The article is dedicated to the outstanding naval surgeon Professor Mikhail Alekseevich Lushchitsky, head of the Department of Naval and Hospital Surgery (NHS) of the S. M. Kirov Military Medical Academy (1973–1986), Major General of the medical Service.

As head of the Department, Mikhail Alekseevich proved himself to be an excellent teacher, surgeon and organizer. He created his own unique school of naval surgeons. Mikhail Alekseevich is the author of 146 scientific papers, twice elected chairman of the Pirogov Surgical Society. Under his leadership, 7 doctoral and 18 PhD theses were prepared and defended. In 1986, he resigned. Mikhail Alekseevich died on March 10, 1999, and was buried at the Theological Cemetery in St. Petersburg.

October 6, 2025, marks the 100th anniversary of the birth of Professor Georgii Silvestrovich Katinas, the great scientist and teacher, whose name is inextricably linked with the Pavlov University and directly with the activities of the Department of Histology, Embryology and Cytology. The authors have summarized the facts of the scientist’s biography and the main stages of his scientific and pedagogical activity. Georgii S. Katinas, the participant in the Great Patriotic War, graduated from the First Leningrad Medical Institute in 1951 and headed the Department of Histology, Embryology and Cytology of the same Institute from 1972 to 1992. During his tenure, new methods of teaching histology as an academic discipline were developed, including the use of electronic computers. The main scientific activity of Georgii S. Katinas was related to issues of chronobiology and the study of the biological rhythms of the functioning of organs and systems. G. S. Katinas was a member of the Problem Commission «Morphogenesis of cells, tissues and the organism», the council on morphology of the USSR Academy of Medical Sciences, was deputy editor of the journal «Archive of Anatomy, Histology and Embryology», a member of the presidium of the USSR Scientific Society of Anatomists, Histologists and Embryologists, a member of the Problem Commission «Chronobiology and Chronomedicine» of the Russian Academy of Sciences. Under his supervision, 19 doctoral theses were defended and about 300 scientific papers were published. The life and creative path of Georgii S. Katinas has for many years served as an example for the younger generations of physicians, scientists, and teachers. 

The literature review is devoted to human herpes viruses 6 and 7 (HHV-6, HHV-7). The history of the study of exanthem subitum, the discovery of HHV-7, HHV-6 and its types, epidemiology, pathogenesis, stages of infection, clinical features, laboratory diagnosis and treatment are discussed. Despite some progress in the study of HHV-6 and HHV-7, many aspects of their pathogenesis, their relationship to human pathology, and issues of diagnosis and therapy remain unclear. This is manifested by both under-diagnosis of acute forms of the disease and overdiagnosis of latent infection as acute, which leads to irrational therapy of patients. Further research in this area is needed.

The objective was to analyze the anatomical features of the structure of the frontal sinuses and the anterior ethmoid air cells, to study the existing various modifications of endoscopic surgeries on the frontal sinuses, as well as to identify current problems and controversies in this field.

Methods and materials. We analyzed historical and modern publications devoted to endoscopic frontal sinus surgery, with emphasis on classifications, techniques and results of operations presented in PubMed, Scopus, eLibrary databases. The material was selected by keywords: «frontal sinus», «endoscopic frontotomy», «frontal recess anatomy», «frontal sinus surgery», «extended frontal sinus surgery», «Draf classification», «modified Lothrop procedure». In addition, monographs and manuals on sinus surgery are included in the review.

Results. With the advent of computed tomography and endoscopic techniques, frontal sinus surgery has evolved significantly. Various techniques such as Draf I, IIA, IIB, III and other surgeries have been developed to minimize trauma, reduce recovery time and improve outcomes after surgical intervention. However, such pathology as stenosis of frontal recess, osteoneogenesis and lack of clear indications are remained challenging to make a right choice for particular surgical intervention.

Conclusion: Despite significant advances in endoscopic frontal sinus surgery, there remains a need for further research to optimize surgical approach in each particular case for improving long-term outcomes and standardize indications for different types of surgical interventions.

Phosphoinositol-3-kinases (PI3K) may be considered as targets for targeted therapy of tumors. The 1,3,5-triazine core is considered the promising scaffold in antitumor drug development, that affect to various targets in tumor cells. This review examines 1,3,5-triazine derivatives (s-triazine) with strong inhibitory activity against PI3K kinases. Moreover, the key structural fragments that play a crucial role in binding to the active sites of PI3K are summarized. The prospects of developing bifunctional agents, which simultaneously affect two or more targets within the same or different signaling pathways, are also discussed. 

