The article examines the phaleristic heritage of Pavlov First Saint Petersburg State Medical University. It introduces into scholarly circulation a collection of awards, medals, and commemorative badges reflecting the history of the institution from the late nineteenth century to the present day. The study considers the “Woman Physician” badge of 1880, academic badges awarded to graduates, faculty and departmental awards, anniversary and graduation badges, as well as badges associated with student scientific societies, sports organizations, and medical teams. Particular attention is paid to changes in the university’s award symbolism during the post-Soviet period and to the development of its own system of honorary medals commemorating prominent scientists and founders of scientific schools. Phaleristic objects are examined not only as museum exhibits, but also as sources for studying the university’s symbolism, corporate traditions, and mechanisms of collective memory formation.

Long-term non-healing wounds do not pose an immediate threat to patients’ lives, but they can serve as entry points for infection, potentially leading to septic conditions and, consequently, a possible fatal outcome. Although this problem is not new, there is currently no adequately effective and minimally invasive treatment available. The aim of this literature review was to analyze scientific publications using the PubMed, Google Scholar, and eLIBRARY databases for the period 2020–2025, focusing on systematic reviews and meta-analyses to assess the prospects of using PRP therapy as a combined approach in treating long-term non-healing wounds, particularly pressure ulcer defects. The analysis revealed that the topic is globally relevant, as up-to-date meta-analyses have been published over the past five years, mostly in foreign sources. According to the analyzed literature, PRP is effective and safe and can be considered a potential therapeutic agent. The obtained data undoubtedly provide promising prospects for future research in this area of cellular regenerative medicine.

Introduction. Currently, acoustic voice analysis in cases of vocal apparatus damage is being actively integrated into clinical practice as a novel diagnostic method. However, data on its effectiveness are not always unambiguous. There remains a lack of sufficient data regarding the analysis of speech biomarker changes across various pathologies.

The objective was to determine the potential use of acoustic analysis parameters of the speech signal in diagnosing diseases associated with involvement of the vocal apparatus.

Methods and materials. The information search was conducted in accordance with PRISMA guidelines in the following databases: PubMed, Google Scholar, Clinical Trials, CyberLeninka, and eLibrary. A total of 3 publications were selected for the final full-text analysis. These studies evaluated speech signal parameters in cases of organic and functional diseases of the vocal cords and thyroid dysfunction. The meta-analysis examined Jitter and Shimmer in pathological conditions compared to healthy volunteers.

Results. The meta-analysis assessing the diagnostic potential of diseases accompanied by organic or functional damage to the vocal cords included 3 studies encompassing 180 patients and 194 healthy volunteers. The results of the meta-analysis demonstrated that both Jitter and Shimmer values in patients with vocal cord lesions were statistically significantly higher compared to healthy individuals (p=0.002).

Conclusion. This systematic review and meta-analysis of studies have demonstrated that the application of acoustic voice analysis is feasible in diagnosing diseases associated with vocal apparatus damage.

Introduction. The study of modifiable cardiometabolic risk factors (CMRFs) influencing the clinical phenotype of hypertrophic cardiomyopathy (HCM) is currently relevant. It is known that modifier genes can affect the course and progression of symptoms in HCM. At the same time, the analysis of associations between single nucleotide variants of the interleukin-6 receptor gene (IL6R) and the specifics of the clinical course of HCM remains a poorly studied area.

The objective was to investigate the associations of the SNP rs2228145 of the IL6R gene with HCM, the presence of arterial hypertension (AH) in patients with HCM, age at diagnosis and serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6).

Methods and materials. The analysis of the SNP rs2228145 of the IL6R gene was conducted in 218 adult patients with HCM aged >18 years (median 53 [35.3; 64] years) and in 200 individuals from a comparison group (general population).

