Vol 24, No 2 (2025)
- Year: 2025
- Published: 11.08.2025
- Articles: 41
- URL: https://ogarev-online.ru/2225-6016/issue/view/24108
CONGRATULATIONS FROM RECTOR R.S. KOZLOV TO THE STAFF AND STUDENTS OF SMOLENSK STATE MEDICAL UNIVERSITY WITH THE ANNIVERSARY OF THE UNIVERSITY
Vestnik of the Smolensk State Medical Academy. 2025;24(2):5-5
5-5
ADMINISTRATIVE GROUP OF THE JOURNAL "BULLETIN OF THE SMOLENSK STATE MEDICAL ACADEMY" TO READERS AND AUTHORS OF PUBLICATIONS ON THE OCCASION OF THE 105-th ANNIVERSARY OF THE UNIVERSITY
Vestnik of the Smolensk State Medical Academy. 2025;24(2):6-6
6-6
Preventive Medicine: Original Articles
CLINICAL AND LABORATORY FEATURES OF CHRONIC SPONTANEOUS URTICARIA IN OVERWEIGHT/OBESE PATIENTS
Abstract
Objective. To study the clinical and laboratory features of CSU in patients with normal and overweight/obesity. Methods. The study included 159 patients suffering from CSU. All patients were divided into 2 groups depending on body mass index (BMI): Group I - 110 patients (average age 53 [41;61] years) with CSU and overweight/obesity; and group II - 49 patients (average age 31 [25;42] years) with CSU and normal body weight. UAS7 was assessed, ELISE was used to determine the level of IgE, the concentration of CRP determined turbodimetric method, ESR was assessed by Westergren. Statistical analysis was carried out using the Mann-Whitney and Fisher tests. Results. It was shown that 69.2% of patients with CSU were overweight/obese, while 30.8% of patients had normal body weight (BMI, respectively, is 27 [26; 29] kg/m2, 33 [30; 36] kg/m2, 22 [20;24] kg/m2; p <0.001). The onset of CSU in patients with overweight/obesity occurred at a later age compared to patients with normal body weight (47,4±1,4 y and 30,7±1,9 y; p <0.001). The average duration of the disease in both groups did not differ and was 42.1±7.9 months in group 1. and in group 2 46.6±10.1 months. (p=0.504). The presence of angioedema in patients with CSU occurred with the same frequency in both groups (group 1 - 71.8%, group 2 - 69.4% (p = 0.755). UAS7 on the moment of examination was 17 points [6;26] in group 1 and 17 points [8;24] in group 2 (p=0.912). In patients of group 1, compared with group 2, concomitant diseases such as arterial hypertension (37.3% and 6.1%, respectively; p<0.001), chronic cholecystitis (33.6% and 14.3%, respectively; p =0.012). At the same time, allergic rhinitis was significantly less common (10% and 24.5%, respectively; p = 0.016). The content of total IgE in the serum was 123.4±28.9 IU/ml in group 1, and 132.0±36.5 IU/ml in group 2 (p=0.422). The concentration of CRP in patients with overweight/obesity is significantly higher compared to patients with normal body weight (7.1 ± 0.8 mg/l and 1.8 ± 0.3 mg/l, respectively; p < 0.001). The ESR indicator was 12.1±0.8 mm/h in group 1 and 7.1±0.6 mm/h in group 2 (p<0.001). Conclusion. It was revealed that 2/3 of patients with CSU are overweight/obese, which is associated with late manifestation of the disease, a significant increase in ESR and CRP, and less common concomitant allergic pathology (allergic rhinitis) compared to patients with normal body weight. The duration and activity of CSU, as well as the level of eosinophils, basophils and total IgE, were not significantly affected by BMI indicators.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):7-14
7-14
MEDICO-BIOLOGICAL SCIENCES: ORIGINAL ARTICLES
PRECONDITION TO ACUTE EXOGENOUS HYPOXIA BY METAL-COMPLEX COMPOUNDS IN EXPERIMENT
Abstract
Objective. To study the possibility of using some metal-complex compounds as agents of pharmacological preconditioning for acute exogenous hypoxia in an experiment. Methods. The experiments were performed on 140 male CBF1 mice weighing 20-25 g. Acute exogenous hypoxia was simulated in two ways: by placing the animals in an enclosed space (acute hypoxia with hypercapnia - АH+Hс) and by simulating elevation (acute hypobaric hypoxia - АH+Hb). The tolerance of mice to АH+Hс was assessed by the "life-span" indicator, and to АH+Hb by the "standby time" indicator. Previously, for 7 days, a single daily injection of metal-complex substances πQ1983, πQ2116 and πQ2721, which had previously proven themselves as antihypoxic agents in doses of 10, 25 and 40 mg/kg, was carried out. On the 8th day, at 10:00 a.m., mice were placed in conditions of acute exogenous hypoxia in accordance with the model for evaluating the preconditioning result. The effect of substances on heat generation processes was studied by measuring rectal temperature. Results. Of the three substances studied, only the substance πQ2721 demonstrated a preconditioning effect in the conditions of АH+Hс. After 7 days of its administration in doses of 25 and 40 mg/ kg, an increase in animal life expectancy was recorded by 56.5 and 82.6%, respectively. In the AH+Hb model all substances demonstrated a positive effect on the tolerance of mice to acute hypoxia. Conclusion. Among the three complex metal compounds - πQ1983, πQ2116, πQ2721, studied in two models of acute exogenous hypoxia in experiments on mice, all revealed a preconditioning effect, which is most clearly demonstrated in conditions of АH+Hb. In contrast to substances πQ1983 and πQ2116, substance πQ2721 provides a distinct dose-dependent preconditioning effect, significantly increasing the level of tolerance of animals to oxygen deficiency. The preconditioning effect of metal-complex compounds is most effectively realized in the case of concomitant hypothermia, which can be used as an indicator of a targeted search for new agents for pharmacological preconditioning.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):15-24
15-24
MEDICO-BIOLOGICAL SCIENCES: REVIEWS
RISKS OF PHARMACOTHERAPY OF TYPE 2 DIABETES MELLITUS IN GERIATRIC PRACTICE
Abstract
Objective. Assessment of the risks of pharmacotherapy of type 2 diabetes mellitus in geriatric practice and possible ways to prevent them. Methods. A search and analysis of the results of scientific research by domestic and foreign authors, including databases eLibrary and PubMed, on this issue has been carried out. From the selected literary sources, the most significant publications of the last 5 years were used for analysis. Results. The article describes and discusses the possible risks of pharmacotherapy by various groups of sugar-lowering drugs for type 2 diabetes in geriatric practice. The pharmacodynamic parameters of the main representatives of hypoglycemic agents are given, which make it possible to assess the safety of their use in geriatric patients. The requirements and principles of pharmacotherapy of type 2 diabetes mellitus in elderly patients are described to reduce the risks of adverse reactions. Conclusion. In elderly and senile patients, metformin remains the drug with the lowest risk of adverse reactions in the treatment of type 2 diabetes. There are prospects for the use of modern groups of sugar-lowering drugs, such as incretinomimetics and gliflozines. Sulfonylureas, glitazones, and glinides are not indicated for the elderly.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):25-36
25-36
Clinical Medicine: Original Articles
OBSTRUCTIVE SLEEP APNEA SYNDROME AND THE RELATIONSHIP WITH RED BLOOD COUNTS
Abstract
