The article concerns the subjects related to the possibility of defending doctoral dissertations by women at the beginning of the twentieth century. The beginning was laid by the transfer of the Women’s Medical Institute to the subordination of the Ministry of Public Education. The task was to form not only researchers, but also teachers from talented female graduates. Social upheavals gave women the opportunity not only to teach, but also to head the departments of the Institute. Using the example of 5 female graduates of the Women’s Medical Institute, their path to the professorship is considered.

Introduction. Acute respiratory infections (ARI) are one of the main causes of morbidity and mortality from infectious diseases in the world. Respiratory infections can be caused by pathogens of various etiologies: viruses, bacteria, mycoplasmas, etc. Rapid and accurate identification of pathogens, such as bacteria, in biological samples is an important task, for which 16S rRNA gene sequencing using new generation platforms is used.

The objective was a comparative analysis of the qualitative characteristics of the oropharyngeal microbiome of healthy volunteers and patients with ARI of unknown etiology based on the 16S rRNA gene sequencing.

Methods and materials. Using V3–V4 region of 16S rRNA Illumina MiSeq sequences from oropharyngeal swabs, we analyzed the microbiome of hospitalized patients with ARI symptoms and healthy patients.

Results. In this study, we conducted V3–V4 region of 16S rRNA sequencing analyses of the oropharyngeal samples from 116 hospitalized patients with ARI symptoms and 81 healthy patients. Patients with ARI exhibited higher abundance of opportunistic pathogens, particularly Staphylococcus, Ralstonia, Aeribacillus, Acinetobacter baumannii, Methylobacterium-Methylorubrum, Rhodococcus equi. In the control samples, normal commensal respiratory tract microbiota, such as Neisseria, Prevotella, Fusobacterium, Veilonella was dominated.

Conclusions. The microbiota samples of hospitalized patients with ARI showed a predominance of opportunistic and potentially pathogenic microbiota, while normal representatives of the respiratory tract microbiota predominate in healthy volunteers. For a more detailed analysis, data on the species composition of the microbiota is required, which can be obtained by sequencing the complete sequence of the 16S rRNA gene.

Introduction. The method of positron emission tomography combined with X-ray computed tomography (PET/CT) with [18F]-L-dihydroxyphenylalanine ([18F]-DOPA) is the most accurate technique in the detection of tumor tissue in the patients with biochemical relapse of medullary thyroid carcinoma. According to foreign recommendations, the optimal time to [18F]-DOPA PET/CT scanning begin is considered to be an interval of 30–60 minutes after injection of the radiopharmaceutical. However, there are limited publications with a small group of patients that have demonstrated increased sensitivity of [18F]-DOPA PET/CT when scanning was started 15–20 minutes after tracer administration.

The objective was to improve the [18F]-DOPA PET/CT study protocol in patients with biochemical relapse of medullary thyroid carcinoma by selecting the optimal time to the start of PET/CT scanning after injection of the radiopharmaceutical.

Methods and materials. We analyzed the data of [18F]-DOPA PET/CT studies of 102 patients with biochemical relapse of medullary thyroid carcinoma (54 women and 25 men (68 %:32 %), the median age at the time of the study was 49 years [37;63]). PET/CT acquisition was performed in 15 minutes (early scanning) and 30 minutes (scanning in the standard time point) after intravenous administration of the radiopharmaceutical. The average specific activity of [18F]-DOPA was 3.9 (±0.16) MBq/kg of the patient’s body weight. The presence of foci of pathological accumulation of radiopharmaceutical, their number and localization, and the intensity of accumulation of radiopharmaceutical were determined on PET/CT images performed at different time points.

Results. We obtained a statistically significant advantage of early PET/CT scanning in detecting the number of foci of pathological hyperaccumulation of [18F]-DOPA (228 versus 211, p<0.001). The intensity of radiopharmaceutical accumulation in the early phase of scanning was also higher than when scanning in a standard time period, by an average of 16 % (p><0.001). Conclusion. [18F]-DOPA PET/CT should be started 15 minutes after tracer administration to improve topical diagnosis of recurrent medullary thyroid carcinoma due to more intense accumulation of the radiopharmaceutical in the tissue of the recurrent tumor. In addition, early scanning ensures a reduction in radiation exposure to the patient and optimizes the workflow.> <0.001). The intensity of radiopharmaceutical accumulation in the early phase of scanning was also higher than when scanning in a standard time period, by an average of 16 % (p <0.001)

Conclusion. [18F]-DOPA PET/CT should be started 15 minutes after tracer administration to improve topical diagnosis of recurrent medullary thyroid carcinoma due to more intense accumulation of the radiopharmaceutical in the tissue of the recurrent tumor. In addition, early scanning ensures a reduction in radiation exposure to the patient and optimizes the workflow.

Introduction. The endoscopic transsphenoidal approach has become much more widely used in the last decade as the main one for the removal of tumors of the cellular and parasellar regions, especially pituitary adenomas. Moreover, despite the low traumatic access and excellent visualization, nasal liquorrhea is still its main problem. The objective was to analyze the frequency of nasal liquorrhea after transsphenoidal endoscopic surgery of pituitary adenomas in the period from 2019 to 2022, to analyze materials and methods of its prevention and treatment.