Results. It was found that the CC genotype was more common in the group of patients with HCM than in the general population (p=0.005). Carriage of the CC genotype of rs2228145 was associated with a 3.64-fold increased risk of HCM (OR=3.64; 95 % CI: 1.44–9.15; p=0.005). The CC genotype of rs2228145 of the IL6R gene was more prevalent among HCM patients with concomitant AH (n=134) compared to HCM patients without AH (14.9 % vs. 2.4 %, p=0.003) and was associated with a 7.29-fold increased risk of AH in HCM patients (OR=7.29; 95 % CI: 1.62–32.85; p=0.003) relative to the AA genotype. The C allele predominated in the HCM+AH group compared to the HCM without AH group (35.4 % vs. 25.6 %, p=0.03) and was associated with a 1.6-fold increased risk of AH in HCM patients (OR=1.6; 95 % CI: 1.04–2.45; p=0.03). Among HCM patients with concomitant AH aged ≥45 years (n=119), the age at diagnosis in CC genotype carriers was lower than in carriers of the AA and AC genotypes (59 [54.5; 62] years vs. 63 [57.3; 69.8] years, p=0.03). Serum CRP and IL-6 concentrations were higher in HCM patients aged ≥45 years with overweight or obesity than in HCM patients of the same age group with normal body weight: CRP – 2.9 [1.28; 4.23] mg/L vs. 1.4 [0.3; 2.42] mg/L (p=0.04); IL-6 – 1.42 [0.89; 3.37] pg/mL vs. 0.19 [0.11; 0.74] pg/mL (p=0.004), respectively.

Conclusion. Carriage of the CC genotype of the rs2228145 variant of the IL6R gene increases the risk of HCM by 3.64-fold. Carriage of the CC genotype of rs2228145 is associated with a 7.29-fold increased risk of AH in HCM patients, while carriage of the C allele is associated with a 1.6-fold increased risk of AH in these patients. In HCM patients with concomitant AH aged over 45 years, carriage of the CC genotype was associated with a 4-year earlier diagnosis compared to carriers of the AA and AC genotypes. In HCM patients aged ≥45 years with overweight or obesity, serum CRP and IL-6 concentrations are higher than in normal-weight individuals of the same age.

Introduction. In patients with oncological and hematological diseases, thrombocytopenia significantly complicates surgical oral sanitation required for the timely initiation and continuation of antitumor therapy. The lack of uniform criteria for transfusion support and the risk of post-extraction bleeding determine the need to assess the safety of tooth extraction in this patient population.

The objective was to assess the incidence of socket bleeding after tooth extraction in patients with thrombocytopenia and its surgical treatment.

Methods and materials. We performed a retrospective analysis of the medical records of 84 patients treated at the R. M. Gorbacheva Research Institute of Pediatric Oncology, Hematology and Transplantation, who underwent 106 tooth extractions in 2019–2023. Platelet counts before and after the intervention, transfusion support, and the incidence of postoperative bleeding were assessed.

Results. At platelet counts <100×10⁹/L, extractions were performed in 57 episodes; moderate socket bleeding was observed in 14 % of cases (n=8), at PLT levels of 6–34×10⁹/L. In 21 episodes, patients received prophylactic platelet concentrate transfusions before extraction (PLT 7–39×10⁹/L); moderate post-extraction bleeding was observed in 19 % (n=4) of these cases. In another 3 cases, transfusions were performed after extraction; nevertheless, in 1 of these episodes, the patient developed moderate socket bleeding during the first 24 hours. All bleeding episodes were controlled conservatively and did not require surgical hemostasis. No bleeding was recorded at PLT ≥100×10⁹/L. In the group without transfusion support, moderate socket bleeding was observed during the first 24 hours after extraction in 3 episodes (PLT 25–30–34×10⁹/L) and resolved spontaneously.

Conclusions. The risk of post-extraction bleeding in patients with thrombocytopenia requires surgical oral sanitation to be performed in an inpatient setting. Consequently, the time required to prepare the patient for treatment of the underlying disease increases. The use of donor blood components may prevent post-extraction bleeding but does not eliminate its risk. The use of allogeneic biological products derived from donor blood components, as an adjunct to existing methods or as a standalone approach to improve local hemostasis and accelerate healing, appears to be a promising direction.

Introduction. Currently, there is a consistent trend toward de-escalation of surgical treatment in breast cancer (BC), largely driven by advances in modern neoadjuvant chemotherapy (NACT), which increase the rates of clinical (cCR) and pathological complete response (pCR). When complete regression is achieved, minimally invasive approaches such as vacuum-assisted biopsy (VAB) are often preferred over conventional surgery. Pathomorphological assessment of tumor response to NACT requires a standardized approach and often involves specialized grading systems, one of which is the Residual Cancer Burden (RCB) index. However, one of the key components of the RCB formula – the linear dimensions of the tumor bed – cannot be accurately determined from fragmented VAB specimens.