Objective. Identification of correlation between COAS and indices of red blood, oxygen transport function of blood in patients applying to Smolensk Clinical Hospital №1 with suspected COAS, as well as evaluation of their potential diagnostic and prognostic significance. Methods. The study included 96 patients divided into two groups: with COAS (n=50) and without COAS (n=46). All subjects underwent respiratory monitoring, cardiorespiratory monitoring and general blood analysis to determine the red blood count and oxygen transport function. Results. Changes in blood CTF indices in patients with COAS were revealed, as well as the relationship between these changes and the severity of the disease. Hemoglobin level was within the reference values and did not significantly differ in the studied groups. The mean value of IAH in the group of patients with COAS amounted to 15.4±13.2/hour. Increase of p50 real and p50 standard values in patients of the main group in relation to the comparison group was revealed. Correlation analysis revealed the presence of weak and moderate strength relationships between blood CTF indices and IAH: with p50st (r=0,30; p=0,005) and pO2 (r=0,25; p=0,024). Conclusions. The obtained data indicate that changes in CTF indices can be associated with COAS and can be used as additional markers for diagnosis and assessment of disease severity. The importance of blood CTF analysis is emphasized by the fact that hemoglobin level was within the reference values and did not differ significantly between the studied groups.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):37-41
37-41
PRIORITY PATHOLOGY IN MILITARY PERSONNEL SERVING IN THE EXTREME NORTH. DISEASE RISK FACTORS AND PREDICTORS
Abstract
Objective. The purpose of the study is to assess and analyze the levels and structure of priority pathology, risk factors, and predictors in military personnel serving in Russia’s Extreme North. Methods. Morbidity data for the military personnel serving in the Arctic, subarctic, and temperate zones was taken from annual medical reports (medical record forms N 025/y and N 025-1/y for 2015-2020 and form N 030/y) and provided in the M(SD) format. We used the ranking method to identify the priority pathology and relative risk and Student’s t-test to compare parameters. Difference was considered statistically significant at p=0.05. The correlation and regression analysis was used to establish correlations between morbidity and morphofunctional parameters. Results. Analysis of the prevalence structure of diseases in military personnel serving in the Arctic, subarctic, and temperate zones has shown that the priority diseases affecting the servicemen are from ICD chapters 1-6: J00-J99, N00-N99, M00-M99, E00-E90, I00-I99 and K00-K93. The priority pathology in the prevalence structure coincides with the overall prevalence for code ranges J00-J99, N00-N99, M00-M99 and E00-E90, and for J00-J99, N00-N99 and M00-M99 in the temperate zone. The prevalence of these diseases among military servicemen in the Arctic and subarctic zones is higher than among those serving in the temperate zone (р<0.001). In the Arctic, the prevalence is higher for code ranges E00-E90 (p=0.009) and I00-I99 (p=0.032), and in the subarctic zone, for N00-N99 (p=0.088), E00-E90, and I00-I99 (p<0.001). Overweight is a risk factor for all the six disease groups. Disease predictors for I00-I99 include the index of functional changes (r=0.894), physical fitness level (r=-0.874), vital capacity (r=-0.984), FEV1 (r=-0.978), the FEV1/FVC ratio (r=-0.959) and the cardiovascular and respiratory index (r=-0.991); the predictors for J00-J99 are the FEV1/FVC ratio (r=-0.926), vital capacity (r=-0.961), FEV1 (r=-0.953) and the cardiovascular and respiratory index (r=-0.973). Conclusion. Preventing diseases in military personnel serving in the Extreme North requires a differentiated approach that takes into account risk factors and predictors of the priority pathology.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):42-50
42-50
COMPARATIVE ANALYSIS OF THE USE OF MODERN APPROACHES TO THE DIAGNOSIS OF SARCOPENIC OBESITY IN SCHOOL-AGE CHILDREN
Abstract
Objective. The article presents an analysis of the use of modern approaches to the diagnosis of sarcopenic obesity in school-age children. Methods. At the first stage (catamnestic), the results (anthropometry, bioimpedance measurement) of preventive examinations of 1590 schoolchildren in Smolensk were analyzed. At the second stage (prospective), 100 school-age children (10-17 years old) were randomly selected into the study, who were divided into 3 groups depending on body mass index (BMI, kg/m2): group 1 (n=41) - schoolchildren with a BMI of ± 1 SDS BMI; Group 2 (n=29) (n=30) - children with BMI from + 1 SDS to + 2 SDS BMI (overweight children); Group 3 - schoolchildren with a BMI of + 2 SDS BMI or more, taking into account gender and age (obese children). Results. The results of the 1st stage indicate that the incidence of sarcopenic obesity when using the MFR index in its diagnosis (according to bioimpedance analysis) in the general population of schoolchildren (regardless of body mass index) is 15,74 % in boys and 8,04 % in girls; the incidence of sarcopenic obesity in school-age obese children The body mass index is 66,13 % for boys and 47,05 % for girls. A comparative analysis of the results of a comprehensive examination of schoolchildren using sarcopenia criteria in accordance with the recommendations of EWGSOP (2019) showed that, according to bioimpedance analysis, obese schoolchildren have an increase in muscle mass (FFBW, MKM, IFFBW) against the background of the absence of differences in absolute indicators characterizing muscle strength and muscle function. At the same time, a further comparative analysis of the relative (adjusted for IFFBW) indicators revealed that these parameters had significantly lower values per unit of measurement of the FFBW (fat-free body weight) index according to bioimpedance measurements. That is, obese schoolchildren showed a relative decrease in muscle strength and muscle function against the background of a tendency to increase muscle mass compared with children with normal body mass index. Conclusion. Thus, the issue of the need to develop clear diagnostic criteria for sarcopenic obesity for school-age children remains relevant today. Further study of sarcopenic obesity in schoolchildren, as well as its effect on cardiovascular and metabolic risks, will remain in demand for pediatric practice.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):51-59
51-59
OSTEOPENIA IN ADOLESCENTS: ANALYSIS OF BONE MINERAL DENSITY AND THE FACTORS INFLUENCING IT
Abstract
Objective. To study the prevalence of osteonecrosis in adolescents aged 17 and identify significant risk factors for this period. Methods. A total of 302 adolescent children aged 17 years to 17 years 11 months 31 days participated in the study. The gender distribution was predominantly girls: 204 (67.5%) versus 98 (32.5%) boys of the total number of subjects. All subjects underwent objective examination and osteodensitometry procedure on the ultrasound densitometer "MiniOmni" (SunlightMedicalLtd, Israel). Results. Analysis of the data showed that osteoarthritis was recorded in 57% of the examined. Certain combinations of factors that have a negative effect on bone mineral density were identified. So high level of physical development is an important risk factor for the development of osteopathy. In the group of children with excess body weight, the Z-criterion deviation from normal was found in 77.3% of cases, osteoporosis was detected in 25% of those examined with an elevated body mass index. The relationship between bone density indicators and risk factors such as calcium intake from food, low physical activity, aggravated family history of fractures, chronic diseases of upper gastrointestinal tract intestinal tract and smoking. Conclusion. A high frequency of decreased bone density has been registered among adolescents aged 17-18 years (57%), which is an indicator of mineral metabolism disorders. This may lead to impaired accumulation of mineral density and osteoporosis in the future. It is necessary to pay special attention to adolescents at this age, considering the risk factors for the development of osteopenia: a tall physical development type, increased body mass, the presence of chronic gastrointestinal pathology, low intake of vitamin D and calcium from food, smoking, and a family history of fractures.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):60-65
60-65
RESULTS OF PENETRATING KERATOPLASTY IN VARIOUS TYPES OF OPHTHALMOPATHOLOGY
