Objective: to explore microsurgical anatomy of the anterior incisural space (AIS), its topography and size in the skull, and to assess the topography of the basilar artery apex in AIS and find possible craniometric correlations.

Materials and methods. In this anatomical study, we used 100 non-fixed heads of people who died from somatic pathology without diseases of the central nervous system. All heads were dissected using standard methods. Then we modelled the topography of the tentorial incisure (TI) in the skull  by cutting off the hemispheres at the level of the brain stem in parallel to the free margin of TI. We measured  length and width of TI, analyzed its topography in the cranial cavity, performed TI morphometry, and  measured cranial indices and angular parameters of the skull base relief. Morphometric analysis of our data  was conducted by calculating coefficients and indices. Data analysis was performed using the STATISTICA  Statsoft. Microsurgical anatomy of the AIS and TI was studied using the operating microscope MBS-10 and digital video camera Sony HDR-CX560 E. The photos were taken with a 2–8-fold magnification.

Results. Results. AIS length varied between 14 and 24 mm, whereas its width was between 24.0 and 36.0 mm. Almost half of all TI samples (42%) had AIS with a length of 17–19 mm. In all series of measurements, the length of the AIS was minimal – 14 mm (6%); 15–16 mm (19%), medium – 17–19 mm (42%), large – 20–22 mm (24%) and maximum – 23–24 mm – 9%. AIS were divided by TI types into four groups: A, B, C,  and D. Minimum and small AIS were grouped into into ‘short-size AIS’ [14–16] mm, while large and maximum AIS were grouped into ‘long-size AIS’ [20–24] mm. The proportions of short AIS, long AIS, and medium AIS were 25%, 33%, and 42%, respectively. In group A, long-size AIS were found in 53.68% of samples; in garup B, long-size AIS were found in 3.7% of samples, in group C, there were only large AIS–33.3%; in group D, the maximum size of 24 mm was more frequent – 18.2 %, but the total number of samples with large AIS  was two times lower–27.3% than in group A. Group A (sub- and brachycephaly) had the highest percentage of long AIS with a length of 20–24 mm (~54% of cases). The position of the BA in the AIS depends on the AIS length and clivus tilt.

Conclusion. The size and topography of the AIS in the cranial cavity vary significantly; this must be taken into account when planning neurosurgical approaches. The concept of limited AIS boundaries, their structural flexibility in terms of surgical approach is the basis for choosing an optimal approach or its direction. The size  of the AIS, its anatomical structure, and topography of the borders, access paths through AIS, possibility of  manipulations with the content and boundaries of the AIS, the degrees of freedom or limits in acceptable surgical corridors, etc. should be taken into account when planning surgical intervention and choosing an  optimal approach. 

The problem of repair of full-layer defects in the articular surface remains highly relevant. New methods of  chondroplasty should be tested in preclinical studies on animals. Full quality control of the newly formed regenerate is often possible only when an animal is euthanized. However, the design of some experiments implies animal observation for a long time. Therefore, lifetime assessment of the quality of the formed tissue  regenerate after chondroplasty would be very convenient. We have developed a new method for assessing the  quality of regenerate using computed tomography in preclinical studies on rabbits. This method can be used to measure completeness of defect filling, density of the newly formed regenerate, and also to evaluate similar  parameters of the newly formed tissue in the area of the subchondral bone, intermediate zone, and cartilage. The  new method makes it possible to assess the dynamics of formation and restructuring of newly formed tissue after
chondroplasty without euthanizing the animal.

Mechanical eye injury and damage to the blood-ocular barrier cause inflammation resulting in oxidative stress,  which, in turn, triggers myocardial ischemia, since the heart's need for oxygen exceeds its supply. A rapid decrease in the oxygen concentration in ischemic tissues causes a switch from oxidative to anaerobic metabolism, when  energy deficit initiates a chain of physiological processes. The discovery of the molecular mechanisms underlying  the manifestation of oxidative stress in the cardiac tissues will enable the development of effective therapeutic  approaches to such condition.

Objective: to analyze the dynamics of glutathione peroxidase (GP) activity in cardiac tissues of rats in response to oxidative stress caused by mechanical eye injury.