The objective was to identify preoperative neuroimaging parameters that predict the consistency of pituitary adenoma intraoperatively and determine further treatment tactics.

Material and methods. A clinical study of 75 patients with a histologically confirmed diagnosis of pituitary adenoma was conducted. The average age was 51.3±14.8 years, the median was 52 (37/65) years. Preoperative diagnosis was based on clinical and laboratory data, the results of neuroimaging research methods. The study analyzed neuroimaging predictors of adenoma consistency in the preoperative period, with subsequent confirmation intraoperatively. Intraoperative interpretation of tumor density was based on the classification of Rutkowski M.J. (2020).

Results. Transsphenoidal access with endoscopic assistance was used for all the studied patients. Radical removal was performed in 89.3 % of cases (N=67), subtotal removal in 10.7 % (N= 8). In all subtotally operated patients, after 3–6 months, continued tumor growth was observed in MRI monitoring, which in a number of patients required repeated transsphenoidal removal of the sac (in 9.4 %), and in 1.3 % – transcranial removal (through lateral supraorbital access). There was no correlation with histological subtypes of the tumor and the level of ki-67. During the intraoperative analysis, the soft consistency of pituitary adenoma was predominantly found (74.7 %), medium and dense consistency was less common (10.7 and 13.3 %, respectively). T1-isotensive signal may be a predictor of intraoperatively milder pituitary adenoma density (r=0.383; p=0.02). Hyperintensivity of the T2 signal only in combination with elevated values of hypocoagulation markers (PTT and INR) may indicate a soft density of pituitary adenoma (p<0.04).

Conclusions. Predicting tumor consistency at the preoperative stage is an important factor in planning surgical tactics, but not the only one. The prognosis of a dense tumor structure combined with an assessment of its invasiveness – laterosellar growth into the cavernous sinus (Knosp 3–4), suprasellar spread into the structures of the hypothalamus, ventricular system (Hardy 3–4), may preoperatively indicate a high probability of continued growth, the expediency of transcranial removal of the tumor, the timing of follow-up examinations, the need for radiosurgical treatment.

Introduction. Cancer patients with chronic kidney disease stage 5 on dialysis (CKD 5D) constitute a separate, complex group of patients. Conducting diagnostics and specialized oncological treatment for such patients is often associated with a number of difficulties and risks. However, there is still no data on the incidence and predominant localization of malignant tumors in patients with CKD in the Russian population.

The objective was to determine the frequency of detection of solid oncopathology in people with CKD 5D using the example of the population of St. Petersburg.

Methods and materials. In 2019, the population of Saint Petersburg was 532,890 people. The number of new cases of solid malignant neoplasms (MNP) of diseases in 2019 amounted to 20,028 people. The number of patients registered on 31.12.2018 in the nephrological registry of Saint Petersburg was 2,958 people with CKD 5D.

Results. When comparing the databases with the first oncopathology in 2019 and the database of nephrological patients in Saint Petersburg, it was revealed that solid MNP were diagnosed in 37 patients suffering from CKD 5D. Most often, the localization of solid MNP with CKD 5D patients were: lung, stomach, prostate, and uterine cancers.

Conclusions. The risk of developing solid MNP in patients with ESRD was significantly higher – the odds ratio (OR) was 3.353.

The objective was to improve the treatment results in patients with submucosal tumors of the stomach.

Methods and materials. 70 cases of treatment of patients with submucosal tumors of the stomach who underwent endoscopic and combined interventions were analyzed.

Results. In all the presented cases, the ST was removed, and the intraoperative and early postoperative complications that occurred were eliminated using endoscopic techniques and laparoscopic intervention. Based on the experience gained, criteria for the selection of removal techniques (endoscopic and in combination with surgery) were determined based on the size of the ST, its location in the stomach, as well as the presence of compromised mucosa above the ST. No relapses were noted during follow-up.

Introduction. According to international publications, migraine (M) is more common in patients with multiple sclerosis (MS) than in the general population, while other types of primary headache (PH), including tension-type headache (TTH), do not have a similar tendency. There are several theories about the relationship between M and MS, but the substantiated mechanisms are currently unknown.

The objective of our work was to analyze the data on the occurrence and characteristics of M in patients with MS.

Methods and materials. A retrospective monocenter cohort study of patients with MS for the period 2018–2024 based on the Pavlov First Saint Petersburg State Medical University. Medical records of 168 patients with MS were analyzed.