Abstract
Objective. Investigation the nature of corneal transplant integration after penetrating keratoplasty in patients with various types of corneal disease, including those who occur in combination with other eye conditions over a follow-up period of up to 30 years. Methods. We observed 63 patients after penetrating keratoplasty, performed both in monovariance and in combination with other surgical procedures, depending on the concomitant pathology. Penetrating keratoplasty was performed by one surgeon using a standardized technique between 1994-2011 at the Ophthalmology Department of the Smolensk Regional Clinical Hospital. The age of the patients ranged from 27 to 76 years (the average age was 65.3 years). All patients had surgery between 12 months and 6 years after the initial diagnosis of corneal disease. Concomitant eye pathology was noted in 18 patients. All patients were divided into three groups based on their specific corneal changes: group 1 included 22 individuals with minor tissue alterations (keratoconus and epithelial-endothelial dystrophy), group 2 comprised 27 individuals with avascular leukoma, and group 3 comprised 14 individuals with vascularized leukoma. Results. In all cases, complete adaptation of the donor's cornea tissues and the recipient's cornea was achieved as a result of the surgery. After 1 month, examination revealed transparent graft engraftment in all three groups (100%). During the follow-up period up to 6 months, transparent engraftment was observed in all patients (100%) in groups 1 and 2. In group 3, 4 patients (28.5%) showed translucent graft engraftment associated with graft disease. After conservative treatment with corticosteroids and non-steroidal anti-inflammatory drugs, the condition of the graft improved significantly. During the follow-up period of 1 year in the first group, transparent engraftment was noted in 19 cases (86%), translucent engraftment in 2 cases (9%), and graft disease (opacity) in 1 patient (4.5%). In the second group, transparent engraftment was noted in 18 cases (67%), translucent engraftment in 3 cases (11%), and graft disease (opacity) in 6 cases (22%). In the third group, transparent engraftment was observed in 4 cases (28.6%), translucent engraftment in 3 cases (21.4%), and graft disease (opacity) in 7 cases (50%). Conclusions. The transparent engraftment of the donor's cornea graft directly depends on the degree of opacity of the recipient's cornea. After penetrating keratoplasty, the percentage of successful graft engraftment gradually decreases over time. During the first year of follow-up, 86% of patients in the first group showed successful graft engraftment, 67% in the second group, and 28.6% in the third group. There are two main causes of graft opacification: immune conflict between donor and recipient tissues, and a contravention of the nutrition of the donor cornea due to pathological changes in the recipient's corneal structure near the limb.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):66-72
66-72
SHORT-TERM AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF SURGERY OF COMPLICATED AND UNCOMPLICATED RECTAL CANCER
Abstract
Objective. To evaluate the immediate and long-term results of treatment of complicated and uncomplicated rectal cancer. Methods. 160 patients with rectal cancer, for the period 2018-2023 included in the cohort retrospective study. Two groups of patients were compared: group 1, n = 80, who underwent emergency resection; group 2, n = 80, who had planned. Emergency operations were performed in multidisciplinary hospitals by oncological surgeons. Planned were performed at an oncological hospital. Results. In group 1, patients more often had ASA ≥3 than in the group with planned operations (55.0% and 21.25%, p <0.0001). There were more postoperative complications in group 1 than in group 2 (p=0.0043). In group 1, R1 resections were 16.25%, CRM+ - 2.5%, which caused a statistically significant difference with group 2, where R1 resections - 1.25%, CRM + in 0 cases (p = 0.019). There were no statistically significant differences between the groups in the number of examined lymph nodes (p=0.061). The factors that had an unfavorable effect on 3-year overall survival: stage of the disease (risk ratio (RR) 1.16; 95% confidence interval (CI) 1.06-1.27; p = 0.002); tumor perforation (RR 1.53; 95% CI 1.44-1.63; p <0.001), age ≥ 75 years (RR 1.50; 95% CI 1.35-1.67; p <0.001); general condition ASA ≥3 (RR 1.04; 95% CI 0.61-1.76; p = 0.001). Local recurrence in group 1 were 11.25%, in group 2 - 3.75% (p=0.043). Conclusion. There was a tendency for postoperative morbidity to increase in the emergency group compared to the planned group. The number of local recurrences was higher in the emergency group.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):73-80
73-80
COMORBID PATHOLOGY IN PATIENTS WITH METABOLIC SYNDROME AND CHRONIC DIFFUSE LIVER DISEASE: POSSIBILITIES OF ULTRASOUND SCREENING AND MONITORING
Abstract
Objective. To evaluate the possibilities of using complex multiparametric ultrasound for screening and monitoring of comorbid pathology in patients with metabolic syndrome. Methods. In 2023-2024, 104 patients under treatment in gastroenterology and endocrinology departments were examined on the basis of two clinical hospitals. Observation group (n=104) - patients with overweight (BMI>25), signs of metabolic syndrome with confirmed hepatic steatosis, steatohepatitis and diffuse liver lesions at the age of 21 to 78 years (mean age - 56.75±13.76 years). To clarify the diagnosis we performed general and biochemical blood analysis, used methods of instrumental diagnostics: ultrasound of abdominal cavity organs, transient elastography, dual-energy X-ray absorptiometry in “Whole body” mode; 44 patients underwent transthoracic echocardiography. The control group consisted of 30 practically healthy people (15 men, 15 women) aged 20 to 40 years. Results. In patients of the observation group there was a slight increase in cytolysis indicators - hepatic transaminases, GGT, increased glucose and cholesterol levels. According to ultrasound of the hepatobiliary system in B-mode, almost ¾ of the studied patients had an increase in the size of the liver with a predominant disturbance of the echo structure. Dilation of hepatic veins was observed in almost half of the patients. In 50.9% of patients pathologic changes of gallbladder were observed, represented mainly by heterogeneous content in the lumen and concretions. According to steatometry data, hepatic steatosis was detected in all patients, with predominance in the range in S1-S2 (initial/moderate manifestations). Elastography showed predominant indices in the range of F3-F4, which corresponds to venous hepatic fullness (in combination with ultrasound signs) and/or formation of true clinically significant fibrosis; a quarter of patients showed cirrhotic transformation - F4 according to METAVIR scale. Moderate structural and functional myocardial abnormalities were detected in both groups. Conclusions. Multiparametric ultrasound of the liver is an important method in the diagnosis and monitoring of comorbid pathology in patients with metabolic syndrome, which allows detecting and evaluating liver steatosis and fibrosis at early stages, taking into account the acquisition of quantitative data correlating with the results of histologic study of liver biopsy specimens.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):81-89
81-89
Clinical Medicine: Literature Reviews
IMPORTANCE OF DENTAL FACTORS IN THE DEVELOPMENT OF INFECTIVE ENDOCARDITIS
Abstract
