The article is devoted to the consideration of the question of how the staff of the St. Petersburg (Petrograd) Women’s Medical Institute participated in the fight against epidemics from the beginning of the century to the 1920s. The use of the Institute’s laboratories and the participation of the staff in the fight against cholera epidemics are considered. The contribution of professors D. K. Zabolotny and S. I. Zlatogorov to the fight against epidemics was noted.

Introduction. Nowadays, obesity is considered as a chronic metabolic disease that occurs at any age. The relevance of the study is defined by the high prevalence of obese people

The objective was a psychological assessment of the level of compliance, emotional state, characteristics of eating behavior and satisfaction with the quality of life in patients with morbid obesity before and after bariatric surgery.

Methods and materials. The study included 30 patients with morbid obesity who underwent bariatric surgery aged 26 to 53 years. Psychodiagnostic techniques and clinical scales were used to determine the level of compliance, emotional state and features of eating behavior.

Results. The study showed that in patients with morbid obesity after bariatric surgery, the type of eating behavior changed towards stronger compliance to the diet, their emotional state improved but at the same time, satisfaction with the quality of life decreased. 6 months after the bariatric surgery, compliance to medical recommendations in patients decreased. Patients began to violate the prescribed regimen, depreciated the possible consequences and complications, and began to neglect some aspects of treatment and dietary compliance.

Conclusion. It is important to pay attention to the creation of preventive programs aimed at informing patients about food composition and caloric value, awareness of habitual behavioral reactions to food stimuli and risk factors for repeated breakdowns. 

Introduction. Endocrine insufficiency of the pancreas manifests, as a rule, in the form of carbohydrate metabolism disorders.

Methods and materials. The levels of insulin concentration were analyzed in 21 patients with various forms of acute pancreatitis with a degree of clinical severity on the APACHE II scale from 10 to 14 (12±2) and the levels of glucagon concentration in 16 patients with a degree of clinical severity on the APACHE II scale from 8 to 10 (9±1) on the 1st, 3rd and 7th day since the onset of disease, the dynamics of blood glycemia was observed in all patients.

Results. As a result, despite the relatively normal blood glucose level in all observations compared with the control group, there was a decrease in insulin by more than 2 times, a decrease in glucagon by 1.5 times, the level of which increased by the outcome of the disease. In the presence of normoglycemia in all studied cases.

Conclusions. The obtained data indicates that insufficiency of insulin and glucagon exists in all forms of AP. Relative normoglycemia is caused by absolute insulin insufficiency against the background of interstitial edema of the pancreas in AP. Correction of endocrine disorders in AP is a promising direction in the treatment of patients with various forms of AP.

Objective was to conduct a comparative analysis of routine clinical and laboratory parameters in two groups of patients with chronic viral hepatitis C (CHC) depending on the presence or absence of hepatic steatosis.

Methods and materials. The observational retrospective cross-sectional study included 411 patients with CHC, of which 43.80 % were those with hepatic steatosis. The studied parameters were routine clinical and laboratory parameters, the viral genotype, as well as formalized results of a liver biopsy and ultrasound examination of the abdominal organs. To assess the differences between the two groups, the following were calculated: Pearson’s test, two-tailed Fisher’s test, Wilcoxon rank sum test, Spearman’s correlation coefficient, and partial correlation coefficient.

Results. It was found that CHC patients with hepatic steatosis were older and had a higher body mass index (BMI) than patients without hepatic steatosis (p<0.01). Among patients with hepatic steatosis, the 3a genotype of the virus (p<0.001) and advanced stages of liver fibrosis (p<0.01) were more often detected, higher concentrations of hepatic transaminase (p£0.001) and iron (p<0 .01) in blood serum were observed, as well as higher liver (p<0.001) and pancreas (p<0.001) sizes on ultrasound than among patients without hepatic steatosis.

Conclusion. Age, BMI, viral genotype, stage of liver fibrosis, ALT, AST, GGT, and iron levels, as well as liver and pancreas size are potential predictors of the presence of hepatic steatosis in CHC patients.

