Introduction. This article presents an analytical review of scientific publications by Russian authors over the past ten-year period from 2015 to 2024, reflecting the processes of digital transformation of anesthesiology and intensive care services in Russian medical institutions.

The objective was to systematize and critically comprehend the main directions, outcomes and limitations of domestic research in the field of digitalization of the anesthesiology and intensive care services and to identify key trends, knowledge gaps and promising vectors of further development.

Methods and materials. The main keywords and their combinations were used to search for publications in the Russian electronic scientific library eLibrary for the period from 2015 to 2024.

Results. The analysis of publications is intended not only to describe the current state and dynamics of digital technology development in anesthesiology and intensive care in Russia, but also to highlight the most significant scientific and practical foundations, as well as potential bottlenecks and barriers to scaling up successful solutions.

Conclusions. The absence of a comprehensive synthesis of Russian research on the digitalization of anesthesiology and intensive care services limits the ability to develop coordinated development strategies, set priorities for science and technology policy, and inform governmental decision‑making in the field of medical informatics and artificial intelligence technologies in anesthesiology and critical care medicine.

The incidence of autoimmune diseases is increasing worldwide. Systemic sclerosis (SSc) is more common in young adults and is characterized by extensive progressive fibrotic lesions of the skin and other organs. The rapidly progressive diffuse form of SSc can lead to short-term mortality in 30% of cases. High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT-AHSCT) has multiple immune-mediated effects that can reduce clinical manifestations and improve prognosis in patients with SSc. The method has been used for SSc since 1997. Approximately 900 transplant procedures for SSc have been performed within the registry of the European Society for Blood and Marrow Transplantation (EBMT). This paper analyzes the results of randomized clinical trials (ASSIST, ASTIS, SCOT) using HDIT-AHSCT in SSc. It presents patient group characteristics, conditioning regimens, and efficacy compared to standard therapies. The criteria and patient selection process, as well as indications and contraindications for the procedure, are also presented. This information can be used to further justify the expansion of care options for patients with SSc in the Russian Federation.

Based on the literature data, we considered the features of the influence of the interposition of the occipital and sphenoid bones on the formation of a pattern of micro-mobility of other cranial bones during intrauterine development and after the implementation of the biomechanism of natural childbirth or cesarean section. A systematic approach to the study of alternative-varying features of these cranial structures at the present stage requires the use of accurate lifetime technologies of cranioscopy and craniometry (computer and magnetic resonance imaging) for targeted correction of the structural and functional position of the cranial bones.

Bacterial resistance to antimicrobials is one of the actual medical problems that require urgent solutions. The severity of the course of infectious diseases caused by multidrug-resistant bacteria is an impetus for the search for other treatment options, in particular, the use of bacteriophages as antimicrobial agents. Potentially, phage therapy can be used both as an addition to antibiotics and as a substitute for the latter. However, isolation of a native bacteriophage is a laborious and time-consuming process. In addition, during the interaction of bacteria and phages, bacterial defense mechanisms develop, aimed at evading phage exposure. The use of accelerated evolution technologies based on changing the genotypes of bacteriophages may be a solution to this problem. Viruses obtained in this way can have unique properties that help not only overcome bacterial resistance mechanisms, but also expand the range of lytic activity, which makes it possible to use them even in conditions of constant bacterial evolution. In addition, new mutations can improve the stability of phages when they are stored as drugs for phage therapy. In general, accelerated evolution technologies, including Appelman protocol recombination, chemical and thermal mutagenesis, modification of phages using ultraviolet radiation, and phage and bacterial coevolution procedures, are affordable and relatively inexpensive, but at the same time effective methods for converting phage genomes to expand the possibilities of using bacteriophages in medical practice.

According to current statistics, pituitary neuroendocrine tumors (PitNETs) are quite common, occurring in approximately 1 in 1,100 individuals in the general population, accounting for 16.4–25 % of all central nervous system and intracranial tumors.

