Objective: to analyze dynamics of sporulation of mold fungi in order to predict the risks of exacerbation of allergic diseases in Samara.

Materials and methods. We evaluated the concentration of fungal spores between April 1st and September 30th in 2016–2019 in the air. Mold spores were captured using an impactor trap on slides covered with a mixture of vaseline and wax with subsequent counting of spore number and their identification.

Results. The mean vegetative period of mold fungi in Samara city was 164 days. We have identified spores of Cladosporium and Alternaria, which accounted for 34.4 % of the total number of spores in the atmospheric air of Samara. Cladosporium spores were detected during the entire observation period; their proportion was 15.3% from the total number of fungal spores, their maximum concentrations were within the normal limits and did not exceed 960 spores/m3. The proportion of Alternaria spores was 19.1%. In some periods, concentrations of Alternaria spores exceeded threshold values: the concentration between 10 and 100 spores/m3 was observed 4 to 31 days per months; the concentration above 100 spores/m3 was observed 2 to 25 days per month. The highest total monthly concentration of Alternaria spores was detected in July–September, during the period of sagebrush and ragweed pollination, which can potentially hamper the diagnosis and treatment of patients who have exacerbations of their allergic diseases in this period.

Conclusion. We have identified the main taxa of mold fungi, analyzed their regional specificity and assessed the risk of allergic diseases in individuals sensitized to Alternaria and Cladosporium species. Our findings will help to optimize the diagnosis, treatment, and prevention of allergic diseases in the region. 

This article demonstrates experimental data from the study evaluating total antioxidant activity of water systems saturated with hydrogen using coulometric analysis applied in the Clinic of Ecological Medicine LLC.

The problem of rehabilitation therapy after ischemic strokes is one of the most relevant in current neurology [4, 7]. Neurophysiological research is currently leading in the evaluation and control of brain plasticity. Approximately 80% of all injuries are the injuries to the musculoskeletal system; almost half of them are upper limb traumas. Treatment efficacy depends on the quality of first aid. Conservative treatment methods are effective in 13%–60% of patients, whereas with surgical methods, the efficacy is between 10% and 70%. Moreover, patients with radius fractures usually lose their ability to work for 6 to 8 months; 10% of them have to change their profession after it; 6% to 17% of patients become disabled. Rehabilitation of such patients should include dynamic electroencephalographic (EEG) monitoring, since the information about the functional state of cerebral structures is necessary for organizing an effective rehabilitation program, predicting and assessing treatment outcomes.

We have examined 26 patients with cerebral stroke (14 men and 12 women aged 42–65 years) in the early stages with the leading neurological syndrome manifesting as spastic hemiparesis and 27 patients with extension fractures of the distal radial physis (after manual reposition and plaster splint removal) at different stages of their rehabilitation with a week interval.

We found that changes in brain electric activity (from similar leads of the contralateral hemisphere) were more significant in patients with acute stroke, which can be associated with specific changes in the cerebral rhythms after stroke, since deep location of the alteration focus results in more diffused EEG symptoms due to conducting paths. Positive dynamics in the reduction of slow-wave activity above the affected area in the late rehabilitation period was more pronounced in patients who performed dynamic and static exercises. Normalization of electrogenesis was more effective in patients performing static exercises than in those performing dynamic exercises. 

The incidence of complications after endoscopic retrograde cholangiopancreatography (ERCP) is reported to be 1% to 15% [4]. Acute post-intervention pancreatitis is a serious complication after endoscopic transpapillary procedures; it is characterized by rapid progression and high mortality rates [8]. In up to 15% of patients, severe acute post-intervention pancreatitis is accompanied by pancreatic necrosis and multiple organ failure [4]. The death rate in sterile pancreatic necrosis varies between 15% and 30%, whereas in infective pancreatic necrosis, the death rate reaches 85% [3, 9]. Intraductal pancreatic hypertension has a crucial importance in the pathogenesis of acute pancreatitis; therefore, early and adequate decompression minimizes the risk of severe parapancreatic complications [1]. Preventive stenting of the main pancreatic duct (MPD) significantly reduced the risk of this complication. However, there is still no consensus on the effectiveness of this preventive measure [7]. The accumulation of collective experience will allow us to develop a unified strategy for patients at risk of acute post-intervention pancreatitis.