Objective. To highlight the importance of dental factors as a risk factor for infective endocarditis. Methods. Based on the available information sources, data on the potential impact of dental factors on the development of infective endocarditis are presented. Results. In conditions of a low percentage of etiologically significant pathogens, deciphering the structure of risk factors in patients with infectious endocarditis plays an extremely important role, allowing us to assume the pathogen, and, accordingly, choose the most rational scheme of antimicrobial therapy. Over the past decades, the number and ratio of the main risk factors for infective endocarditis have increased. Injecting drug addiction, cardiac surgery, and invasive medical procedures (long-term vein catheterization, hemodialysis) began to play the most important role. At the same time, the condition of the oral cavity and dental manipulations are a typical risk factor for infective endocarditis, causing its subacute course. Conclusions. Over the past decades, the number and ratio of the main risk factors for infective endocarditis have increased. Injecting drug addiction, cardiac surgery, and invasive medical procedures (long-term vein catheterization, hemodialysis) began to play the most important role. At the same time, the condition of the oral cavity and dental manipulations are a typical risk factor for infective endocarditis, causing its subacute course.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):90-93
90-93
FEATURES OF DIFFERENTIAL DIAGNOSIS OF ABDOMINAL MYOCARDIAL INFARCTION WITH DISEASES OF THE ABDOMINAL CAVITY
Abstract
Objective. To generalize the available data on abdominal form of myocardial infarction and diseases of abdominal cavity organs, to perform their differential diagnostics. Methods. The analysis and generalization of the data of publications devoted to the study of abdominal form of myocardial infarction and diseases of gastrointestinal tract were performed, their comparative characteristic was made. Results. When analyzing the data it was obtained that despite the similarity of clinical picture, each of the presented nosological forms has distinctive features: abdominal form of myocardial infarction - reliable ECG signs without specific clinical manifestations; chronic gastritis - predominance of dyspepsia is noted, and it can also proceed without pain syndrome; gastric and duodenal ulcer - there is a dependence of pain syndrome on food intake; acute cholecystitis - there is anamnesis data on biliary colic attack, indication of dull excruciating pain in the right subcostal area; acute pancreatitis - characteristic shingles pain, anamnesis indication of alcohol or fatty food intake on the eve of the attack; gastroesophageal reflux disease - dyspepsia, noncardiac chest pain. Conclusion. Primary diagnosis is a key moment in making a quick and correct diagnosis and, in accordance with this, the prompt start of treatment, with a more favorable outcome. Abdominal form of myocardial infarction is the case when all medical workers, starting from a district therapist, finishing narrowly focused specialists of surgical profile, need to have ideas about this pathology, to be able to distinguish it from acute abdominal cavity diseases and to know the signs detected in this case on ECG, which will not allow to make a mistake.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):94-99
94-99
STATE OF GENERAL MICROCIRCULATION IN PATIENTS WITH HEMOPHILIA, SURGICAL INTERVENTIONS IN PATIENTS WITH HEMOPHILI
Abstract
Objective. To analyze the state of general microcirculation in patients with hemophilia and to study the specifics of surgical interventions in these patients Methods. The work includes research by foreign and domestic scientists on this topic. Results. The study showed that working with patients with hemophilia requires a comprehensive approach, including early diagnosis, careful treatment planning, involvement of a multidisciplinary team of specialists, and the use of modern monitoring and treatment methods. The importance of such measures lies in reducing the risks of serious complications associated with potential bleeding during and after surgeries. Conclusion. Adhering to strict precautions and an individualized approach to patients with hemophilia is a key factor in the successful performance of surgical interventions. Modern approaches to diagnosis, planning, and treatment management significantly improve patients' quality of life and minimize the risk of severe complications.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):100-105
100-105
EVOLUTION OF MYOCARDIAL INFARCTION TREATMENT
Abstract
Objective. To review and synthesize data from literature on evolving approaches to myocardial infarction treatment. Methods. Collection, systematization, and analysis of literature data, including domestic and international research, dedicated to myocardial infarction and its treatment. Results. This review provides a brief historical analysis of myocardial infarction research, highlighting key discoveries that have significantly impacted the improvement of treatment for this disease. The article presents the data on the possibilities of treating myocardial infarction at the current stages of medical development in comparison with past centuries. Conclusion. Myocardial infarction, the sudden and life-threatening cessation of blood flow to the heart muscle, has remained a medical enigma for centuries. Our understanding has evolved from vague observations to detailed analyses of molecular mechanisms, leading to revolutionary changes in diagnosis and treatment. While myocardial infarction treatment has drastically improved, it remains a dynamic field requiring continuous refinement of diagnostic and therapeutic approaches to further reduce mortality and improve patient outcomes. Research continues to focus on enhancing existing treatments and developing novel, more effective strategies, including targeted therapies and genetic engineering.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):106-114
106-114
PECULIARITIES OF IMMUNOPHENOTYPIC CHARACTERISTICS OF BLOOD CELLS IN PATIENTS WITH CHRONIC PANCREATITIS
Abstract
Objective. Study of literature data regarding the state of cellular and humoral links of the immune system, functional activity of immunocompetent cells by various methods in the aspect of chronic pancreatitis with effectiveness of complex immunocorrective therapy. Methods. The review is based on the analysis of literature sources of scientific electronic libraries “PubMed”, “Elsevier”, “Cyberleninka”. The selected publications are relevant, correspond to the topic and represent the data of the leading Russian and foreign studies of the last decade. Results. Increased concentration of IgA, IgG, B-cells, CIC is caused by pronounced chronic inflammation of pancreas, inconstancy of antigenic and autoantigenic composition. Dysfunction of cellular immunity in pancreatitis has been established: decrease of T-lymphocytes (CD3+), T-helpers (CD4+), functional activity of HLA-DR+ lymphocytes, immunoregulation index (CD4+ / CD8+). The activity of cytotoxic cells (CD8+), natural killer CD 16+ and phagocytic activity of neutrophils, lymphocytes with morphological signs of nucleus fragmentation - µ1 with variability of imbalance in different forms of chronic pancreatitis increased. Conclusions. The increase of scientists' interest to the immune status of patients with pancreatitis, aspects of immunologic imbalance in the pathogenesis of chronic pancreatitis, justification of introduction of immunocorrective drugs in the classical therapy of pancreatitis has been revealed. The activity of immune inflammation correlates with the spread of the pathologic process in the pancreas and prolonged inflammation in patients with various forms of chronic pancreatitis. Knowledge of disorders of immunoreactivity of the organism has a high diagnostic and prognostic value, is the basis of modern immunocorrection of forms of pancreatitis.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):115-121
115-121
PREVENTION OF COGNITIVE IMPAIRMENT IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
Abstract