Materials and methods. In our experiment, we used 150 healthy white mature (8-month old) male rats weighing 190–210 g and kept under standard conditions in a vivarium. GP activity was evaluated before the experiment and then on days 1, 3, 5, 7, and 14. Nonparametric statistical analysis was used in this study.

Conclusion. GP activity in cardiac tissues of rats during oxidative stress caused by mechanical eye injury was most effectively stabilized by standard treatment for mechanical eye injury plus injections of quercetin.

Objective: to analyze clinical and epidemiological characteristics of patients with COVID-19 treated in a federal hospital of Samara region and their association with disease severity.

Materials and methods. We analyzed the results of clinical and epidemiological examination of 361 patients with  COVID-19 divided into two groups: patients with moderate disease (n = 285) and patients with severe disease (n  = 76). All study participants received inpatient treatment in the federal hospital of Samara State Medical University  in 2020. The diagnosis was verified using enzyme-linked immunosorbent assay (ELISA) and/or  polymerase chain reaction (PCR).

Results. There were no significant differences in the gender and age of COVID-19 patients in the two groups compared. Patients in Group 2 were slightly older than those in Group 1 (62.5 years (range: 53.0–68.8) vs 57.0 years (47.0–65.0) (trend; р = 0.008). The disease severity correlated with the time to hospitalization: the longer patients stayed at home, the more likely they developed severe disease. Such symptoms as sore throat and rhinorrhea were associated with a less severe disease, whereas shortness of breath, any changes in consciousness, nausea, and stool disorders on weeks 2–3 of the disease correlated with a more severe course. The proportion of patients with concomitant diseases (especially, more than one) was significantly higher in patients  with severe COVID-19 than in patients with moderate COVID-19 (74% vs 63%).

In this review, we describe clinical and anatomical prerequisites for the regeneration of injured tympanic membrane, as well as the principles of using composite material LitAr for tympanic membrane repair.

We have developed and implemented a new approach to postoperative defect repair in patients with pilonidal fistula (PF) and pilonidal cyst (PC). We analyzed different variants of subcutaneous fat and skin suturing, as well as the avoidance of drains in the area of intervention. The new approach reduced the incidence of postoperative  wound suppuration and wound dehiscence.

This study included 30 patients with abdominal stab wounds and splenic injuries who had undergone thromboelastography. All patients were divided into two groups (15 patients in each). Group A included  individuals admitted to a healthcare institution within an hour after injury; Group B comprised patients  who arrived to a healthcare institution more than one hour after injury. We found that splenectomy in patients with penetrating splenic injury causes changes in hemostasis manifesting as an increase in all thromboelastography parameters. These parameters correlated with the time to hospitalization: patients admitted to hospital within an hour after injury demonstrated thromboelastography changes on day 3 postoperatively and later with restoration registered by day 7 postoperatively. Patients who arrived to hospital later had more pronounced  thromboelastography changes that were observed already 1 day postoperatively with restoration on day 10.  Patients in both groups matched for age, gender, type of injury, blood loss, and overall performance.

We analyzed treatment outcomes in patients with pelvic organ prolapse (POP), some of whom had signs of undifferentiated connective tissue dysplasia (uCTD). Women from subgroup 1 used a pessary, while women from subgroup 2 underwent electromyostimulation in an outpatient department and performed Kegel exercises. After two treatment courses and pharmacotherapy, all patients demonstrated positive dynamics. Electrostimulation in combination with Kegel exercises was more effective than pessary; the effect was more pronounced in women without uCTD than in patients with uCTD. The results of our study were used for the development of a scale to  assess POP severity, which enables a tailored approach to the diagnosis and management of such patients  depending on the presence of uCTD.

The male reproductive system is one of the most vulnerable systems in the body and is exposed to many negative factors that affect the endocrine glands, central nervous system, and gonads, thereby causing dystrophic changes in the seminiferous tubules and testicular interstitial tissue. In 7–8% of cases, infertility is caused by low semen quality. Hyperproduction of reactive oxygen species is believed to be one of the factors reducing male fertility.