These clinical observations describe two cases of pituitary MR-elastography in patients with PitNETs (a 45-year-old woman with a GH-secreting tumor; a 56-year-old man with a non-GH-secreting tumor), including the characteristics of the patients’ complaints, medical history, clinical presentation, preoperative MR-elastography results, intraoperative presentation, and surgical treatment outcome.

Preoperative determination of pituitary neuroendocrine tumor consistency can alter surgical technique and influence the surgical approach, treatment outcome, and reduce the risk of complications, reoperation, or the need for postoperative radiosurgery.

Introduction. The frequency of obstructive sleep apnea syndrome (OSA) detection in the population is progressively increasing, and the lack of clinical recommendations for otorhinolaryngologists and low compliance with PAP therapy in patients with severe and moderate OSA stimulate the search for effective surgical treatment of these patients.

The objective was to evaluate the effectiveness of surgical treatment in patients with OSA.

Methods and materials. The article presents the results of an examination of 15 patients with OSA before and after surgical treatment in the volume of bilateral tonsillectomy with laser uvulopalatoplasty.

Results. All patients were satisfied with the results of the operation and subjectively noted a significant improvement in their well-being according to the results of the questionnaire. None of the patients complained about snoring. According to the results of the somnological control examination, AHI became less than 5 in 11 patients, and AHI decreased by more than 50 % in 4 patients. On average, the AHI decreased by 30.9. Saturation rates increased in all patients in the group, so the average saturation increased by 4 %, the minimum saturation increased by 11 % on average. There were no indications for PAP therapy or the need for it in patients in the postoperative period.

Conclusions. Performing tonsillectomy with uvulopalatoplasty in the presence of significant oropharyngeal obstruction due to palatine tonsillectomy can relieve the patient of OSA, which is confirmed by the data of somnological examination in the postoperative period.

Mucocele is a benign cyst-like lesion of the paranasal sinuses that occurs due to obstruction of the anastomoses and is characterized by a locally destructive effect. The treatment consists of a surgical method, with a transition from external access to an endoscopic endonasal approach. Mucocele can exist as an independent disease of the paranasal sinuses or as a complication after previously performed surgical interventions on the paranasal sinuses. This article will present an analysis of the factors leading to the formation of this formation, as well as several clinical observations.

Introduction. Given the diversity of clinical and electrophysiological phenotypes of chronic inflammatory demyelinating polyneuropathy (CIDP) and the variability of their response to disease-modifying therapy, immunopathological mechanisms likely differ across disease forms. Identifying key laboratory and instrumental features of various clinical and pathogenetic variants within the CIDP spectrum remains an important unmet need.

The objective was to compare serum and cerebrospinal fluid (CSF) laboratory findings and instrumental study results in typical CIDP and its variants.

Methods and materials. This retrospective-prospective study analyzed clinical, laboratory, and instrumental data from 158 patients with definite CIDP meeting the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) criteria, stratified into typical CIDP and CIDP variants.

Results. Anti-ganglioside and anti-sulfatide antibodies were most frequently detected in the sensory CIDP variant, in 46.2 % (12/26) of cases. Serum paraprotein was identified in 27.2 % (36/132) of patients; among these, a substantial proportion had the sensory variant – 33 % (12/36). When analyzing the structure of clinical phenotypes among patients screened for the presence of paraprotein (n=132), patients with the distal variant prevailed – 40% (8/20) of cases. The highest protein levels in the cerebrospinal fluid (CSF) were observed in patients with disease onset at the age of 15-29 years (Kruskal–Wallis test, p=0.028), as well as in patients with a relapsing type of course and acute onset (Pearson’s Chi-Square Test, p=0.01). No significant differences in CSF protein levels were found between typical CIDP and CIDP variants. Abnormal CSF oligoclonal IgG patterns were detected in 21.7 % (20/92) of patients and were observed significantly more often in CIDP variants, comprising 60.0 % (12/20) of such cases. According to electroneuromyography (ENMG) data, an increase in distal latency according to n. tibialis was significantly more often recorded in patients with typical CIDP compared with the variants (26.5% vs 7.3%, respectively; Pearson’s Chi-Square Test, p=0.0019). The analysis of cumulative indicators (Σ indicators) for n. tibialis also revealed a higher frequency of pathological changes in patients with typical CIDP (61.2% vs 35.8%; Pearson’s Chi-Square Test, p=0.0033). On magnetic resonance imaging (MRI), accumulation of contrast agent by nerve roots and cerebrospinal nerves was detected in 57.2 % (4/7) of patients with motor CIDP variant, which was significantly more often than in other disease variants (Fisher–Freeman–Halton test, p=0.006).