Objective. To analyze and systematize the data of scientific literature on the relationship between obstructive sleep apnea syndrome (OSAS) and cognitive impairments (CI) and to identify current methods for preventing these disorders. Methods. Collection and evaluation of the results of major scientific studies on the problem of the emergence and prevention of CI in patients with OSAS using the databases PubMed (https://pubmed.ncbi.nlm.nih.gov), Medscape (https://www.medscape.com), Elibrary (https://elibrary.ru), search depth - from 2009 to 2024. Results. The first part of the work presents an analysis of the results of scientific research on the epidemiology, pathogenesis, and clinical features of CI in the presence of OSAS. It was found that patients with OSAS are characterized by a decrease in working memory, attention, information processing speed, and executive function deficits. Key mechanisms triggering CI in OSAS include oxidative stress, neuroinflammation, increased blood-brain barrier permeability, and deposition of pathological proteins in brain tissue due to hypoxia. The second part of the study provides possible methods for preventing CI associated with OSAS. Conclusion. As the severity of OSAS increases, so does the likelihood of developing cognitive and emotional-affective disturbances. Intermittent nocturnal hypoxia, sleep fragmentation, and excessive daytime sleepiness can negatively affect attention, memory, and executive functions, but the degree of these changes is not always linear and may depend on comorbidities. Further research using various neuropathological testing techniques, as well as an assessment of patient comorbidity, is needed for a deeper understanding of the mechanisms underlying CI. Prevention of CI in patients with OSAS requires not only elimination of apneic episodes but also correction of concomitant somatic and mental illnesses.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):122-130
122-130
CONSIDERABLE ASPECTS OF NEURODIETOLOGY
Abstract
Objective. To study the current data of modern neurodietology as a key concept for brain health, its main vectors, potential targets and prospects of application for prevention and treatment. Methods. Collection and analysis of the results of scientific research by Russian and foreign authors in considerable aspects of neurodietology. Results. The achievements in the field of optimal nutrition models that contribute to the prevention and elimination of neurological symptoms in various pathological conditions are presented. Specific nutrients are discussed, as well as the impact of integrated nutritional approaches and a holistic diet, which are particularly promising for addressing the growing burden of age-related cognitive impairment. The molecular mechanisms underlying brain structure and function depend on nutrition throughout the life cycle, which has profound consequences for health and disease. Recent advances in genomics and epigenomics are expanding the understanding of how nutrition and genes interact. The main molecular targets include neuroinflammation, mitochondrial dysfunction, neurotransmitter imbalance, and impaired interaction between the gut and the brain. Changing the nutritional culture, improving the diet, and using key neuronutrients based on a specific neuronutrient goal is a promising approach. Conclusion. Understanding the key aspects of neurodietology allows us to form comprehensive clinical approaches that are currently relevant and promising integrative directions that can affect the health of the brain and the whole organism.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):131-142
131-142
PROBLEMS OF COMORBIDITY OF TYPE 1 DIABETES MELLITUS AND OBESITY IN CHILDREN
Abstract
Objective. To analyze the main results of scientific research of the Department of Hospital Pediatrics with the course of Neonatology of the FDPO on the problem of comorbidity of type 1 diabetes mellitus and simple obesity in children and adolescents, as well as the analysis of the available literature data on this problem. Methods. The analysis of the scientific activity of the department, publications carried out at the department over the past 5 years, as well as the results of previous studies on the problem of obesity in children with type 1 diabetes mellitus were analyzed. Results. The frequency of excess body weight and obesity in children with type 1 diabetes mellitus and its dynamics depending on the duration of the disease are described. The clinical characteristics of patients with type 1 diabetes mellitus and obesity, as well as the characteristics of their carbohydrate metabolism, are presented. The main risk factors for obesity in type 1 diabetes mellitus, as well as possible complications, are considered. Conclusion. It has been established that simple obesity in type 1 diabetes leads to the development of insulin resistance, dyslipidemia, increasing the risk of macrovascular and microvascular complications, atherosclerosis and metabolically associated fatty liver disease, and therefore it is necessary to pay special attention to the development of adequate approaches to the correction of obesity in type 1 diabetes and its prevention.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):143-150
143-150
Clinical Cases
COMORBID PATIENT WITH OBSTRUCTIVE SLEEP APNEA SYNDROME: CLINICAL CASE
Abstract
Objective. Actualization of the problem of underdiagnosis of obstructive sleep apnea syndrome. Improving the quality of medical care for patients with obstructive sleep apnea syndrome and chronic lung diseases. Methods. A comprehensive study and retrospective analysis of the materials of medical records of an inpatient patient, extracts from medical records, results of clinical, laboratory and instrumental methods of examination of a patient with interstitial lung disease and obstructive sleep apnea syndrome. Results. In the demonstrated clinical case, the patient suffered from hypersensitivity pneumonitis and bronchial asthma for a long time. Despite long-term hormonal therapy and the lack of significant dynamics according to the results of computed tomography, the patient's condition steadily worsened. In the autumn of 2024, the patient was diagnosed with obstructive sleep apnea syndrome with a high risk of cardiovascular disasters. СPAP was suggested to provide respiratory support to the patient. Taking into account the combined pathology of the respiratory system, the air supplied by the device was enriched with moistened oxygen at a flow of 3 liters/min. The patient’s condition has improved significantly as a result of treatment, and the severity of cardiovascular pathologies has been reduced. Conclusion. CPAP with enrichment of the supplied air with low-flow oxygen improves the quality of life of patients with hypoxemia caused by comorbid pathology of the respiratory system.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):151-155
151-155
A CLINICAL CASE OF KIDNEY TRANSPLANTATION AGAINST THE BACKGROUND OF CHRONIC KIDNEY DISEASE IN A PATIENT WITH AN ANOMALY IN THE DEVELOPMENT OF THE GENITOURINARY SYSTEM
Abstract