Methods and materials. A retrospective analysis of the incidence of liquorrhea in 527 patients diagnosed with pituitary adenoma who underwent transsphenoidal endoscopic surgery in our clinic in the period from 2019 to 2022, as well as an analysis of the methods of plastic surgery of the postoperative defect of the base of the skull and its effectiveness. A comparative analysis of the frequency of postoperative nasal liquorrhea and the closure of the sella turcica bottom defect in 121 patients diagnosed with pituitary adenoma operated on by transsphenoidal endoscopy in the same time period by five inexperienced surgeons working in the same neurosurgical center and performing less than 50 such operations per year was carried out. The analysis of the presence/absence of correlation between the occurrence of postoperative liquorrhea and the demographic indicators of patients, the type, size and nature of adenoma growth was also performed. The patients were divided into two groups – operated on by «experienced» (more than 200 transsphenoidal operations per year) and «inexperienced» (less than 50 such operations) surgeons, respectively.

Results. Our result of a statistical analysis of the treatment results of 527 patients diagnosed with pituitary adenoma who underwent transsphenoidal endoscopic surgery showed a frequency of postoperative liquorrhea comparable to world literature data (0.9 %). There were no statistically significant differences in the frequency of liquorrhea depending on the type and materials of plastics. However, there has been a statistically significant increase in cases of liquorrhea in patients with larger tumors and with an antesellar growth direction. It is impossible not to note a significant difference in the frequency of intraoperative and postoperative liquorrhea, depending on the experience of the surgeon. An experienced surgeon had two times fewer cases of intraoperative liquorrhea and 16 times fewer cases of postoperative nasal liquorrhea.

Conclusion. Thus, over the past five years, we can note a significant decrease in the frequency of postoperative nasal liquorrhea after transsphenoidal surgery of pituitary adenomas, the emergence of many options and algorithms for closing the postoperative defect of the base of the skull to prevent and treat it. Simple low-traumatic plastic surgery methods are highly effective in solving this problem. It is necessary to strive reducing the frequency of use in surgical practice of more aggressive methods of closing the defect of the bottom of the sella turcica, including the collection of autologous tissues and cutting out the mucoperiosteal flap, without forced necessity.

The objective was to evaluate the safety and effectiveness of endoscopic methods for the removal of subepithelial tumors of the esophagus and cardia.

Methods and materials. The study includes 121 patients with subepithelial tumors of the esophagus and cardia, which were removed by endoscopic methods. In order to characterize and study the tumor and determine the correct treatment approach at the diagnostic stage, all patients underwent gastroscopy and endoscopic ultrasonography.

Results. In all cases described above, the tumors have been successfully removed, and no relapses have been noted. The average duration of surgery was 91.49 minutes and it further depended on the size of the tumor. The size of the tumor determines the possibility of removing it as a whole. There are diverticula that form in the area of the removed tumor in some cases, however it is mostly asymptomatic.

Conclusion. Endoscopic methods for the removal of subepithelial tumors are safe, effective and low-traumatic, however, delayed sequela require further study.

Introduction. Low anterior resection syndrome (LARS) is a socially significant problem in oncology and coloproctology, leading to disability and a decrease in the quality of life in up to 80 % of patients after anterior rectal resection (ARR) with total mesorectumectomy (TME). Many methods have been developed to prevent and treat LARS, but the results have remained unsatisfactory in practice. The objective of the study was to assess the incidence, severity, contribution of neoadjuvant therapy and other risk factors in the development of LARS after ARR with TME in patients with cancer.

Methods and materials. A multicenter, retrospective, cohort clinical trial was conducted. 7 medical and preventive institutions in the Russian Federation took part in the study. The study included patients with tumors of the middle and lower ampulla rectum who underwent radical surgical treatment including ARR with TME. The patients were divided into 2 groups: a group of patients who underwent neoadjuvant treatment and a group of patients who did not underwent neoadjuvant treatment. Telephone questionnaires and medical record analysis (paper or electronic) was conducted in both groups. Primary endpoints: the incidence of LARS after ARR with TME, depending on the presence of a neoadjuvant stage of treatment. Secondary endpoints: the frequency of occurrence and severity of LARS depending on risk factors (RF). The first step of the study: the telephone questionnaire using the LARS score questionnaire, an verbal assessment of the RF: the presence of preventive stoma, neoadjuvant and adjuvant therapy. The second step: analysis of medical documentation in order to assess the RF: type of anastomosis, surgical access, postoperative complications, lymph node dissection volume, use of intraoperative neuromonitoring, duration of surgery, timeframe of the reconstructive step, mode and timing of drug or combined treatment. Depending on the type of data and the distribution of values, the methods of parametric and nonparametric statistics was used. Regression analysis methods was used to assess the contribution of the RF to the LARS. Intergroup differences are considered statistically significant when p<0.05. Data analysis was conducted using the SPSS 19.0 software package. Results. Data from 104 patients who met the inclusion criteria for the study were analyzed: 83 patients (79.8 %) with neoadjuvant treatment and 21 patients (20.2 %) without it. The groups were comparable to each other in terms of gender, age, tumor location, cT-criterion and pathomorphological characteristics of the tumor. In both groups, LARS occurred in 66 patients (63 %), with 39 people (37 %) having pronounced LARS. A statistically significant difference was found in the incidence of LARS between the groups: in the group with neoadjuvant treatment, LARS was detected in 58 patients (70 %), in the group without preoperative treatment in 8 patients (38 %), Mann–Whitney 594.5, p = 0.007. There is also a statistically significant difference in the incidence of pronounced LARS between the groups: in the group with neoadjuvant treatment in 35 patients (42 %), in the group without preoperative treatment in 4 patients (19 %), Pearson Chi-square: 7.302, p = 0.038. A statistically significant correlation was found between the presence of LARS and the volume of lymph dissection, the Pearson Chi-squared conjugacy coefficient = 8.152, p=0.004, and the V-Kramer value 0.280 (average correlation). Conclusion. LARS is a common complication after ARR with TME, occurring in 63 % of patients even 78 months after the initial surgery. After the neoadjuvant stage of treatment, LARS occurs statistically significantly more often. > <0.05. Data analysis was conducted using the SPSS 19.0 software package.