Results. The overall prevalence of PH in our cohort of patients was 36.9 %, including headache type M 22 %, TTH 6.6 %, unclassified headache (UH) 8.3 %, drug-induced headache (DIH) in the presence of any form of PH 6.5 %. M was significantly more common in the relapsing-remitting type of MS (RRMS) than in the primary and secondary progressive types (PPMS, SPMS) combined (p=0.031). The median EDSS (Expanded Disability Status Scale) disability scale in the group with M was 2 [2.0; 3.5], which is lower (p=0.046) than in the group of patients without headache 3.5 [2.0; 6.0]. Demographic characteristics and the use of disease-modifying drugs (DMARDS) did not differ significantly between the groups, and M was observed both before clinical manifestations of MS, at its manifestation, and developed after diagnosis.

Conclusion. The obtained data demonstrate a high prevalence of M in MS. Patients predominantly with RRMS and a low level of disability represent a promising category for further study of the relationship between HD and demyelinating disease.

Introduction. Optimal adherence to antiretroviral therapy (ART) is a key factor in achieving an undetectable HIV viral load (HIV VL). Among people with opioid use disorder (OUD), it is insufficient to suppress viremia. Treatment of OUD helps to increase the adherence and effectiveness of ART and HIV outcomes.

The objective was to evaluate the adherence to ART in patients with HIV and OUD treated with naltrexone in oral or implantable formulations, and to compare the data obtained using the Adherence Assessment Questionnaire (AAQ), Electronic Monitoring of Treatment (EMT), and dynamic of HIV VL.

Methods and materials. 200 patients with HIV infection (IV A-IV B) with OUD who completed a course of detoxification were divided into two groups (100 in each), where they received oral (ON) or implantable (IN) naltrexone treatment for 48 weeks simultaneously with ART. Outcomes of ART adherence: 1) adherence index (AI) (based on AAQ data); 2) EMT – the ratio of the number of actual openings to the number of openings to be made («correct openings»); 3) dynamic of the HIV VL level.

Results. ART adherence to AI and EMT is significantly higher in patients who completed treatment with naltrexone compared with those who discontinued the treatment earlier (92.4±15.17 vs. 89.32±21.33, p<0.001 and 73.3±22.0 % vs. 65.10±32.1 %, p=0.038, respectively). A significant correlation was found between AI and EMT (r=0.78, p=0.0001); and moderate for each method with the difference in HIV VL in dynamic (AI, r=0.306, p=0.0002; EMT, r=0.305, p=0.0002).

Conclusion. The stabilization of OUD remission helps to increase the ART adherence and improve the HIV outcomes. The results demonstrate the consistency of the objective and subjective methods for assessing ART adherence in patients with HIV and OUD.

Introduction. Myelodysplastic syndromes (MDS) are diverse in terms of their appearance, symptoms, survival rate, and progression risk. A TP53 mutation in a patient with MDS indicates a higher risk category, a lower chance of treatment success, a faster progression, and a poorer overall outcome. However, at present, there is insufficient focus on the degree of gene functional deficiency as a result of mutations.

The objective was to develop a system for risk stratification of patients with MDS by assessing the pathogenicity of TP53 mutations.

Methods and materials. We performed a retrospective analysis of TP53 mutations discovered during the 2022 International Working Group for the study of MDS research. The study was done on 2,343 adult patients with MDS without a known deletion in the TP53 gene. Additionally, we reviewed the results of a separate study on the TP53 gene, which involved patients with MDS as well as others with acute myeloid leukemia (AML). This study was conducted at Pavlov University.

Results. Based on the previously established classification algorithm, all patients were divided into three groups: those without a mutation in the TP53 gene, those with a damaging mutation according to the classification system, and those with a neutral genetic variant according to it. There were differences in overall and leukemia-free five-year survival rates between groups of patients with MDS with damaging and neutral variants according to the developed system. Furthermore, a group of patients at the Pavlov University showed a difference in progression-free survival between groups of patients with MDS or AML with damaging and neutral variants according to our classification system.

Conclusion. The novel information system can be used to support medical decision-making in case of detection of variants of unknown significance in the TP53 gene. The universality of the approaches used makes it possible to adapt the system to other genes and pathologies.

Introduction. Phantom pain syndrome (PPS) affects approximately 85 % of patients after amputation and inhibits active participation in rehabilitation, critically reducing its effectiveness. Current treatment methods are insufficiently effective. The increasing incidence of traumatic amputations, including those resulting from mine blast injuries, requires the development of reliable PPS treatment protocols that incorporate non-pharmacological methods implemented within a multidisciplinary rehabilitation team.

The objective was to compare the effectiveness of additional non-pharmacological treatments for PPS during the first stage of rehabilitation of patients with traumatic amputation.