Introduction. The risk of pituitary apoplexy is 5.4 times higher than the risk of hemorrhage into another intracranial tumor. Despite the fact that in 80 % of cases, hemorrhage into the pituitary adenoma is the first manifestation of the disease, the issues of neuroendocrine recovery, evaluation of the results of surgical treatment are insufficiently studied at present.

Methods and materials. A clinical study of 72 patients with histologically confirmed diagnosis of pituitary adenoma was conducted. According to MRI of the brain with intravenous contrast, neuroimaging signs of pituitary apoplexy were found in all the studied patients. The studied patients were aged from 28 to 55 years, the average age of patients was 48.9±15.25 years (median 49 years). All the examined patients underwent surgical treatment – transsphenoidal endoscopic removal of pituitary adenoma; there were no emergency indications for surgical treatment among the examined patients. In the preop- erative and late postoperative periods, the relationship between the values of prolactin and other pituitary hormones with the parameters of neuroendocrine recovery was evaluated.

Results. In patients with recurrent pituitary adenoma and pituitary apoplexy, suprasellar (χ²=8; r=0.005) and laterosellar growth (χ²=3.92; r=0.048) are significantly less common; reduced prolactin and ACTH values are more often detected after surgical treatment (p<0.05). It was revealed that with preoperative increased prolactin indices, general cerebral symptoms (r=–1; p=0) and visual disturbances (r=–0.982; p=0.28) are less common after surgery. In patients with ACTH-secreting pituitary adenoma after apoplexy, the totality of removal of Near Complete Gross Resection was more often observed (r=0.382; p=0.004).

Conclusion. In patients with pituitary apoplexy before surgery, an increased prolactin index is one of the markers of regression of hypopituitary disorders in the postoperative period.

The objective was to study the clinical features of symptomatic hypertrophic cardiomyopathy (HCM) depending on the age of onset and the presence of cardiometabolic risk factors.

Methods and materials. From 2014 to 2020, 250 patients were examined, 100 patients with symptomatic HCM aged 18 to 86 years were included in the study.

Results. The incidence of arterial hypertension (AH), obesity, and angina syndrome was significantly higher in patients with HCM aged 45 years and older. The patients with HCM and associated obesity had greater left ventricular end-diastolic dimension and left antero-posterior size regardless of the age of onset of clinical manifestations. The young patients with HCM and associated obesity had more often AH. Patients with HCM with the disease onset ≥ 45 years of age and associated obesity had greater left ventricular posterior wall thickness, left ventricular end-diastolic dimension index. In this group of patients, pulmonary hypertension was more often diagnosed.

Conclusion. Obesity and other cardiometabolic risk factors are predictors of the progressive course of HCM, which points the need for their prevention and timely correction.

Introduction. In most cases, dural arteriovenous fistulas of the brain can be effectively treated endovascularly. However, rare fistulas with an isolated segment of the venous sinus may be difficult to treat surgically. Hybrid surgical interventions (combination of open surgical access to the sinus and puncture embolization in hybrid operating room) can significantly increase the effectiveness of surgical treatment of patients with this pathology.

The objective was to improve the results of surgical treatment of patients with cerebral dural arteriovenous fistulas with isolated segment of the venous sinus by using a hybrid surgical intervention.

Methods and materials. 2 surgical interventions were performed using microsurgical and endovascular methods. Surgical interventions were made in hybrid operating room.

Results. Radical occlusion of dural arteriovenous fistulas was achieved in both cases. The postoperative period was favorable in both cases with positive dynamics in the neurological status.

Conclusions. Hybrid interventions combining microsurgical and endovascular methods make it possible to achieve radical occlusion of “complex” cerebral dural arteriovenous fistulas with isolated segments of the venous sinus.

Introduction. Effective and available rehabilitation methods are necessary in the context of the ongoing pandemic of COVID-19 (CoronaVirus Disease 2019).

The objective was to develop a personalized rehabilitation program for patients who have undergone COVID-19 based on the proven effectiveness of methods.