Conclusion. In contemporary practice, laboratory and instrumental diagnostics in CIDP patients plays a critical role in excluding alternative causes of polyneuropathy. The identified laboratory and instrumental features across CIDP variants may be important not only for diagnosis but also for selecting optimal pathogenetic therapy.

Introduction. Given advances in hematological oncology and increased progression-free survival in patients with hematological diseases after allogeneic hematopoietic stem cell transplantation (allo-HSCT), assessing the quality of life of recipients who have experienced complications from treatment of the underlying disease has become an urgent issue.

The objective was to evaluate the quality of life of oncohematological patients with late neurological complications after allo-HSCT.

Methods and materials. The study included 157 patients (88 women, 69 men) with oncohematological diseases in the late (≥D+180) period after allo-HSCT (452±552.9 days) between 2022 and 2023.

Results. Pain of any localization was reported in 86 (54.8 %) patients. In this case, there were 74 (47.1 %) out of 157 patients with one complaint, 36 (22.9 %) with two, 18 (11.5 %) with three, 4 and 5-7 (4.4%) and 1 (0.6%), respectively. Incidence of the identified pathology: headache (not migraine) was recorded in 52 (33.1 %), polyneuropathy – 18 (11.5 %), neuropathy – 18 (11.5 %; cranial 2 (7.2 %), non-cranial 16 (10.2 %)), degenerative-dystrophic spine disease – 18 (11.5 %), encephalopathy – 12 (7.6 %), anxiety-depressive disorders, musculoskeletal disorders and benign muscle cramps – 10 each (6.4 % each), joint syndrome – 9 (5.7 %), myalgia – 7 (4.4 %), neurotoxicity – 6 (3.8 %), other – 17 (10.8 %). The likelihood of a poor physical component of health increases with age; in patients with musculoskeletal disorders and myalgia (36.17 vs. 43.58, p=0.001). The likelihood of poor mental health is associated with a diagnosis of encephalopathy (p=0.001) and increases in patients with neuropathy at all stages after HSCT, worsening at later stages (p<0.05) and with age. The likelihood of anxiety is higher in patients in the late post-HSCT period and in the presence of headache. The likelihood of depression in men is lower than in women (4.72 vs. 5.96), especially with a combination of neuropathy and headache.

Conclusion. The combination of several factors can significantly worsen the quality of life of allo-HSCT recipients with late neurological complications due to mutual aggravation. Depression was associated with the presence of cephalgic syndrome. Persistent pain syndromes are associated with a higher risk of anxiety and negatively impact on almost all aspects of quality of life. Factors affecting the physical component of health after allogeneic HSCT include musculoskeletal disorders and myalgia. The underlying hematological disease, patient age, and the presence of post-transplant complications are also associated with a decline in quality of life.

Introduction. The number, shape, and size of the pulmonary vein (PV) orifices together form anatomical variants that may be associated with atrial arrhythmias and require personalized diagnostic and surgical tactics.

The objective to provide an anatomical description of the number, shape, and size of the pulmonary vein orifices in the wall of the left atrium in human adults.

Methods and materials. We studied 54 heart atrial specimens obtained from middle-aged and elderly humans who died from non-cardiac diseases. We modeled the diastole of the left atrium (LA) by filling it with silicone. After the silicone hardened, the walls were dissected. We measured the short and long diameters of each orifice with a digital caliper, calculated the area of the orifices using the formulas. The Mann – Whitney U-test and Spearman correlation (Rs) were used.