Methods and materials. A total of 166 patients with traumatic amputations participated in this prospective, randomized study. The control group included patients who received only basic PPS therapy during the first stage of rehabilitation: gabapentin, exercise therapy, and tight bandaging. Four experimental groups comprised patients who additionally received 10 sessions of the following for two weeks: transcranial electrical stimulation (TES); psychotherapy (PSI); simultaneous PSI and TES; and mirror therapy (MT). The dynamics of PPS were assessed.

Results. The additional methods demonstrated greater effectiveness compared to the control group: significant improvement (3 or more VAS points) was noted in 57 % of patients versus 22 %, moderate improvement (<3 points) in 35 % versus 56 %, and deterioration in 8 % versus 22 %. Linear mixed model analysis revealed a statistically and clinically significant difference in PPS dynamics in the experimental groups compared to the control group (F (16, 423.013)=3.542; Partial η²=0.118; p < 0.001).

Conclusions. Additional non-pharmacological treatments for PPS, such as TES, PSI, and MT, significantly improve its course during the early stages of medical rehabilitation. Further research should focus on understanding the factors that contribute to the development of PPS, identifying indications for specific treatments, and personalizing PPS treatment protocols.

We present an observation from practice – a clinical case of successful treatment of a pregnant woman with a closed abdominal trauma. This article demonstrates the difficulties of diagnostics and treatment of pregnant women with a closed abdominal trauma that has a complicated course and requires emergency surgical intervention.

Introduction. The authors of the article address one of the most pressing issues in modern gastroenterology and coloproctology – the choice of an optimal approach to treating acute complications of Crohn’s disease (CD), such as intestinal obstruction. This work is notable for its interdisciplinary nature and its focus on the specifics of diagnosis and treatment during an acute crisis, where timing and the accuracy of decision-making play a crucial role. The researchers rightly point out that most patients with CD experience recurrent exacerbations and complications such as intestinal obstruction, which require a specialized treatment approach. Standard surgical protocols used for similar conditions in other patients may be ineffective or overly aggressive, leading to undesirable outcomes. The need for a differentiated approach underscores the particular relevance of the topic.

The objective of the article was to demonstrate the feasibility and importance of an interdisciplinary approach in managing acute complications of CD. The authors aimed to present a clinical case that illustrated the benefits of collaboration between gastroenterologists, colorectal surgeons, and general surgeons in deciding on a treatment strategy. The objective was clearly defined and achievable, allowing the article to effectively showcase the advantages of a multidisciplinary approach.

Methods and materials. The central element of the article is a clinical case of a patient with acute intestinal obstruction during a CD exacerbation. An emergency surgery was initially recommended, but thanks to a prompt interdisciplinary consultation, a conservative treatment plan was chosen, which helped avoid unnecessary surgical intervention. This approach strengthens the evidence base of the article, serving as a vivid illustration of the importance of interdisciplinary collaboration.

Results. One of the major strengths of the article is the detailed description of the treatment course in this particular case. The specific steps taken by the medical team led to a successful resolution without surgery, avoiding serious complications and adverse outcomes for the patient. The results support the authors’ central thesis: managing complications of CD requires tailored approaches distinct from standard protocols used for other conditions.

Conclusion. The authors’ key conclusion is the necessity of conducting interdisciplinary consultations when diagnosing and choosing a treatment strategy for patients with acute manifestations of CD. Their conclusion is supported by a specific clinical case showing that well-coordinated collaboration among specialists from different fields can help avoid unwarranted surgical interventions and minimize the risk of complications.

This article addresses the current challenges in treating obstructive sleep apnea syndrome (OSA) in patients with severe somatic concomitant diseases in combination with nasal pathology, which often complicates the use of continuous positive airway pressure (CPAP) therapy. The nasal obstruction significantly reduces CPAP effectiveness by causing discomfort and limiting airway patency. The article reviews studies highlighting a higher prevalence of apnea among patients with non-allergic rhinitis.

Special emphasis is placed on minimally invasive surgical methods, particularly interstitial laser coagulation of the inferior nasal turbinates, which effectively reduces tissue volume and edema, improves nasal breathing, and enhances CPAP compliance. A detailed clinical case is presented involving a patient with severe OSA and vasomotor rhinitis, who demonstrated significant improvement in respiratory function and overall clinical status after laser coagulation.

This work is valuable for specialists in somnology and otorhinolaryngology, as well as physicians managing comprehensive OSA therapy in patients with multiple somatic disorders. The described data and practical experience with minimally invasive treatments aid in assessing the efficacy of modern approaches and improving adherence to CPAP therapy, directly impacting patients’ quality of life.