The objective was to evaluate the feasibility of measuring the tumor bed area in VAB specimens compared to standard surgical samples in patients with early-stage breast cancer who achieved both clinical and pathological complete responses following NACT.

Methods and materials. The study included 57 patients with breast cancer cT1–2N0–1M0 who received NACT and achieved pCR. VAB was performed in 21 patients, while 36 underwent standard surgical treatment (mastectomy or breast-conserving surgery). Histological specimens were digitized using a 3D HISTECH PANORAMIC 1000 slide scanner, and manual annotation of tumor bed areas was performed using various methods.

Results. The mean age of the patients was 48.79 years (range 27–68): 49.19 years (35–68) in the VAB group and 48.56 years (27–68) in the standard surgery group.The median tumor bed area with terminal ductal-lobular units (TDLU) in the VAB group was 175.24 mm2 (124.73–309.69), and 151.83 mm2 (85.66–282.67) in the standard surgery group. The median tumor bed area without TDLU was 170.07 mm2 (123.75–262.69) for VAB and 129.86 mm2 (79.39–264.08) for standard surgery. Differences between the groups were not statistically significant (Mann–Whitney U=448.0, p=0.2503, and U=450.0, p=0.2369, respectively). The median TDLU density was 0.274/mm2 (0.150–0.452): 0.265/mm2 (0.177–0.461) in the VAB group and 0.278/mm2 (0.150–0.365) in the surgery group. No statistically significant differences in TDLU density were observed (Mann–Whitney U=455.5, p=0.203). A downward linear trend in TDLU density was observed with increasing age. The mean relative proportion of TDLU in the samples was 6.67 % (0.00–28.40): 6.34 % (0.79–19.94) in the VAB group and 6.87 % (0.00–28.40) in the standard surgery group.

Conclusions. The volume of histological material obtained via vacuum-assisted biopsy is comparable to that from surgical specimens in the context of tumor bed area assessment. The average proportion of TDLU in samples is approximately 6 %; however, in some cases, residual adenosis structures may persist within the tumor bed, increasing the TDLU proportion to as much as 29 %.

The objective was to analyze the experience of surgical treatment of patients with complicated diverticular disease of the colon at the Pavlov First Saint Petersburg State Medical University and propose ways to improve the treatment algorithm to improve treatment outcomes for this category of patients.

Methods and materials. The analysis of treatment outcomes of 280 patients with complicated diverticular disease of the colon, hospitalized on an emergency basis in the clinic of the Research Institute of Surgery and Emergency Medicine of the Pavlov First Saint Petersburg State Medical University in the period from 2017 to 2025, was performed. A total of 17.5 % (n=49) of patients underwent surgery. 63.3 % (n=31) of patients underwent emergency surgery, 22.4 % (n=11) underwent urgent surgery, and 14.3 % (n=7) underwent elective surgery. Three main types of emergency surgical interventions were performed: the Hartmann procedure, performed in 67.7 % (n=21) of patients; laparoscopic lavage, performed in 25.8 % (n=8); and the Mikulicz procedure, performed in 6.5 % (n=2). Both urgent and elective patients underwent resection of the affected colon with primary anastomosis.

Results. Analysis of treatment outcomes for patients undergoing emergency surgery revealed a high rate of postoperative complications, with an overall incidence of 54.8 % (n=17). Early postoperative complications occurred in 32.2 % (n=10) of cases. Late complications were recorded in 22.6 % (n=7) of cases. Repeat surgeries in the early postoperative period were required in 22.6 % (n=7) of cases. Restoration of colonic continuity was achieved in 73.9 % (n=17) of cases, with a high rate of postoperative complications – 52.9 % (n=9). Early postoperative complications occurred in 35.3 % (n=6) of cases. Late complications were recorded in 17.6 % (n=3). Repeat surgical interventions in the early postoperative period were required in 29.4 % (n=5) of cases. In emergency surgeries, only 9 % (n=1) of patients experienced complications in the early postoperative period. In patients undergoing elective surgery, no complications were recorded in either the early or the late postoperative periods.

Conclusion. Accumulated experience demonstrates a high rate of life-threatening, both early and late, postoperative complications following the traditional Hartmann procedure and colonic continuity restoration performed for complicated diverticular disease, necessitating a radical revision of surgical tactics. Formation of a primary anastomosis in emergency surgery appears to be a technically feasible and justified step in a new strategy for surgical treatment of patients with complicated forms of diverticular disease of the colon, which allows avoiding a large number of complications in the postoperative period and improving the quality of life of patients.