Results. In 90.7 %, each of the four PVs flowing into LA had its own orifice. In 9.3 %, the atrial roof bore three PV orifices: two orifices of the right PVs and a common orifice of the left PVs. Oval orifices were more common for the left PVs than for the right ones. The orifice areas of the left superior (median 135.6 mm²) and right inferior PVs (median 136.2 mm²) were larger than the area of the left inferior PV (median 103.5 mm²), but smaller than the orifice area of the right superior PV (median 152.2 mm²). Analysis revealed moderate correlations between the values of the area of the right inferior PV orifice, the heart length (Rs 0.37) and mass (Rs 0.43). The area values of the other three PVs orifices correlated with the LA width (Rs 0.35).

Conclusion. In middle-aged and elderly humans who died from non-cardiac diseases, LA posterior wall commonly exhibited two right and two left PV orifices of different areas, rather oval than round.

The objective was to study the features of intestinal ultrasound examination in patients with complicated Crohn’s disease (CD). To specify equipment settings and parameters, and to develop ultrasonographic criteria for diagnosing CD complications.

Methods and materials. Intestinal ultrasound was performed in 68 patients with complicated CD. The examinations were conducted using a specific pre-set equipment mode.

Results. New equipment settings for intestinal examination were studied and implemented. Ultrasonographic criteria for inflammatory bowel changes were developed and applied. Ultrasonographic signs of fibrotic changes in the bowel wall were described, along with distinguishing features between inflammatory and fibrotic alterations in the area of intestinal strictures. The application of these new diagnostic techniques in CD patients increased the method’s sensitivity to 90.3–94.1 % and specificity to 97.1–100 % (p<0.05), depending on the disease phenotype.

Conclusions. The implementation of a refined ultrasound examination protocol for patients with Crohn’s disease and the application of established criteria for assessing intestinal inflammatory processes improved the accuracy of diagnosing complications of this disease.

The widespread in Russia lichen Parmotrema tinctorium (Despr. ex Nyl.) Hale accumulates orcinolic depsid – lecanoric acid in the core layer of the thallus, which potentially has biological activity. In the present study, we isolated and characterized lecanoric acid and evaluated its cytotoxic properties. The structure of lecanoric acid was confirmed based on spectral data (NMR, MS, and IR). The cytotoxic activity of the isolated compounds was assessed against cancer (Panc-1, A 549, T98G, HeLa) and normal (HEK293) human cell lines using the MTT assay. It was shown that lecanoric acid exhibited moderate cytotoxicity against the HeLa cervical carcinoma cell line with IC₅₀ values of 121 μmol. The results of the performed docking and molecular modeling indicate the potential binding of lecanoric acid to AKT 1 and PI3Kα proteins. These results highlight the potential of lichen depside as a source of anticancer drugs and require further study of its mechanisms of action.

The objective was to assess the impact of antiplatelet therapy using acetylsalicylic acid on platelet aggregation in patients with diabetes mellitus and a history of ischemic stroke.

Methods and materials. Two groups of patients (target and control) were selected, comprising 72 individuals who had experienced either a lacunar or an atherothrombotic subtype of ischemic stroke within the past two years, accompanied by multifocal atherosclerosis. The target group consisted of 38 patients with type 2 diabetes mellitus, managed through hypoglycemic therapy, while the control group included 34 patients without type 2 diabetes mellitus.

Results. The evaluation of aggregatometry results revealed that platelet hypoaggregation was significantly more prevalent in response to acetylsalicylic acid therapy in the group of patients without diabetes mellitus. In contrast, laboratory resistance to acetylsalicylic acid was notable predominant in the group of patients with diabetes mellitus. This resistance may indicate insufficient therapeutic efficacy in clinical practice, potentially leading to recurrent cardiovascular events.

Conclusion. It is advisable to incorporate platelet aggregation capacity assessment via impedance aggegatometry as part of secondary prevention strategies for ischemic stroke to evaluate the therapeutic effectiveness of the antiplatelet drugs. Additionally, identifying excessive platelet hypoaggregation may be crucial in patients with an elevated risk of bleeding.