Objective. To analyze the medical history of a patient with a transplanted kidney against the background of end-stage CKD. Methods. Questioning, physical examination of the patient; analysis of medical documentation, data from laboratory and instrumental research methods. Results. The article presents a clinical case of kidney transplantation against the background of anomaly in the development of the genitourinary system. In infancy, the patient was operated on for bladder exstrophy: plastic surgery of the bladder neck with the formation of the bladder with osteoplasty of the anterior semicircle of bones was performed. On June 18, 2015, the Bricker operation was performed - cystectomy, intestinal plastic surgery of the ureters, and the formation of a urostomy. Subsequently, signs of chronic renal failure for more than 10 years. During the last hospitalization - an increase in nitrogenous waste products - (creatinine level 590 μmol / l). For hemodialysis, the patient attempted to form a fistula, which resulted in fistula thrombosis. The patient was examined as a kidney recipient. 29.05. 23 years old, a related predialysis kidney transplantation with simultaneous bilateral nephrectomy and ureteroconduit anastomosis was performed. The graft function was immediate, no hemodialysis sessions were performed, and there was no episode of acute rejection. Restoration of function on the 3rd day. Receives triple immunosuppressive therapy Conclusion. Kidney transplantation in this clinical case is the main treatment method, as it is a highly effective and the only way to replenish lost kidney function in case of abnormal development of the genitourinary system in patient N. This treatment method can improve the quality of life and increase its duration.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):156-164
156-164
CLINICAL CASE OF EXTRAESOPHAGEAL MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE IN A PATIENT WITH BRONCHIAL ASTHMA
Abstract
Objective. To present a clinical case of diagnosis and treatment of extraesophageal manifestations of gastroesophageal reflux disease (GERD) in a patient with bronchial asthma (BA). Methods. Outpatient observation, analysis of therapeutic and diagnostic management strategies for a patient with bronchial asthma and the presence of extraesophageal GERD manifestations. Available literature on managing patients with BA and extraesophageal GERD symptoms was analyzed, considering the impact of these manifestations on quality of life and the risk prognosis for GERD complications. Results. A clinical case of diagnosing and treating bronchopulmonary GERD manifestations in a patient with BA is presented. The available literature on managing patients with extraesophageal GERD symptoms is reviewed. Conclusion. Thus, the presence of extraesophageal manifestations of GERD in a patient with BA presents challenges due to the absence of typical symptoms (heartburn, regurgitation, belching) and the manifestation of bronchopulmonary symptoms, necessitating observation by both a pulmonologist and a gastroenterologist. The analysis of the presented clinical case leads to the conclusion about the need for a differentiated approach to diagnosis and selection of personalized combination therapy with proton pump inhibitors (PPIs), prokinetics, and gastroprotectors in a patient with BA and extra-esophageal GERD manifestations, which allows achieving regression of complaints, reducing the risk of relapses, and preventing GERD complications. Additionally, treatment of bronchopulmonary symptoms of GERD contributes to stabilizing the course of BA without intensifying bronchodilator therapy, thereby improving the patient’s quality of life.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):165-171
165-171
PROBLEM OF HEART TRANSPLANTATION IN CASE OF LATE TREATMENT AND LOW COMPLIANCE OF A PATIENT WITH CARDIOMYOPATHY, CLINICAL CASE
Abstract
Objective. Demonstration of the problem on the example of a clinical case of treatment results in the case of late treatment of a patient with severe cardiovascular pathology with low compliance to treatment. Methods. Medical documentation, data of laboratory and instrumental methods of research were analyzed. Results. This clinical case revealed the necessity of timely seeking medical help and following the therapy recommendations in full. Patient S., born in 1966, first came with complications of cardiovascular pathology in the form of STEMI and postinfarction cardiosclerosis. Later the patient was diagnosed with CHD, atherosclerotic cardiosclerosis and dilated cardiomyopathy. Even after treatment in Smolensk and further face-to-face consultations at the National Medical Research Center of Transplantation and Artificial Organs named after V.I. Shumakov. V.I. Shumakov National Medical Research Center of Transplantation and Artificial Organs, the patient did not follow the treatment regimen, which resulted in the progression of the disease, deterioration of the patient's condition and his quality of life. And, as a result, the specialists of the center refused to perform the operation due to high risks of surgical complications, decompensation state and comorbidity of diseases. Conclusion. It is concluded that due to the patient's late seeking medical help and non-compliance with the treatment regimen, the disease has passed into a decompensation state. After multiple consultations due to high risks of surgical complications, he was denied heart transplantation. However, it is the only radical method of treatment of dilated cardiomyopathy.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):172-180
172-180
FUROSEMIDE-ASSOCIATED NEPHROPATHY IN A 17-YEAR-OLD ADOLESCENT WITH EATING DISORDER. CLINICAL CASE. OWN OBSERVATIONS
Abstract
Objective. To study the clinical manifestations and features of the course of furosemide-associated nephropathy in a 17-year-old adolescent with an eating disorder. Methods. Clinical, laboratory, instrumental examinations and treatment were carried out according to the standards of medical care for the disease profile. Physical development was assessed according to WHO criteria (WHO Anthro Plus program, 2006). The daily nutrition reproduction method, caliperometry and bioimpedancemetry were used to assess nutritional status. The psychological examination was conducted using the pathocharacteristic diagnostic questionnaire by A.E. Lichko, the parental attitude test questionnaire by A.Ya. Varga, V.V. Stolin (ORO method), and the ADOR questionnaire for adolescents by E. Shafer (modified by E. Matejcik and P. Rzhichan). Eating disorder was diagnosed using the SCOFF screening scale. Results. The article presents a clinical case of patient L., 17 years old, who had been taking furosemide for 3 years without supervision to reduce her weight. The girl was hospitalized in the pediatric department of the Smolensk Children's Clinical Hospital with the diagnosis: Nephropathy caused by taking medications (furosemide). Concomitant diseases: Cardiomyopathy of mixed genesis, transient, NK0. Excess body weight. Conclusion. Thus, currently furosemide-associated nephropathy, which occurs due to abuse of diuretics, has begun to be detected not only in adults but also in children. The risk group is adolescent girls with eating disorders. The duration of diuretic intake, the rate of dose increase and the maximum daily dose per kg of body weight are important for predicting the outcome of the disease. His problem is interdisciplinary and requires the participation of a wide range of specialists: pediatricians, nephrologists, psychologists, psychiatrists, endocrinologists, gastroenterologists, cardiologists and nutritionists.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):181-191
181-191
A CLINICAL CASE OF PULMONARY AND HEPATIC ECHINOCOCCOSIS
Abstract
Objective. To assess the epidemiological situation of echinococcosis in the Smolensk region. To describe a clinical case of echinococcosis of the lungs and liver. Methods. For the work, reports of medical institutions of the Smolensk region, as well as medical histories of hospitalized patients with echinococcosis were used. Results. When studying the epidemiological situation with echinococcosis in the Smolensk region, sporadic morbidity was registered among the inhabitants of the Smolensk region with a predominance of cases of isolated liver damage. Much less often, the echinococcal cyst was localized in the lung. Only in isolated cases was a combined lesion of the liver, lungs and other organs. Conclusion. In the Smolensk region there are foci of echinococcosis among animals, in whose body adult Е. granulosus parasitize. Therefore there is a risk of infection of people with larval forms of these helminthes. The slow development of the parasitic process and the polymorphism of clinical symptoms, which may appear long time after infection, complicate early diagnosis and may be the reason for late treatment and a severe outcome of the disease. Due to the rarity of echinococcosis and the peculiarities of the course of the parasitic process there is a need to inform the medical community about the existence of this problem.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):192-199
