-gastrectomy syndromes, nutritional status, and survival were assessed. Quality of life was evaluated using a set of PRO instruments (EORTC QLQ-C30, QLQ-STO22, SF-36) preoperatively and at 1, 3 and 6 months after surgery. Results. The groups were comparable in baseline characteristics. The LEG group had a longer operation time (185 ± 45 vs. 173 ± 55 min, p = 0.032), lower blood loss (55 ± 45 vs. 160 ± 55 ml, p = 0.007), and a shorter postoperative hospital stay (9.5 ± 3.2 vs. 12.3 ± 4.1 days, p 0.001). The rate of complications ≥ IIIa was comparable (6.9% vs. 11%, p = 0.335), and 30-day mortality was similar between the groups (1.7% vs. 2%, p = 0.892). The most pronounced differences in QoL dynamics between the groups were chronological. As early as 1 month post-surgery, the LEG group showed significantly better scores on global health and physical functioning scales (EORTC QLQ-C30), as well as less pronounced symptoms of pain, nausea/vomiting, and fatigue (p 0.01). By the 3rd month, these differences remained significant for almost all main functional scales and symptoms of the general questionnaire. However, the maximum and statistically most significant differences by the 6th postoperative month were formed specifically in the spectrum of specific symptoms assessed by the QLQ-STO22 module (dysphagia, reflux, eating restrictions), as well as in nutritional status indicators (p 0.001). SF-36 data confirmed a faster recovery of the physical component of health in the first 3 months after LEG. At 6 months, the LEG group showed a statistically significant reduction in the frequency and severity of post-gastrectomy syndromes (5 patients (8.6%) vs. 28 patients (27.9%), p = 0.014), which directly correlated with better QLQ-STO22 scores and nutritional status. 24-month overall (83.7% vs. 79.2%, p = 0.41) and relapse-free (75.8% vs. 71.5%, p = 0.49) survival rates showed no significant differences. Conclusion. Laparoscopic extended gastrectomy with an original anastomosis technique provides a clinically significant improvement in QoL, characterized by a two-phase dynamic: an initial rapid reduction in postoperative symptoms associated with less traumatic access is followed by a more pronounced long-term advantage in nutritional status and reduction of specific gastrointestinal symptoms, which is due to the reconstruction technique. The obtained data emphasize the importance of assessing QoL at different time points and substantiate the advantages of the minimally invasive approach and improved reconstruction technique for comprehensive patient recovery.
Aim: to evaluate the antitumor effect of ionizing radiation on non-transfected and transfected (with NEK2 gene knockdown) prostate cancer cell lines by analyzing their viability in vitro. Material and methods. The study was performed using human prostate cancer cell lines PC-3 and DU145, as well as a primary culture of tumor cells (PCa-PC) obtained from a patient with acinar prostate adenocarcinoma (Gleason score 7: 4+3). NEK2 gene knockdown was achieved by RNA interference using miRNA. Irradiation was carried out using a Theratron Equinox unit as a single dose of 6 Gy 48 h after transfection. Cell viability was assessed 24 h later by trypan blue staining. Results were expressed as percentages (M ± SD). Radiosensitization was evaluated using the enhancement index (EI). Statistical analysis was performed using two-way analysis of variance (ANOVA) with Holm correction; a p 0.05 was considered statistically significant. Results. Irradiation without NEK2 knockdown caused a moderate decrease in cell viability in PC-3 and PCa-PC cells, whereas no statistically significant effect was observed in the DU145 cell line. NEK2 knockdown alone resulted in a pronounced reduction in cell viability in all studied cell lines (p 0.0001). Combined treatment with ionizing radiation and NEK2 knockdown produced the maximum cytotoxic effect, reducing cell viability by more than threefold compared with control. EI values exceeded 1 and ranged from 2.5 to 3.7 depending on the cell line. Conclusion. Suppression of NEK2 gene expression significantly reduces the viability of prostate cancer cells and increases their radiosensitivity, suggesting NEK2 as a promising molecular target for radiosensitization. The obtained results require further validation in in vivo models.
