The article considers the changes that took place in the Petrograd Medical Institute during the Civil War in the teaching of odontology. Changes affected the teaching staff, as well as students. The growth of the influence of the Party cell in the Institute contributed to the withdrawal of «bourgeois» teachers.

Police reports and papers of the sanitary-executive commission about deceases of people of Tsarskoselskiy uyezd are understudied documents of 1915–1917, representative for comparative study of the resources and epidemic dynamics, special characteristics of healthcare system and interaction of administration, doctors and population.

Celiac trunk compression syndrome is a symptom complex arising from compression of the celiac trunk by the median arcuate ligament, crura of diaphragm or ganglion tissue of the celiac plexus. The main clinical manifestations of this pathological condition are abdominal pain syndrome, indigestion and weight loss. The disease is detected in 0.4–1 % of people in the population, more often in young people. The pathophysiological mechanisms of the development of celiac trunk compression syndrome remain not fully understood, but the key reason for its development is ischemia of the digestive system. The main instrumental methods for diagnosing compression of the celiac trunk are ultrasound duplex scanning of the abdominal aorta and visceral arteries and spiral computed angiography. The only effective treatment for celiac trunk compression syndrome is surgery. Currently, both classical techniques and various minimally invasive technologies are used to decompress the celiac trunk. The advantages of open access include good visual and manual control of anatomical structures, the possibility of eliminating complications, changing the tactics of surgical intervention, if necessary, performing vascular reconstruction. The advantage of minimally invasive surgical technologies is minimal trauma to the abdominal wall tissues, minor postoperative pain syndrome, early rehabilitation, a low risk of developing cusp, wound infection and hernial defects. Regardless of the methodology, surgical treatment can achieve a positive effect in 75–90 % of patients with celiac trunk compression syndrome. These are the modern concepts of epidemiology, pathogenesis, clinical manifestations, diagnosis and methods of treatment of this pathological condition.

Introduction. One of the most significant components of acute destructive pancreatitis (ADP) is enzymatic parapancreatitis (EP). The severity of the defeat of the retroperitoneal tissue from the early stages of the disease largely determines its course.

The objectivewas to assess the features of the evolution of the pathological process in the retroperitoneal tissue in ADP and the effect of EP on the course of phase I of ADP.

Methods and materials. 63 cases (ADP) without enzymatic peritonitis were analyzed. The average age of patients was (46.6±3.2) years (p≤0.05). The sum of points according to the express diagnostic scale of the SPb I. I. Dzhanelidze RIEM was (3.7±0.2) points (p≤0.05). The average time from the onset of the disease to the start of therapy was 2 days (from 7 to 1 day).

Results. Types of EP at admission were distributed as follows: type B – 17.5 % (n=11) of cases, type C – 44.4 % (n=28) of cases, type D – 30.2 % (n=19) of cases, type E – 7.9 % (n=5) of cases. Spearman’s rank correlation coefficient for assessing the relationship between the severity of the condition and the type of parapancreatitis was 0.069. Infiltrative parapancreatitis (IP) was formed in 93.4 % of cases. The types of infiltrative parapancreatitis (pancreatic infiltrate) were distributed as follows: type A – 12.3 % (n=7) of cases, type B – 21.1 % (n=12) of cases, type C – 36.8 % (n=21) of cases, type D – 19.3 % (n=11) of cases, type E – 10.5 % (n=6) of cases. There was a pronounced relation between the severity of the patient’s condition and the prevalence of IP, the Spearman’s rank correlation coefficient was 0.82.

Conclusions. EP is formed in most cases of acute destructive pancreatitis and is evolutionary. It has a significant effect on the severity of the patient’s condition and the course of acute destructive pancreatitis in the infiltrative phase of the disease.

The objective was to investigate the efficiency of the preoperative rehabilitation for patients with planned anatomical lung resections.

Methods and materials.The study included 92 patients aged 27 to 87 years (mean age (63±10.8) years), 25 women (27.2 %) and 67 men (72.8 %) who underwent anatomical lung resections (79 patients, 85.9 % for lung cancer). Group 1 (39 patients – 42 %) included patients who did not smoke or quitted smoking at least 2 months before the operation. Also, they complied with the recommendations regarding respiratory gymnastics and the use of exercise and induction spirometers in full for at least 14 days. All patients who continued smoking or abandoned it less than 2 weeks before the operation, did not use breathing exercises, were included in group 2 (53 patients – 58 %).

Results. Significant difference was found in the number of complications in the studied groups (the average number of complications in one patient in group 1 was (0.46±0.8), in group 2 – (1.47±1.5), p = 0.03). The difference was found in the duration of hospitalization (19.7 days in group 1 and 25.3 days in group 2, p <0.017), in the length of stay in the ICU ((1.6±0.9) days in group 1 versus (3.4±5.9) days in group 2, p = 0.011). The early postoperative period for patients of group 1 was more favorable regardless of the presence and severity of the course of concomitant chronic obstructive pulmonary disease.