192-199
Pharmaceutical Sciences: Original Articles
DEVELOPMENT OF THE COMPOSITION AND TECHNOLOGY OF THE CORRECTED DOSAGE FORM OF VALIDOL
Abstract
Objective. Development of the composition of the original dosage form of validol - medicinal lozenges and its in vitro biopharmaceutical research to establish the optimal complex of auxiliary substances in their technology. Methods. A PC-1 dissolution tester was used to study the kinetics of validol release. The dissolution medium (ethyl alcohol 50%) was sampled for spectrophotometric analysis after 3,5,10,15,20,30 minutes of the experiment (temperature 37 ° C) with the resumption of the dissolution medium. The use of ethyl alcohol dialysate 50% as a dissolution medium is justified by the peculiarity of the composition of the validol substance (levomenthol solution in mentholate), which does not dissolve in aqueous solvents and therefore sample preparation will be complicated. Various auxiliary substances were used to produce medicinal lozenges by molding (casting): lactose, chitosan, hydroxyethylcellulose, propylene glycol-1,2, starch, etc. The kinetics of validol release from medicinal lozenges was studied by a qualitative reaction with p-dimethylaminobenzaldehyde. The quantitative determination of validol in the dissolution medium was carried out by the menthol content using a standard sample of validol by reaction with sulfuric acid. A series of dilutions was prepared and spectrophotometric analysis was performed (with a cuvette layer thickness of 10 mm), measuring the absorption maximum at a wavelength of 540 nm. Results. The optimal composition of the dosage form of medicinal lozenges has been established and constructed, taking into account the kinetics of the release of the active substance (excipients included in the composition - chitosan, lactose, aerosil). Conclusion. Thus, the composition and technology of medicinal lozenges with validol have been developed. A method for the spectrophotometric determination of the active substance in the composition of lozenges has been developed and validated.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):200-208
200-208
SUBSTANTIATION OF COMPOSITION AND DEVELOPMENT OF TECHNOLOGY OF PREPARATIONS BASED ON FRESH RAW MATERIALS OF BEGONIA RED-LEAVED BEGONIA (BEGONIA ERYTHROPHYLLA NEUM.)
Abstract
Objective. Justification of composition and development of technology of preparations based on fresh raw materials of begonia Begonia Erythrophylla for the treatment of chronic renal failure. Methodology. Pharmaco-technological parameters of raw materials were analyzed to develop extraction parameters of fresh leaves of begonia red-leaved, hereinafter “begonia”). We used as extractants: purified water, ethyl alcohol 40%, 70% and 96%. The pH value of begonia juice was determined by potentiometry. Bismaceration method was used to obtain extract and juice from fresh leaves. We used for stabilization of preparations: sodium metabisulfate; citrate buffer with pH 2.7; trilon B; citric acid; pectin; melissa infusion 1:10, rosehip infusion 1:10. Commonly known methods were used for quantitative analysis of raw materials and begonia juice for the content of anthocyanins, flavonoids, organic acids, ascorbic acid. Extract and juice from fresh raw materials were chosen as the studied medicinal forms for begonia raw materials, since begonia leaves contain approximately 90% moisture, have no potent substances in their composition, anthocyanins and ascorbic acid are destroyed by drying of raw materials. Results. Fresh and dried leaves of red-leaved begonia (Begonia erythrophylla Neum.), harvested from plants grown in the open ground conditions of the botanical garden of Pyatigorsk (Caucasian Mineral Waters region), were the material of the study. Extract and juice from fresh raw materials were chosen as the studied medicinal forms for begonia raw materials, since begonia leaves contain about 90% moisture, have no potent substances in their composition, anthocyanins and ascorbic acid are destroyed by drying of raw materials. The fresh leaves were ground to a pulp to obtain the extract. Bismaceration method was used in 1:2 extract process scheme. The extraction time was14 days. We used 96% ethanol as an extractant, which was added until its concentration in the preparation was 40%, in the presence of citrate buffer solution with pH 2.7. When juice 1:1,3 was obtained, the raw material was crushed, ethanol was added (until its concentration in the preparation was 20%) with the addition of citrate buffer solution with pH 2.7 and the mixture was kept under periodic stirring at room temperature for 2 days. Standardization of begonia extract 1:2 and juice 1:1.3 was carried out according to the following parameters: description of appearance, content of anthocyanins, ethanol, pH. The use of extract and juice of begonia from fresh raw materials allows to reduce the dosage of preparations in comparison with “Begonefril” to 12 ml for extract and 7 ml for juice. The content of ethanol (in terms of 100%) is reduced in daily doses of preparations from 12.8 ml (“Begonefril”) to 2.8 ml and 1.4 ml for extract and juice, respectively. The obtained results allow expanding the use of Begonia preparations for categories of patients under 16 years of age after additional pharmacological studies. Conclusions. Conclusion. In the course of the experiment, the main parameters of fresh leaves of Begonia red-leaved, grown in the conditions of the botanical garden of Pyatigorsk were determined. Extract and juice were selected as dosage forms from fresh raw materials. Technological schemes for the production of juice 1:1,3 and extract 1:2 stabilized with citrate buffer solution and ethanol were developed, and the quality of preparations was evaluated.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):209-218
209-218
AN INNOVATIVE APPROACH TO THE ISOLATION OF GLYCYRRHIZIC ACID FROM LICORICE ROOTS: THE USE OF LOW-TOXICITY SOLVENTS AND SIMPLIFIED EQUIPMENT
Abstract
Objective. To develop a technology for the isolation of glycyrrhizic acid from licorice roots that does not require complicated equipment and based on low-toxicity solvents. Methods. To obtain a crude extract from licorice roots, a repeated maceration method was used. The possibility of purifying glycyrrhizic acid was investigated by developing technological processes characterized by simple equipment and the use of low-toxicity solvents. To confirm the suitability of the developed technology for the isolation of glycyrrhizic acid, the results of spectrophotometry and high-performance liquid chromatography of the trisodium glycyrrhizinate sample, obtained in accordance with the developed technology, and a standard sample were compared. Results. The technology for the isolation of glycyrrhizic acid from licorice roots has been developed. It includes the following stages: aqueous extraction of roots, precipitation of the target compound by acidification in a salting-out solution, its dissolution and precipitation in ethyl alcohol, precipitation with calcium hydroxide, dissolution and precipitation in isopropyl alcohol, dissolution in an aqueous solution of sodium chloride, solvent extraction in a two-phase system of isopropyl alcohol - aqueous solution of sodium chloride, dissolution and precipitation in ethyl alcohol, precipitation by acidification without salting-out. The spectral and chromatographic characteristics of trisodium glycyrrhizinate obtained using the developed technique, including the wavelength of the absorption maximum, the absorption spectrum and the retention time of the main peak on the chromatogram, are identical to those for the standard sample. Conclusion. The developed technology is characterized by a simplified equipment and the use of low-toxicity solvents. Acetone is not used in the purification stages, which increases the safety of the process compared to isolation technologies where it is used. There is no need to recrystallize the target component from glacial acetic acid. This allows avoiding its high losses. The introduction of salting-out into the acid precipitation process reduces the holding time and increases the product yield.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):219-227