Anemia was considered one of the epidemics of the twentieth century. Anemia demonstrated its negative impact on the prognosis in many clinical conditions. One in three patients seen by a general practitioner has anemia.  Currently available guidelines on the diagnosis and treatment of anemia do not consider its polymorbidity in elderly  patients, as well as the negative impact of some therapeutic tactics (such as aggressive iron therapy, blood transfusion) on the prognosis. On the other hand, anemia often remains untreated. Since anemia is a modifiable risk factor in elderly patients, further studies aimed at the development of integrated treatment approaches with the consideration of polymorbidity and high prevalence of polyvalent anemia in these patients are highly relevant.

Objective: to analyze some parameters of cellular and humoral immunity and peripheral blood cytokines in patients with grade III idiopathic gonarthrosis, as well as to identify most significant laboratory immunological  tests indicating the activity of articular tissue degradation.

Materials and methods. We assessed laboratory parameters reflecting the immune status in 20 patients with grade III idiopathic gonarthrosis (18 males and 2 females; mean age 64.1 years (range 58.6; 62.1 years).

Results. We observed some immunological changes in peripheral blood of patients with grade III gonarthrosis, such as a decrease in the T cell count (T-helpers and T-suppressors), B cell count, and in the level of immunoglobulins G along with an increase in the count of natural killers, levels of serum immunoglobulin A, and proinflammatory (TNFa, IL-6) and antiinflammatory (IL-10, IL-4)  cytokines.

Conclusion. Degenerative dystrophic changes in the knee joint affect the immune status of patients with grade III gonarthrosis. It is necessary to evaluate parameters of cellular and humoral immunity of patients with advanced gonarthrosis before surgical interventions in order to minimize the risks of early and late postoperative  complications.

Objective: to analyze the effect of neuroprotective therapy with citicoline in combination with hypotensive and  hypolipidemic therapy on the correction of tinnitus and neuropsychological status in patients with atherosclerosis of the brachiocephalic and cerebral arteries and essential hypertension.

Materials and methods. We examined 86 patients aged between 60 and 68 years with essential hypertension and atherosclerosis of the brachiocephalic and cerebral arteries. All patients were diagnosed with decompensated tinnitus that affected their quality of life. The Multidimensional Fatigue Inventory (MFI) was used to assess the severity of asthenic syndrome. The cognitive status was evaluated using the Schulte tables, word pair memory tests, and phrase pair memory tests. Study participants were divided into two groups. Patients in Group 1 (n = 43) received nootropic therapy with citicoline at a dose of 1000 mg/day for 3 months in addition to standard hypotensive, hypolipidemic, and antiplatelet therapies. We found that citicoline as a part of comprehensive therapy  facilitated regression of actual and moderate tinnitus in patients with atherosclerosis of the brachiocephalic and cerebral arteries and essential hypertension. This optimized the neurovegetative status of patients and improved their cognitive functions.

Objective: to evaluate the efficacy of limb pneumomassage as one of the components of comprehensive treatment for patients with polyneuropathies of various origins.

Material and methods. This study included 77  patients (36 men and 41 women) with limb  polyneuropathies treated in the Department of Neurology, Alexander-Mariinsky Regional Clinical Hospital. The  mean age of women was 64 ± 9.6 years, while the mean age of men was 58 ± 7.4 years. All study participants were divided into 5 groups depending on the causes of their limb polyneuropathy. Group 1 included 30 patients (14 men and 16 women) with axonal polyneuropathies plus sensologic syndrome, ataxia, toxic polyneuropathies, diabetic polyneuropathies, and chronic inflammatory demyelinating polyneuropathies.  Group 2 comprised 16 patients (6 men and 10 women) with multiple sclerosis plus lower paraparesis, cerebellar ataxia. Group 3 included 11 patients (7 men and 4 women) with discogenic vascular myelopathy of the thoracic and lumbosacral spine plus paraparesis and gait disorders. Group 4 comprised 10 patients (4  men and 6 women) after ischemic strokes with hemiparesis. Group 5 was composed of 10 patients (5 men and 5 women) with hereditary diseases, including Charcot-Marie-Tooth disease, CurschmannBatten-Steinert  syndrome plus tetraparesis, late-onset cerebellar degeneration with ataxia. All patients received pharmacotherapy that included vascular, neuroprotective, analgesic, antioxidant, and immunomodulatory agents, as well as exercise therapy, acupuncture, and limb pneumomassage. The control group included 21 patients (11 men and 10 women) with polyneuropathies of various origins, who received  standard treatment without pneumomassage. The STATISTICA-16 software was used for data amalysis. We performed correlation analysis and calculated Pearson correlation coefficients.