Prevention and replacement of dentition defects is one of the most important tasks of dentistry. In this case, modern grafting methods are used; implantation is one of such methods. Despite modern technologies, this method causes complications, the most common of which are sinusitis (45.3 %), neuritis (35.5 %), and perimplantitis (19.2 %).

The problem of treatment for benign prostatic hyperplasia (BHP) remains highly relevant due to the high prevalence of this disease, its negative impact on the quality of life, and high risk of serious complications, such as acute urinary retention, acute renal failure, hematuria, and bladder tamponade.

Moreover, patients with BHP usually demonstrate high hospitalized incidence. In Nizhny Novgorod region, the hospitalized incidence was 462.3 per 100,000 men of the relevant age in 2010. The majority of BHP patients admitted to hospitals (87.1%) have undergone surgical treatment. More than half of them had emergency hospitalization; 4.6% of patients suffered from acute urinary retention and 1.2% of patients were diagnosed with acute renal failure.

This study was undertaken to evaluate early and late postoperative periods in patients operated on for gunshot abdominal wounds. We found that the main drawbacks in providing medical care to civilians with severe gunshot injuries received in local conflicts included the lack of pre-hospital emergency care, proper infrastructure for the hospital stage, continuity in treatment, rehabilitation, and the ability to analyze treatment outcomes. Improper training of personnel to provide assistance to patients with severe combined trauma is also an important factor. The main criteria for choosing active surgical tactics for patients with gunshot abdominal wounds received in a regional conflict include the anatomical landmarks of the injury, poor or critical condition of the patient, shock, and absolute signs of a penetrating wound. More than two-thirds of patients with gunshot abdominal wounds (76.4%) develop complications in the late postoperative period, primarily postoperative ventral hernias and adhesions in the abdominal cavity.

Endoscopic interventions have become increasingly popular in the treatment of patients with choledocholithiasis complicated by mechanical jaundice and cholangitis along with conventional surgeries.

Objective: to analyze the outcomes of endoscopic transpapillary interventions in the treatment of choledocholithiasis.

Interventions on the major duodenal papilla were performed in 286 patients with mechanical jaundice associated with choledocholiasis. The study population included 208 females and 78 males; mean age was 64 years; 72% of patients were older than 60 years.

In 255 patients (87.7%) with relatively small (between 0.8 and 1.4 cm) single and multiple common bile duct stones, we managed to extract the concrements into the intestine during endoscopic procedures. Before that, all patients had undergone endoscopic papillotomy to facilitate subsequent stone extraction. The length of papillotomy incision depended on the size of the longitudinal fold, but did not exceed 6–8 mm. In 55 out of 256 patients, a nasobiliary drainage was installed in order to reduce mechanical jaundice and eliminate cholangitis.

Nasobiliary drainage and common bile duct stenting improved patient condition and helped to prepare the patient for more radical endoscopic or surgical treatment. 

Currently available technologies of medical care for patients with chronic non-specific lung diseases (CNLDs), including those with chronic bronchitis and asthma, make it possible to move the epicenter of active treatment from the inpatient to the outpatient facilities. Among the existing non-pharmacological treatments for CNLDs, speleogalotherapy has become increasingly popular. Speleogalotherapy is a specific type of treatment using the microclimate of karst caves, salt mines, or artificial climate chambers of various modifications. The microclimate of karst caves is characterized by a relatively high degree of radioactivity and air ionization, presence of a highly dispersed aerosol, increased concentration of carbon dioxide, relatively low temperature, high absolute humidity, absence of microbes and allergens, and stability of meteorological factors. Multiple studies evaluating different variants of speleogalotherapy in patients with chronic bronchitis and asthma suggest that this type of treatment ensures positive effect in both groups of patients. The dry fine salt aerosol mainly affects the bronchial tree and increases the activity of the respiratory epithelium resulting in an increased sputum production with subsequent cleansing of the bronchi. It also ensures disinfection, which eliminates or mitigates existing respiratory dysbacteriosis.