We present a case of a 62-year-old patient with chronic, recurrent, total ulcerative colitis resistant to hormonal therapy, with a 14-year disease history at first presentation. On December 19, 2024, the patient underwent laparoscopic colectomy, lasting 300 minutes with 150 ml blood loss, and was discharged on postoperative day 7. The early postoperative course was complicated by adhesive obstruction, resolved conservatively. Despite subsequent local therapy aimed at rectal stump remission, inflammation persisted, and the patient declined ileoanal reservoir formation. On December 4, 2025, laparoscopic rectal excision was performed, including reconstruction of the ileostomy. The procedure lasted 170 minutes, with 30 ml blood loss. The patient was discharged on postoperative day 5. This report illustrates the practical application of a staged surgical approach in ulcerative colitis, emphasizing individualized treatment decisions based on disease severity, response to therapy, and patient preference, as well as management of potential complications related to ileostomy.
Aim: to evaluate the dynamics of changes in the anatomy and topography of neck organs and structures after thyroidectomy in the late postoperative period. Material and methods. An analysis of topographic and anatomical changes in neck organs and structures was conducted in patients with compression syndrome due to thyroid pathology before and after thyroidectomy. Magnetic resonance imaging data were used before surgery and two, six, twelve and twenty-four months after surgery to measure the following parameters: the size of the esophagus, trachea, common carotid arteries, and internal jugular veins; and the degree of displacement of neck organs and structures. Results. Analysis of preoperative magnetic resonance imaging data revealed transverse laryngeal dispositions in 46% of cases. The trachea was subject to similar displacements. In patients with autoimmune thyroiditis, the esophagus acquired a spherical shape with a median anteroposterior size of 0.97 cm (0.72; 1.2), transverse, 0.67 cm (0.55; 0.81). Before the operation, the vascular-nerve bundles were displaced posteriorly and laterally. The median parameters of these dispositions on the right were 2.0 cm (1.89; 2.7) and 1.4 cm (1.12; 1.61), on the left, 1.88 cm (1.52; 2.0) and 1.29 cm (1.2; 1.67). In the postoperative period, in patients with multinodular colloid goiter, the esophagus was dislocated to the left. In the first year of the postoperative period, the vascular-nerve bundles in this category of patients were displaced anteriorly and medially. Twenty-four months after the operation, the right common carotid artery was displaced anteriorly and medially; the right internal jugular vein was located parallel to the arterial trunk; the left common carotid artery was displaced anteriorly and slightly laterally, and the left internal jugular vein was located to the left of it. After thyroidectomy in patients with autoimmune thyroiditis, the larynx took a median position after two months and maintained this position twenty-four months after the operation. The trachea was displaced toward the midline of the neck and anteriorly. The median disposition medially was 1.6 cm (1.5; 1.73), anteriorly, 1.17 cm (0.9; 1.22) by the twelfth month of the postoperative period, 1.89 cm (1.74; 2.1) and 1.56 cm (1.46; 1.7), respectively, by the twenty-fourth month. The esophagus was slightly dislocated to the left. The common carotid arteries were displaced anteriorly, and the internal jugular veins were displaced anteriorly and laterally. Two years after the procedure, the venous vessels were parallel to the trachea, and the common carotid arteries were displaced posteriorly.
In the structure of peripheral nervous system disorders, tunnel neuropathies account for about a quarter of all cases, among which cubital tunnel syndrome (CTS) holds one of the leading positions. A high prevalence of CTS is noted among individuals of working age with occupational risk factors (repeated flexion/extension, vibration, prolonged pressure on the elbows). This review summarizes epidemiological data and occupational risk factors, anatomical features of the cubital tunnel and biomechanics of the elbow joint that contribute to ulnar nerve compression and the development of CTS, as well as their role in the formation of the "compression–ischemia–edema" pathophysiological changes leading to subsequent demyelination and axonal damage of the ulnar nerve. Management strategies for patients with CTS are discussed: early severity stratification, timely surgical decompression (the benchmark is the first 4–6 months for moderate/severe cases), correction of risk factors, and rehabilitation to improve treatment outcomes.