Results. Data from 104 patients who met the inclusion criteria for the study were analyzed: 83 patients (79.8 %) with neoadjuvant treatment and 21 patients (20.2 %) without it. The groups were comparable to each other in terms of gender, age, tumor location, cT-criterion and pathomorphological characteristics of the tumor. In both groups, LARS occurred in 66 patients (63 %), with 39 people (37 %) having pronounced LARS. A statistically significant difference was found in the incidence of LARS between the groups: in the group with neoadjuvant treatment, LARS was detected in 58 patients (70 %), in the group without preoperative treatment in 8 patients (38 %), Mann–Whitney 594.5, p = 0.007. There is also a statistically significant difference in the incidence of pronounced LARS between the groups: in the group with neoadjuvant treatment in 35 patients (42 %), in the group without preoperative treatment in 4 patients (19 %), Pearson Chi-square: 7.302, p = 0.038. A statistically significant correlation was found between the presence of LARS and the volume of lymph dissection, the Pearson Chi-squared conjugacy coefficient = 8.152, p=0.004, and the V-Kramer value 0.280 (average correlation).

Conclusion. LARS is a common complication after ARR with TME, occurring in 63 % of patients even 78 months after the initial surgery. After the neoadjuvant stage of treatment, LARS occurs statistically significantly more often.

Background. Restoration of speech function after surgery for oral and oropharyngeal cancer is a complex and lengthy process, the effectiveness of which largely depends on control over corrective speech therapy. Telemedicine has become the fastest growing sector of health care, and its use for speech rehabilitation will allow speech therapy sessions to be conducted regardless of the patient’s physical location. The objective of the study was to evaluate the effectiveness of remote controlled format of speech therapy sessions in patients who underwent surgery for oral and oropharyngeal cancers.

Methods and materials. The study included 36 patients aged 26 to 68 years, diagnosed with oral and oropharyngeal cancer, with a tumor prevalence of T1-3N0-2M0. The patients lived in various regions of the Russian Federation. All patients had speech function disorders after surgery for oral and oropharyngeal cancer. Remote controlled speech rehabilitation was conducted using the «Teleoncocenter» platform according to the techniques developed at the Cancer Research Institute of the Tomsk National Research Medical Center. The effectiveness of speech rehabilitation was assessed by the changes in the indicators of pronunciation disorders of groups of consonant sounds in points (from 0 to 4 points).

Results. The number of online speech therapy sessions depended on the severity of speech impairment and varied from 13 to 32 (Me=21). The duration of sessions was set by the speech therapist (15–45 minutes) depending on the tasks at the current stage of speech rehabilitation therapy and the general well-being of the patient. Remote controlled speech therapy resulted in a significant improvement of the pronunciation of the studied groups of consonant sounds (p <0.001). In the groups of back-lingual and front-lingual sounds, in some cases, it was possible to achieve complete restoration of the pronunciation of sounds (0 points).

Conclusion. The use of remote controlled format of speech rehabilitation demonstrated the effectiveness of correcting speech disorders after surgery in oral and oropharyngeal cancer patients. The use of the «Teleoncocenter» platform made it possible to conduct online speech therapy sessions and consultations, which was especially important for people in remote areas of the Russian Federation or who had limited opportunities to visit specialists.

Cyclic vomiting syndrome is considered to be a chronic functional disorder, the etiology and pathogenesis of which is currently not well understood, and which is characterized by recurrent attacks of intense nausea and vomiting, and sometimes accompanied by abdominal pain, headaches or migraine. This article is the first to demonstrate a case of a cyclic vomiting syndrome in an adult patient with typical vomiting attacks and revealed during the examination dysfunction of the cerebral venous drainage due to a variant of the cerebral venous system development. Neurovisualization showed the signs of the left jugular vein, left transverse and sigmoid sinuses hypoplasia, as well as an asymptomatic neurovascular conflict at the level of right IXth and Xth cranial nerves.