The problem of predicting and preventing postoperative ventral hernias is highly relevant. We examined 450 patients to identify predictors of hernia formation and determine its risk. Seventy-one patients have undergone MRI of the anterior abdominal wall to assess its morphology. We have identified minor and major predictors of hernia formation. Changes in the anterior abdominal wall tissues significant for the pathogenesis of herniation detected during MRI, prevailed in the elderly patients, especially aponeurosis defects that cannot be detected by physical examination, which implies a high risk of postoperative ventral hernias. We used methods of surgical prevention with the consideration of the risk of postoperative ventral hernias. Laparorrhaphy with the staggered strengthening suture is recommended for low-risk patients, whereas high-risk patients should undergo preventive grafting or laparorrhaphy using a polypropylene mesh implant according to the developed technique (if grafting is impossible).

Coronavirus 2019 (COVID-19) is a severe acute respiratory infection (TORI) caused by the new coronavirus SARS-CoV-2. The SARS-CoV-2 virus is a single-stranded stranded RNA virus with nucleocapside. Sequencing of its complete genome has shown that it is closely related to SARS-CoV, with which it shares about 79 % of its genome. The article describes the pathogenesis of COVID-19 and potential approaches to treating patients as well as approaches to patient management after transplantation with COVID-19.

In this study, we analyzed the efficacy of the most common methods of conservative treatment and orthopedic correction of an ingrown toenail at early stages used in outpatient surgical practice. We evaluated treatment outcomes and compared them using the methods of evidence-based medicine. We found that the orthopedic approach is significantly more effective than conservative treatment.

This study aims to analyze the role and impact of psychological aspects of quality of life in patients with ulcerative colitis (UC) on the disease course.

We have recruited 61 patients (39 women and 22 men aged 18–60 years) diagnosed with UC (according to the requirements of the Helsinki Declaration of 1975). Study participants were divided into two groups. Group 1 included 32 patients with a slowly progressing disease. Group 2 comprised 29 patients with frequent UC relapses and rapid development of complications. We analyzed the data from the MOS SF-36 questionnaire, levels of and personal and reactive anxiety (PA and RA respectively) assessed using the Spielberger-Khanin's test, stress tolerance, and social adaptation evaluated using the Holmes and Rahe scale.

We also analyzed the frequency and main clinical manifestations of anxiety and depression in UC patients that affected their quality of life, as well as the state of psychosomatic mental health. UC patients are characterized by a significant decrease in physical and emotional functioning. The analysis of personal and situational anxiety demonstrated an association between psychological health and social functioning. Reactive anxiety was negatively correlated with psychological health, while personal anxiety was positively correlated pain syndrome and negatively correlated with social functioning (r = -0.48) and psychological health (r = –0.34). The level of depression increased with patient age (r = 0.49, р < 0.0001). Situational anxiety increased when patients had troubles in their family (r = 0.33, p = 0.04) and at work (r = 0.49, p = 0.008) or received negative information from the media (r = 0.57, p = 0.003).

The psychoemotional state and quality of life directly depend on the degree of compensation and psychosocial adaptation of the patient, as well as on the compliance of the doctor, patient, and family members. Assessment of quality of life in UC patients is necessary to develop individual treatment strategies that will improve the disease control and increase compliance. 

In this study, we analyzed biocompatibility of polycaprolactone/vaterite scaffolds by assessing the dynamics of systemic inflammatory response. We detected an increase in the CRP level after 7 days and no changes in the level TNF-α and IL-1β after 7 and 21 days, which indicates a weak and short-term inflammatory reaction and is a pathogenetic component of matrix biocompatibility.