Aim: to analyze the results of applying a new approach to the prehabilitation of patients with total knee arthroplasty (TKA). Material and methods. The study included 33 patients with knee osteoarthritis of stages III–IV according to the classification of Kellgren Lawrence. 4 weeks before the operation, the patients underwent a comprehensive examination, which included a clinical examination, scales (WOMAC, KOOS, VAS), motor tests (2MWT, TUG) and electroneuromyography (ENMG) of the quadriceps, biceps femoris and calf muscles. Based on the identified leading OA syndrome, patients were stratified into three subgroups depending on the verified phenotype (chronic pain, inflammatory, and biomechanical disorders). Results. An analysis of the results 72 hours before surgery and 72 hours, 4 and 12 weeks after TKA, showed that in the preoperative period, patients achieved statistically significant improvements in the form of a decrease in WOMAC scores to 38.0 (37.0; 39.0), a decrease in VAS pain to 6.0 (5.0; 6.0) points and an increase in motor activity of the examined muscles. In the postoperative period, at a follow-up period of 12 weeks after TKA, a full-fledged clinical and functional recovery was noted, confirmed by the results of the WOMAC, VAS, and 2MWT questionnaire scales: 15.0 (14.0; 17.0) points, 1.0 (0.0; 1.0) points, 154.06 ± 11.73 meters, respectively. Conclusion. The developed approach to prehabilitation provides a significant improvement in the clinical and functional condition of patients both in the pre- and postoperative periods during knee replacement.
Aim: to study the effect of body weight on the dynamics of anthropometric indicators, somatotype, and morphofunctional condition of the feet in six-year-old children. Material and methods. 262 6-year-old children (123 girls, 139 boys) were examined, divided into groups normal with normal (NBW) and excessive (EBW) body weight. Anthropometry was performed with the calculation of indices (Verveck, Pinier, Brugsch), the skinfold thickness (SFT) was assessed using caliperometry, and computer plantography of the feet was performed. Statistical analysis was conducted in SPSS version 26.0. Data are presented as medians with interquartile ranges (Q1; Q3), and group differences were evaluated at p 0,05. Results. Statistically significant differences (p 0.001) were found between the NBW and EBW groups in all anthropometric parameters. The calculated indices showed the predominance of meso- and brachymorphic traits in children with excessive body weight and a stronger physique, respectively. Skinfold thickness was markedly higher in the EBW group across all measured sites (p 0.001). A plantographic study showed that in children with normal weight, foot flattening is accompanied by an increase in its width in the middle and heel regions (p 0.01). In the EBW group, the foot width was initially higher, and with flattening, the foot length increased significantly in boys (p 0.001). At the same time, the width in the heel area did not change statistically significantly with arch flattening (p 0.05) in the EBW group, remaining wider both in the normal state and with flattening. Conclusion. The results of the study confirm the systemic effect of overweight on anthropometric parameters, somatotype and morphofunctional state of feet in children aged six years. The presence of a pronounced plantar fat cushion in children with EBW distorts the plantographic picture, creating a “masking effect” and requiring a differentiated approach to diagnosis.
Aim: to evaluate the nature of ultrasound changes in some structures of the knee joints among patients seeking outpatient medical care. Using the example of a clinical case to demonstrate the importance of differential diagnosis of diseases of the knee joints with vascular pathology of the lower extremities. Material and methods. 380 volunteers aged 18 to 86 years were examined. SonoAce R7 diagnostic equipment was used. The results were entered into spreadsheets, followed by grouping and statistical analysis using MS Excel, IBM SPSS Statistics 20, and plotting distribution using StatSoft Statistica 10. Results. The average age of the participants diagnosed with Baker’s cysts was 57.9±9.1 years: 56.5±8.5 years for men and 58.3±9.2 years for women. The signs of osteoarthritis, including sharpened articular surface edges and prominent osteophytes, were detected in 67.3% (256) of cases. These manifestations were detected in 56.1% of men and 75.9% of women. Synovitis was observed in 22.1% (84) cases, 24.4% for men and 20.4% for women. Baker’s cysts were diagnosed in 23.7% (90) cases, 12.2% for men and 32.4% for women. Similar dynamics in the development of structural changes in the knee joints were noted, regardless of the patient’s gender. Conclusion. Determining the etiology of pathological changes and assessing their role in the development of associated symptoms and potential complications allows for more effective diagnosis and treatment, as well as the selection of optimal patient management strategies.