Conclusions. Comprehensive preoperative rehabilitation helps to reduce the number and severity of manifestations of complications after anatomical lung resections.

Introduction.Differential diagnosis of various forms of congenital hyperinsulinism (CH) is required at the stage of urgent histological examination, but the difference between the exo- and endocrine parts of the pancreas in frozen sections is visualized very poorly.

The objective was to search for differential diagnostic criteria of focal and diffuse forms of CH, suitable for urgent histological examination.

Methods and materials. Pancreatic surgery material from 25 children with CH, of which 15 cases of focal form (FCH) and 10 cases of diffuse (DСH), and autopsy material from 10 children without CH (K). Frozen and paraffin sections stained with hematoxylin-eosin and histochemical stains were made from the tissue of the pancreas. The number of endocrinocytes with large nuclei was estimated in 10 fields of view for each case.

Results. The average proportion of endocrinocytes with large nuclei was significantly (p <0.01) higher compared to the control both with FCH (in the affected area) and DCH (FCH – (1.82±0.50) %, DCH – (4.68±1.66) %, K – (0.34±0.21) %). We found a tendency to detect a higher absolute number of cells with large nuclei in DCH ((4.95±1.24) DCH and (3.71±1.56) FCH). Staining with azure-eosin, picro Mallory and the PAS reaction gave unstable result, and staining with toluidine blue and May-Grunwald did not allow differentiating exo- and endocrine parts of the pancreas.

Conclusion. An increase in the size of the endocrinocyte nuclei was the unsuitable criterion for the differential diagnosis of CH forms, and histochemical stains did not give a stable qualitative result. For urgent biopsy examination, new immunohistochemical methods are needed.

Introduction. This study contributes to the on-going research of the psychological readiness to learn and personal characteristics of medical students.

The objective of the study was to explore the dynamics of psychoemotional characteristics of medical students during the entire learning process, depending on the level of their psychological readiness for learning, which had been determined in the 1st year.

Methods and materials. The symptomatic questionnaire SCL-90-R was used to measure the psychoemotional characteristics of the 3rd and the 6th years students. Psychological readiness for learning (PRL) was determined in the 1st year according to the results of the study of the general intellectual potential and neuropsychic stability. Descriptive statistics (mean values, standard deviation) and comparison of mean values by Student’s t test were used as statistical methods. The study involved 507 students who studied at Pavlov University from 2013 to 2019.

Results. By the 6th year, students identify an increased risk of developing depression and anxiety, regardless of gender. By the 6th year, students from favorable PRL categories have increased scores of depression and anxiety scales, which indicates high chances of developing depressive symptoms and high anxiety even among responsible and well-adapted students. By the 6th year, sensitivity increases in female students, hostility – in males. Students with a poor PRL category in the 1st year showed a sufficiently high level of general intellectual development, which, probably, allowed these students to complete the training in the University despite their low level of neuropsychic stability.

Conclusions. Study results indicate the need to develop programs of socio-psychological support for students, focused on helping in overcoming emotional problems that arise at the final stages of education in the University.

Introduction. Young people act as a basic component of the security of society. Physical development data is an indicator of the level of health of the population. Studying at the university coincides with the reproductive period. Adverse effects on the body of young people during this period can negatively affect the health of the next generation. Physical culture and sports activities allow students to integrate effectively into the educational space of the university.

The objective of our study was to assess the morphological and medical and social characteristics of the physical development of the student youth in Saratov.

Methods and materials. The study was conducted in 2018–2019 at the base of the department of physical therapy, sports medicine and physiotherapy in Saratov State Medical University named after V. I. Razumovsky. Respondents were the students of the Saratov State Medical University named after V. I. Razumovsky as the most promising group of young people in the preservation of reproductive health. Anthropometric parameters were carried out in accordance with the recommendations of V. V. Bunak. The study included anthropometric parameters: body weight, body length, and mass-growth correlation. We analyzed the values of the method «Diagnosing the real structure of value orientations». Analysis of self assessment of the level of health and assessment of their healthy lifestyle by the author’s questionnaire of a closed type.

Results. Data of anthropometric parameters of physical development and body mass index of boys 2018–2019 tends to be overweight. S.S. Bubnova’s most preferred values for medical students are «help and mercy for people», «recognition and respect for others» and «pleasant pastime» that does not correlate with health care. Analysis of value priorities in the healthy lifestyle of medical students showed that the majority of respondents to health is not quite high role.

Conclusion. Motivated preservation of individual health and active position of the university in the case of healthy lifestyle during the student studies can have a beneficial effect in the formation of health behavior of young people. It is necessary to establish the possibility of regular, accessible and balanced nutrition of students during the study at the university.