Methods and materials. Three months after COVID-19, 855 patients were examined by the method of standardized phone interview, according to the rehabilitation routing scale (RRS). 200 patients have got through the 10-days inpatient rehabilitation course. Breathing exercises, exercise regimen designed to strengthen basic muscles groups, Nordic walking were used. The physical activity level, heart rate and saturation (SpO₂) have been monitored by wearable devices (fitness-trackers) during 3 months.

Results. Inpatient rehabilitation was required for 1 % of patients, outpatient – 19 %. 42 % did not need rehabilitation, but they had respiratory symptoms and decreased exercise tolerance. There was an improvement in flexibility, muscle strength; the duration of breath holding, 6-minutes walk test, exercise tolerance test; reducing the severity of shortness of breath (mMRC scale) and respiratory symptoms (САТ scale). The achieved level of daily physical activity was maintained for 3 months after the end of the rehabilitative program.

Сonclusion. Using the rehabilitation routing scale in the post-COVID period allows stratifying patients according to the degree of need for rehabilitation. Clinically significant and persistent positive effect in most patients can be achieved by physiotherapy methods during 10-days course. Wearable devices of monitoring biometric data are useful additional instruments for monitoring recovery after COVID-19.

The objective was to evaluate the effectiveness of the respiratory rehabilitation program for patients after a new coronavirus infection COVID-19 from the standpoint of the International Classification of Functioning, Disability and Health.

Methods and materials. A study of 59 patients who underwent a new coronavirus infection COVID-19 and were hospitalized after 2–3 months for a rehabilitation course was conducted on the basis of the Pavlov University in 2020–2022. The main group included 38 patients (12 men and 26 women), the comparison group consisted of 21 patients (14 men and 7 women). The program of respiratory rehabilitation of patients who underwent COVD-19 included therapeutic gymnastics (breathing exercises, restorative physical exercises, special strength-oriented physical exercises), Nordic walking and physiotherapy procedures. The program developed by us was implemented during 2 weeks of inpatient stay of patients. Evaluation of the effectiveness of the respiratory rehabilitation program for patients who underwent COVID-19 was carried out on the basis of GOST R 57960 – 2017 “Evaluation of the results of rehabilitation services”.

Results. Based on the evaluation of the effectiveness of rehabilitation in both groups according to GOST R 57960 – 2017 “Evaluation of the results of rehabilitation services”, the sum of individual indicators in patients of the main group was 84.7 points, the average score was 2.2. The sum of individual indicators in patients of the comparison group was 25.4 points, the average score was 1.2. Thus, the effectiveness of respiratory rehabilitation of patients of the main group according to GOST – excellent, in patients of the comparison group – satisfactory.

Conclusions. The ICF categories have been formed, which allow us to provide objective information about the condition of patients who have undergone a new coronavirus infection in moderate and severe forms. A program of respiratory rehabilitation has been developed, including classes in breathing exercises, restorative physical exercises, special strength-oriented physical exercises, Nordic walking, and physiotherapy procedures. The effectiveness of respiratory rehabilitation of patients of the main group can be recognized as excellent.

Pelvic trauma caused by high-energy forces are accounting for 3 % to 8 % of all traumatic fractures. These are often accompanied by other life-threatening injuries that is a serious tactic problem. There are many publications on the advantages and disadvantages of multi-stage treatment with the Damage Control Orthopedics protocol and Early Total Surgical Care. However, the most difficult category was those who are in a borderline or hemodynamically unstable state.

Their treatment is often complicated by acute respiratory distress syndrome (ARDS) and multiple organ failure syndrome (MOFS). The reliable risk assessment, associated with the implementation of a single-stage or multi-stage treatment protocol in patients with unstable pelvic injury, is not sufficient, and surgeon has to choose the treatment protocol based only on own experience.

The objective was to analyze the results of using single-stage and multi-stage treatment protocols for patients with unstable pelvic trauma and identify insufficiently researched aspects of each of them.