Splenic abscess as an independent disease accounts for no more than 1% of all acute surgical diseases of the organs of the abdomen. Diagnosis of splenic abscess is complex and ineffective without the use of instrumental methods, among which ultrasound and CT are of primary importance. Up to 30% of splenic abscesses are cured with conservative treatment. Surgical treatment methods include both modern minimally invasive and traditional open surgical interventions. Mortality from splenic abscess remains high, up to 50%. This article presents a clinical case of splenic abscess in an elderly patient, likely of embolic origin that developed due to atrial fibrillation. The article justifies the abandonment of minimally invasive and organ-preserving treatment methods in favor of splenectomy via a laparotomy approach.
Aim: to identify patterns of lung cancer incidence in the population of the Republic of Tatarstan and its dependence on air pollution and the cyclicity of solar activity. Material and methods. The following data were used as initial data: data on lung cancer incidence available in the cancer registry of the Republican Clinical Oncology Dispensary of the Ministry of Health of the Republic of Tatarstan for the period from 2012 to 2021; data on emissions into the atmosphere and concentrations of carcinogens in the atmospheric air, available in the State reports “On the state of the natural environment of the Republic of Tatarstan” of the Ministry of Ecology and Natural Environment of the Republic of Tatarstan. Results. The study demonstrated a high degree of correlation between the comprehensive index of air pollution with carcinogens (IAPc) and the incidence of lung cancer in the population (r=0.79 at the level of α=0.05). To identify the relationship between the solar activity and the incidence of lung cancer, a statistical analysis of the long-term incidence rate of the population and the level of solar activity was carried out using the relative number of sunspots (Wolf number, W). The correlation factor between W and the incidence of lung cancer is significant at α=0.05, the value being r=0.72, which indicates a noticeable strength of the relationship between the studied indicators. Conclusion. Improving the monitoring system, monitoring the state of the external environment, and measures to prevent air pollution will help reduce the incidence of cancer, including lung cancer.
Background. Preoperative examination of affected regional and distant lymph nodes is an important prognostic criterion when choosing treatment strategies for gastric cancer. In clinical practice, computed tomography (CT) with intravenous contrast is used to determine lymph node metastases, supplemented in controversial situations by positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG). In cases of inconclusive CT and PET/CT scan results, morphological verification of the retroperitoneal lymph nodes is required using minimally invasive techniques: core biopsy and/or laparoscopy with retroperitoneal lymphadenectomy. Aim: to evaluate the informative value and safety of laparoscopic retroperitoneal lymphadenectomy for the evaluation of retroperitoneal lymph nodes suspected of gastric cancer metastases. Material and methods. A total of 482 patients diagnosed with gastric and/or cardioesophageal junction cancer type II-III according to the Siewert classification were analyzed. They were treated at the Blokhin National Medical Research Center of Oncology from 2019 to 2023. If CT revealed retroperitoneal lymph nodes suspicious for metastases, 18F-FDG PET/CT was performed. If PET/CT data clearly showed metastasis, the patient was considered inoperable (M1). If PET/CT data revealed intact retroperitoneal lymph nodes, their morphological verification was not performed. In cases of questionable metabolic changes in the retroperitoneal lymph nodes, a decision was made to morphologically verify them using core biopsy under ultrasound or CT navigation. If core biopsy was not technically feasible, laparoscopy with retroperitoneal lymphadenectomy was performed. Results. CT scans revealed retroperitoneal lymph nodes suspicious for metastases in 19/482 (3.9%) patients. 18F-FDG PET/CT scanning revealed foci of pathological radiopharmaceutical accumulation in retroperitoneal lymph nodes (M1) in 5/19 (26.3%) patients; metabolic and structural changes in the retroperitoneal lymph nodes were not detected in 6/19 (31.6%) patients. Questionable metabolic changes in the retroperitoneal lymph nodes were detected in 8/19 (52.6%) patients: core biopsy with ultrasound or CT navigation was performed in 3 (15.8%) patients, and biopsy was technically unfeasible in 5 patients. In one patient (5.3%), gastric cancer metastasis was confirmed by ultrasound-guided biopsy, and in two patients (10.5%), gastric cancer metastases were verified by retroperitoneal lymphadenectomy. No complications were recorded during core biopsy or retroperitoneal lymphadenectomy. Conclusion. Laparoscopic retroperitoneal lymphadenectomy is an informative and safe minimally invasive method for morphological verification of retroperitoneal lymph nodes suspected of containing gastric cancer metastases.