Introduction. Hand osteoarthritis (HOA) is a poorly studied form of the disease, and biomarkers with diagnostic and prognostic value have not been identified yet.

The objective was to study the role of some biomarkers in patients with НОА.

Materials and methods. 52 women with НОА were included into the study. The degree of pain, morning stiffness and functional impairment in hand joints was determined in all patients. The laboratory examination included determination of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-1 beta (IL-1β), osteocalcin, cartilage oligomeric matrix protein (COMP) and C-terminal telopeptides of type II collagen in urine (uCTX-II). All women underwent hand joint radiography and densitometry.

Results. COMP increase was detected in the «50-65 years» age subgroup, while the values of ESR, CRP, IL-1β, uCTX-II, COMP and osteocalcin in the study group were within the reference range. The use of IL-1β in the diagnosis of НOA is limited by its extremely low concentration in the blood, but the biomarker may be a predictor of a more severe course of the disease in obese patients. No significant correlations were found between the studied biomarkers and functional parameters. In contrast to the body mass index (BMI) and bone mineral density (BMD), age and menopause did not have significant effect on the studied parameters.

Conclusions. The determination of uCTX-II and COMP is potentially useful in the diagnosis of not only НOA in general, but also the osteoporotic phenotype of НOA in particular.

Introduction. Cyanocobalamin (vitamin B12) deficiency is an important but often overlooked cause of neurological disorders, including polyneuropathy, especially in the absence of classic hematological signs.

The objective was to describe a clinical case of B12-deficient polyneuropathy induced by occupational exposure to nitrous oxide and to discuss the features of diagnosis and treatment.

A clinical case of a 27-year-old female patient with complaints of weakness, paresthesia, and ataxia is presented. Clinical and neurological examination, laboratory tests (complete blood count, biochemical analysis, B12 level), and instrumental methods (electroneuromyography) were performed. The patient was found to have severe B12-deficient polyneuropathy (B12 level – 90 pg/ml) against the background of occupational contact with nitrous oxide. Neurological status was characterized by sensory ataxia and impaired deep sensitivity of the polyneuropathic type. ENMG confirmed mixed axonal-demyelinating lesion.

Conclusion. Occupational exposure to nitrous oxide can be a cause of severe vitamin B12 deficiency with dominant neurological manifestations. Timely diagnosis and replacement therapy with cyanocobalamin lead to significant clinical improvement, emphasizing the importance of a thorough occupational history in patients with polyneuropathy.

Gastric cancer remains a pressing issue in oncology. One of the rare but extremely dangerous complications is metastasis to the pericardium, leading to carcinomatous pericarditis. This article presents a clinical case of a 68-year-old patient with diffuse gastric adenocarcinoma who received neoadjuvant chemotherapy followed by gastrectomy. On the third day after surgery, the patient died from pericardial hemotamponade caused by coronary artery erosion secondary to pericardial carcinomatosis, which was diagnosed during pathological examination. A review of the literature shows that pericardial metastases from gastric cancer are extremely rare (4.2 % of patients), more often associated with poorly differentiated and signet-ring cell carcinoma, and are often diagnosed at terminal stages or even postmortem. The clinical presentation is nonspecific, complicating early detection. Diagnosis is based on echocardiography; however, as demonstrated in this case, changes may not be apparent until death. Treatment remains challenging due to the low incidence of this condition. Pericardiocentesis in combination with systemic or local chemotherapy can prolong survival, but the prognosis is generally poor. This suggests the need for increased vigilance in patients with gastric cancer and cardiovascular symptoms, as well as the importance of developing diagnostic algorithms for the early detection of pericardial lesions, especially in patients with comorbid cardiac pathology.

Mayer – Rokitansky – Küster – Hauser syndrome results from congenital dysmorphogenesis due to delayed development of the Müllerian ducts. The main gynecological consequences of this syndrome are aplasia of the uterus and vagina. One of the most commonly used approaches to managing vaginal aplasia is colpopoiesis using pelvic peritoneum with laparoscopic assistance. This article presents, through a clinical case, a modification of this procedure that makes it possible to minimize technical difficulties in forming a functional tunnel while using minimal instrumental support.