Introduction. Voluntary anonymous HIV counseling and testing can be an effective tool to reduce the behavior that has high risks of HIV, hepatitis C (HCV) and B (HBV) transmission. The dissemination of general information on HIV, HCV, HBV to reduce risky behavior is not as much of importance as counseling on specific individual infection-related sexual risk behavior. The objective was to identify HIV/HCV/HBV-related risk factors that have to be discussed during psychosocial counseling
to help the individual to focus on his/her sexual risk behavior.

Methods and materials. The study was conducted on the base of Saint-Petersburg Center for Control of AIDS with participation of 90 individuals who voluntary applied for HIV counseling and testing. Participants’ behavioral risks and HIV knowledge were assessed by the specifically developed structured questionnaire. The level of anxiety was measured by State-Train Anxiety Inventory (STAI adapted by Hanin), the level of need for extreme-risk behavior was measured by the Sensation Seeking Scale (Zuckerman).

Results. Only 50 % of participants use condom with their steady sexual partner always or almost always. In 62 % cases, the steady sexual partner’s HIV-status is unknown. Many participants agree that HIV transmission occurs always after sexual contact with HIV-infected person. The level of situational anxiety is higher by those who do HIV testing repeatedly. Those who are more likely to seek new sensations use condom with their steady or other partner more often.

Conclusion. Motivational intervention during pre- and post-counseling by HIV/HCV/HBV testing has to focus on the discussion of individual difficulties of condom use as the means for protection and on the individual’s resources for changing sexual behavior to protect him/her-self and his/her partner from infection with HIV and viral hepatitis.

Introduction.Sepsis is a public health priority due to its high incidence and mortality. There are no clear criteria for assessing the vessels of the microvasculature in the pathological diagnosis of septic condition.

The objective of the work was to characterize changes in the vessels of the microvasculature with different morphological variants of sepsis.

Methods and materials. We analyzed 93 cases of death with a clinical diagnosis of sepsis. A study was made of pathomorphological signs of microcirculatory disorders, organ cell damage, and the presence of inflammatory infiltrates.

Results. In the course of the study, it was found that the morphological manifestations of sepsis, in addition to purulent metastasis of various degrees of severity, are signs of damage to microvessels, such as the expression of adhesive molecules by the endotheliocytes, their desquamation, leukocyte stasis, marginal standing and output of single leukocytes beyond the vessels, fibrin and hyaline microthrombi as a manifestation of DIC syndrome.

Conclusion. Regardless of the severity of the purulent metastatic process, septic lesions are characterized by the same changes in the microvasculature, expressed in increased expression of adhesive molecules by the endotheliocytes (ICAM-1), desquamation of endotheliocytes (51 %), marginal standing of leukocytes (38 %), the output of single leukocytes beyond the vessels (21 %), leukocyte stasis (55 %), the formation of fibrin and hyaline microtrombi (45 %), the sludge phenomenon (91 %), diapedetic hemorrhage in the tissues (72 %), which indicate a leading role in microcirculation disorders and, correspondingly, the formation of multiple organ failure during sepsis of secondary microvascular damage. With septicopyemia, bacterial dissemination leads not only to primary damage of the walls of blood vessels, but also to activation of their secondary lesions, as evidenced by the revealed relationship between an increase in the severity of purulent metastasis and an increase in the number of microtrombi
in blood vessels, the frequency of detection of diapedetic hemorrhages in brain tissue, and hyaline membranes in alveoli of the lungs, leukocyte stasis in the vessels of the myocardium and kidneys, necrosis of the vascular loops of the glomeruli of the kidneys.

Introduction.The biological heterogeneity of chronic lymphocytic leukemia (CLL) is reflected in the rate of progression, the need for therapy, and the response to treatment. Analysis of prognostic factors contributes to improving the quality of treatment and rational distribution of healthcare resources.

Materials and methods. Among 890 patients with documented stage of CLL, 405 (45.5 %) received treatment. As the first-line of treatment, 173 patients received intensive regimens (FCR or BR), 6 – new agents, and 226 – all other regimens. The initial stage of the disease, mutation status of IGHV, del17p with or without complex karyotype were analyzed as prognostic markers.

Results. Immunochemotherapeutic regimens were shown to be highly effective in case planned amount of treatment was completed. The combination of such prognostic parameters as the initial stage of the disease, the mutation status of IGHV, and the presence of del17p and/or complex karyotype allows us to clearly identify a group of patients with an unfavorable prognosis, for which it is advisable to use either intensive programs or new agents in the first-line therapy.

In the practice of a doctor of any specialty, patients with hypercorticism – a syndrome of excess glucocorticoids level in the body – are not uncommon. Despite the fact that most of these patients have characteristic appearance and clinical manifestations, the correct diagnosis is often established months or even years after the first complaints.

The objective of this article was to demonstrate the clinical cases of patients with hypercorticism of various genesis, as well as a short theoretical reference based on the National Guidelines for the Management of Patients with Cushing’s Syndrome (2016).