Using clinical, radiological, neuromiographic, and biomechanical data, we have developed an original system for comprehensive assessment of hip dysplasia degree in children. Its sensitivity and specificity was 95.6% and 87.5 % respectively; its overall accuracy was 95.1%; its validity was as follows: Сr–0.89; Cs–0.86; Cc–0.85.

Naturally, a person's health and quality of life cannot be considered in isolation from the natural environment in which he lives, works and rests. The aim of the study is to show how the main sciences of the XXI century - ecology and innovation and integrated impact on human beings - seem to interact closely. The article deals in detail with the aspects of innovation. (environmental rationing, new methods of bioindication and biomonitoring, waste utilization, environmental audit of the territory, public health, etc.). The issues of innovation in environmental management aimed at improving the quality of life of the population are covered in detail. We have considered "from beginning to end" aspects of interaction between innovation and ecology. The main conclusion is that there is a need for a program of phased innovative actions, describing the content and sequence of planned measures and setting the final objectives of the reform of environmental management system, activities.

In article, we observe the changes of main parameters of heart biomechanics and kinetics of main arteries in patients with different types of atrial fibrillation. We describe mechanisms that cause the trauma of mechanical factors on arteries walls in atrial fibrillation with different duration of maximum pause between ventricles contraction. Atrial fibrillation is the additional risk factor of main arteries atherosclerosis. We demonstrated the danger of atrial fibrillation with pauses between ventricles contractions more than 2 seconds from the point of view of appearing and progressing of atherosclerosis.

In article, we studied the heart biomechanics and main arteries kinetics in different types of atrial fibrillation. We described the increase of main hemodynamic parameters in atrial fibrillation. We created the functional classification of atrial fibrillation based on the maximum duration of pauses between ventricles contractions. We demonstrated that more dangerous in prognosis is atrial fibrillation with pauses between ventricles contractions more than 2 seconds.

We measured mean amplitude (MA-EMG) and oscillation repetition rate (ORR-EMG) during dynamic and static exercises in clinical setting for the first time. We found that in healthy individuals, EMG amplitude depends on the nature of the exercises. The highest EMG amplitude was registered during static exercises. Patients with acute stroke primarily demonstrated low-amplitude EMG activity extended through the entire cycle of movement without a clear peak. Static exercises significantly improved the amplitude and frequency of EMG oscillations.

This article discusses methodological approaches to the shift method in the work of healthcare professionals. This method solves the problem of personnel shortage in certain medical specialties and ensures the availability and high quality of medical care for the population residing in small towns and rural areas, as well as in remote areas of the Russian Federation.

The paper presents information about the importance of laboratory services for the effective treatment process of patients. Monitoring and evaluating the laboratory services themselves remains an urgent task. Solving the problem requires a standardized approach and methodology. To solve this problem, the World Health Organization has developed a document. The document is a guide for evaluating individual laboratories and the national laboratory system. The document describes the general procedure for evaluating laboratories and contains questionnaires. Questionnaires are used to evaluate the national laboratory system and specifically individual laboratories.

The paper studies the main performance indicators of the Samara Perinatal Center over the past three years. Positive dynamics which manifests itself in a decrease in the number of premature births and the number of newborns with extremely low body weight and in a decrease in perinatal mortality and morbidity in newborns is noted. It is emphasized that the positive results in practical medicine are interconnected with the introduction of new scientific approaches to the problems of gestation proposed by scientists and graduate students of Samara State Medical University.