Results. We found that limb pneumomassage improved the condition of patients with metabolic, toxic, and inflammatory polyneuropathies. However, limb pneumomassage was ineffective in patients with hereditary polyneuropathies due to more significant and irreversible lesions of the nervous system. 

This article discusses specific approaches to the diagnosis, treatment, and rehabilitation of children with different neuroorthopedic disorders. Particular attention is paid to the experience of foreign specialists in treating neuromuscular disorders in children, as well as the need for a comprehensive and systematic approach to their rehabilitation. In this manuscript, we provided examples of high-tech surgical and conservative treatment, as well  as grafting and orthotic support for children with various congenital and acquired diseases of the musculoskeletal system and the central nervous system in the Russian Federation.

Objective: to evaluate the awareness of diseases causing to chronic arterial insufficiency by analyzing web search queries.

Material and methods. In this study, we used the online keyword selection tool ‘Google Trends.’ The analysis was conducted for different countries and separately for CIS countries.

Results. We found that the search query ‘obliterating endarteritis’ was most common in Kazakhstan and Pakistan, while the query ‘obliterating atherosclerosis’ was most common in Belarus, Trinidad, and Tobago. The query ‘leg cramps’ was most frequent among residents of Ukraine and the Republic of South Africa, whereas people residing in the Republic of Kazakhstan and Philippine Islands usually searched for ‘leg  numbness.’ As for diagnostic methods, ‘angiography’ was the most frequent query in countries such as Bulgaria and Pakistan, while ‘dopplerography’ was the most popular query in the Republic of Kazakhstan. The most common queries related to treatment of chronic arterial insufficiency were ‘balloon angioplasty’ (most popular in Russia) and bypass surgery (most popular in Zambia, Ethiopia, Myanmar, and Ghana). The most  frequent queries associated with pharmacotherapy were ‘acetylsalicylic acid’ and ‘pentoxifylline’ in the Russian Federation and Trinidad, Tobago, Jamaica, and Puerto Rico.

Conclusion. The assessment of web search queries related to the diagnosis and treatment of chronic arterial insufficiency may help to understand the health status of people residing in different countries, which will enable effective disease prevention by reducing the risks and will ensure sufficient attention to timely diagnosis and effective treatment of chronic arterial insufficiency. It is also very important to inform  people about obliteration of lower extremity and explain that people with such symptoms should consult their phusician rather than search for information online.

In this study, we analyzed technologies for obtaining, processing, segmentation, and transmitting of microphotographs for subsequent recognition. We selected the most promising machine learning algorithms optimal for the processing of medical images, investigated the technologies of analyzing medical texts, studied the aspects of using the Watson neural network for analyzing the semantics of medical images, as well as the aspect of using the unified medical language UMLS for the needs of syndromic diagnostics for the evaluation of medical texts from medical histories in natural language. We also developed an interface for receiving,  processing, segmenting, and transmitting microphotographs to artificial neural networks and an interface for  the primary accepting and processing of microphotographs based on the OMERO medical image processing  platform. To send data online, a demo script for jupiter was prepared. An interface for transmitting medical texts  to the medical text semantics recognition system was also developed. The IBM Watson Annotator for Clinical  Data was used to perform preliminary analysis of medical texts. We created a database of medical images of  the bone marrow for neural network training. We made 3,500 color microphotographs (600×400 pixels) of  bone marrow smears at a resolution of ×600 (light microscopy; hematoxylin and eosin staining). We performed  marking of 11 types of bone marrow cells. We created a database of medical texts (167 patients, 40,000 words) to prepare a neural network. The database was stripped of all personal identifiers.