Aim: to provide an anatomical description of the labyrinth and cock crest of the ethmoid bone in humans in the first period of adulthood based on computed tomography data. Material and methods. The object of the study was 60 computed tomograms of the skull of people in the first period of mature age (22-35 years old - men, 21-35 years old - women), of different sexes, without pathology of the paranasal sinuses. Results. In the first period of mature age, the value of the anteroposterior size of the labyrinth of the ethmoid bone on the right was 36.39±4.25 mm, on the left, 36.04±4.44 mm, with a range of values from 28.30 to 46.61 mm. The anteroposterior size of the ethmoid labyrinth on the right and left was 1.4 times greater than the height and 3 times greater than the width. The height of the ethmoid labyrinth in females on the right and left was 26.72±3.29 mm and 27.32±3.39 mm, respectively, and was significantly greater than this indicator in males. The height and anteroposterior size of the cock crest in the studied group were equal, amounting to 13.98±3.76 mm and 13.39±2.63 mm, respectively, and were 3 times greater than its width. In 25%, a pneumatized middle nasal concha was observed, and in 21%, a pneumatized cock crest. Conclusion. The anatomical characteristics of the ethmoid bone, as an element of the nasal cavity, paranasal sinuses, internal base of the skull, and orbit, are of great importance for choosing the optimal surgical approach, in particular in endoscopic endonasal intervention.
Aim: to determine age and gender patterns of morphometric parameters of the pancreas of children and adolescents based on intravital imaging data. Material and methods. Abdominal CT scans of 88 children and adolescents with no visible abdominal pathology were analyzed. Subjects were divided into four age groups: early childhood, early childhood, and late childhood, as well as adolescence. The study was performed using 16-slice CT scanners, determining the length, thickness, height, and volume of the head, body, and tail of the pancreas. The obtained data were processed using standard methods of variation statistics. Results. It was found that among all those examined, the body of the pancreas had the greatest length of 4.22 (3.74; 4.89) cm, the length of the head was 3.14 (2.76; 3.79) cm, and the length of the tail was 2.87 (2.60; 3.36) cm. The thickness of the head, body and tail was 2.14 (1.90; 2.44) cm, 1.99 (1.82; 2.29) cm and 1.59 (1.36; 1.80) cm, respectively, and the height was 3.72 (3.24; 4.20) cm, 2.34 (1.96; 2.78) cm and 1.91 (1.74; 2.25) cm. A significant age-related increase in the length, thickness, height, and volume of each pancreatic section was determined from early childhood to adolescence. No significant gender differences were found between the parameters of girls and boys in the same age group for any parameter. Conclusion. Using the computed tomography method, data were obtained on the intravital morphometry of the pancreas of children and adolescents. The obtained information will allow us to expand our understanding of the intravital anatomy of the pancreas in age and gender aspects and can be used in planning surgical interventions on the pancreas.