Oncoepidemiological burden on the female reproductive system is influenced by both increased oncological factors and decrease in the quality of life, and aging of the population. Human health is highly dependent on the environmental conditions. Ecological factors by 15–25 % affect the quality of human potential. Findings obtained by different specialists confirm that negative influence of ecological factors is the most pronounced in Bashkortostan, Tatarstan, the Samara region and the Perm region. Ecological and the population analysis of the morbidity demands the use of complex methods for the estimation of the influence of ecology on human health. It is hard to reveal cause-and-effect relationship because a human being and his health have not been considered as the objects and the criterion of the environmental safety yet. Ecologists do not work together with doctors, though ecological safety demands such cooperation.

The purpose of the article is to analyze the dynamics of the gross emission into the atmosphere of the Samara region, to reveal the extent of the air pollution in different districts of the Samara region, to study the reports of the Samara Ministry of Natural Resources and Environment, to evaluate the urban air and water quality

Factual information and analysis data which characterize the environment condition and the condition of its main constituents, natural ecological systems in the Samara region, state reports about the environment and natural resources in the Samara region over the period of 2014–2018 have been thoroughly studied. 

According to the National Project ‘Demography,’ cumulative birth rate per 1 woman should increase from 1.62 in 2017 to 1.70 in 2024. From an ethical point of view, the use of hormonal contraceptives is unacceptable due to their abortive effect. However, there is an increasing number of women taking these drugs, often, without a doctor's consultation, despite potential contraindications and risks to their health they are unaware about. Such women usually visit their general practitioner (GP) in case of any health problems; therefore, a GP should take into account this factor as a potential cause of pathological conditions and assess the safety of using contraceptives.

The analysis of patients' awareness of the effect of hormonal contraceptives demonstrated that 30% to 60% of women do not know about all negative effects of these drugs on their own health and the health of their future children. More than 30% of respondents did not know about the abortive effect of hormonal contraceptives; 70% of women considered this information important. Approximately half of all women using these drugs did not know about the risk of neural tube defects in the fetus, increasing insulin resistance, and stopping the production of their own sex hormones. In general, our findings indicate insufficient patient awareness of the effects of hormonal contraceptives the need for doctor consultation and appropriate educational work of pharmacists among the population. The analysis of patients’ histories (those who were currently taking hormonal contraceptives or used them in the past; n = 12) demonstrated that 91.7% of them (11 women) had contraindications or health risks. Among 7 patients taking these drugs, 5 women (71.4%) were found to be at risk of developing thrombosis, 1 woman (14.3 %) had contraindications, and only 1 woman (14.3 %) had no contraindications or risks. The assessment of hormonal contraceptive safety using patients’ histories and drug package inserts, showed that 2 out of 7 patients should stop taking oral contraceptive and 4 patients can continue using them with caution. From an ethical point of view, 5 out of 7 patients can be recommended to stop taking the drug, since information about the abortive effect of hormonal contraceptives is important for them. 

Drugs are an integral part of modern civilization, accompanying a person from conception to death, ensuring prevention and treatment of diseases, health, and a comfortable life. The expansion of the medicine market, possibility of drug remote purchase and delivery actualize the problem of safe and rational use of medicines and make it an integral part of safe human life. Public education about medicines is one of the main activities of the WHO to promote their rational use. To make the educational activity of pharmacists more effective, it is necessary to explore the awareness of the population on pharmaceuticals. In this study, performed with the involvement of students, we found that about 70% of respondents consider it necessary to deliver medicines from a pharmacy to their home; however, approximately 40% of respondents do not know the difference between traditional (allopathic) medicines and homoeopathic medicines and some 30% of respondents do not know their difference from dietary supplements. More than half of respondents do not know about long-release drugs, while 30% of people mistakenly believe that conventional tablets last longer. Almost half of respondents using homeopathic drugs noticed no positive effect from them; among people taking dietary supplements, only 15% reported positive effects. This raises the question of the rationality of their use by this population group. Approximately 70% of respondents believed that traditional medications were more effective than homeopathic ones; still about 60–70% of respondents would like to know more about long-release tablets, homeopathic medications, and dietary supplements. In general, our findings indicate insufficient public awareness of medicines and the need for educational programs to ensure their rational and safe use.