219-227
History of medicine and pharmacy
PROBLEMS OF THE USE OF GALENIC PREPARATIONS IN THE PHARMACEUTICAL PROVISION OF CIVILIANS AND EVACUATION HOSPITALS DURING THE GREAT PATRIOTIC WAR ON THE EXAMPLE OF THE SMOLENSK REGION
Abstract
Objective. To study of the use of galenic preparations in the pharmaceutical provision of civilians and evacuation hospitals during the Great Patriotic War using the example of the Smolensk region. Methods. The work was carried out using historical-genetic and problem-chronological research methods. A set of methods of historical and archival heuristics is used. Results. The article presents union-wide and regional material on the organization of the collection of plant raw materials and the organization of galenic preparations. The materials of funds revealing the damage caused to the pharmaceutical industry of the Smolensk region during the Great Patriotic War are being introduced into scientific circulation. Based on the documentary data, the activities of the department of the USSR General Pharmacy Administration for the Smolensk region aimed at collecting medicinal herbs and their results are shown. Conclusion. During the Great Patriotic War, the problem of acute shortage of pharmaceuticals was caused by an increase in demand for medicines and vitamin preparations in the context of the devastation of the country's pharmaceutical industry. Thanks to the organization of the Main Pharmacy Department, it was largely solved by monitoring the allocation of resources, innovation, and the active involvement of galenic preparations and fortified nutrition based on herbal remedies.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):228-233
228-233
Anniversaries
DEPARTMENT OF HISTOLOGY, CYTOLOGY AND EMBRYOLOGY OF SMOLENSK STATE MEDICAL UNIVERSITY: YESTERDAY, TODAY, TOMORROW (ON THE 105TH ANNIVERSARY OF THE DEPARTMENT)
Abstract
The article describes the stages of formation of the Department of Histology, Cytology and Embryology of Smolensk State Medical University (SSMU), which is a contemporary of SSMU. The creation and development of the department is associated with the name of Professor I.O. Mikhalovsky, the founder of experimental teratology. His case was continued by L.I. Falin, V.V. Anisimova-Alexandrova. Subsequent generations of histologists at SSMU studied the effects of overheating on various organs of white rats (Pugachev M.K., Romanov V.I., Shilkina L.A., Novikova T.G., Bozhenkova M.V.), the embryogenesis of the visual analyzer, and issues of teratology (Stepanova I.P.).
Vestnik of the Smolensk State Medical Academy. 2025;24(2):234-239
234-239
FORMATION AND DEVELOPMENT OF THE DEPARTMENT OF THERAPY, ULTRASOUND AND FUNCTIONAL DIAGNOSTICS OF THE FACULTY OF ADDITIONAL PROFESSIONAL EDUCATION (TO MARK THE 40TH ANNIVERSARY OF THE DEPARTMENT'S ESTABLISHMENT)
Abstract
In 1985, at the Smolensk Medical Institute, on the basis of the order of the Ministry of Health of the RSFSR No. 458 dated 06.06.85, a decision was made to open a department of therapy at the faculty of advanced training for doctors.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):240-247
240-247
THE HISTORY OF THE DEPARTMENT OF DENTISTRY OF THE FACULTY OF ADDITIONAL PROFESSIONAL EDUCATION WITH THE COURSE OF ORGANIZATION OF MEDICAL CARE
Abstract
The staff of the Department of Dentistry of the Faculty of Additional Professional Education (FDPO) with the course of organization of medical care conduct training of highly qualified personnel in residency in 6 dental specialties, professional retraining and advanced training of dentists, actively engage in educational, methodological and scientific work, provide medical and advisory dental care to the population of Smolensk and the Smolensk region, participate in federal projects, the volunteer movement, and the Priority 2030 program for strategic academic leadership.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):248-252
248-252
253-256
PYOTR FYODOROVICH STEPANOV - FAMOUS MORPHOLOGIST AND TEACHER
Abstract
The article is devoted to a major Soviet and Russian anatomist, Professor Pyotr Fyodorovich Stepanov. He organized and headed the Department of Human Anatomy in Chita, then Smolensk, was a leading anatomist in the field of anatomy of the nervous system, a wonderful teacher, a kind, responsive and principled person with an active lifestyle.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):257-261
257-261
PROFESSOR V.A. LOSEVA IS A GLORIOUS NAME IN THE SCIENCE AND CLINICAL PRACTICE OF DERMATOVENEREOLOGY (ON THE 105th ANNIVERSARY OF THE FOUNDING OF THE SMOLENSK STATE MEDICAL UNIVERSITY)
Abstract
Objective. To present biographical data of the famous scientist, dermatovenerologist, head of the department of the Smolensk State Medical Institute (1982-1996) Professor Valeria Aleksandrovna Loseva, defining her contribution to the formation of the Smolensk dermatological school and the development of domestic dermatovenerology. Methods. A comprehensive analysis of published literary sources (scientific articles), personal, departmental and museum archival data, including photographic materials about professor of dermatovenereology Valeria Aleksandrovna Loseva, was conducted using historical and problem-chronological research methods. Results. The known biographical information is supplemented by previously unknown facts from the professional life of V.A. Loseva, which made it possible to systematize and determine the professor’s significant contribution to the formation of the Smolensk dermatovenereological school, her role as a physician-scientist and teacher in the development of domestic dermatovenereology based on the principles of continuity and evidence-based medicine.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):262-267
262-267
Miscellaneous
APPLICATION OF BUSINESS GAMES IN PHARMACEUTICAL CHEMISTRY CLASSES TO DEVELOP PROFESSIONAL WORK SKILLS (FUNCTIONS) IN PHARMACEUTICAL FACULTY STUDENTS
Abstract
Objective. To propose a methodology for conducting and criteria for evaluating the business game of the discipline "Pharmaceutical Chemistry". Methods. The development of the methodology for conducting a business game was based on several key principles and approaches that ensure its effectiveness in teaching. Results. The article presents the methodology of a business game in studying the discipline "Pharmaceutical Chemistry" and suggests criteria for assessing the results of students' mastering their professional work skills (functions) in accordance with the professional standard "Pharmaceutist" and the professional standard "Pharmaceutist-analyst". Conclusion. The use of active teaching methods at the Department of Pharmaceutical Technology in the study of the discipline "Pharmaceutical Chemistry", in particular business games, contributes to the effective development of professional competencies at the level of professional knowledge, skills, critical thinking skills, the formation of motivation, the ability to make decisions by future specialists, making the study of the discipline more exciting and meaningful.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):268-273
268-273
ANALYSIS OF THE SURVEY OF THE PARTICIPANTS OF THE THEMATIC OLYMPIAD: TOWARDS IMPROVING THE EDUCATIONAL, CLINICAL AND SCIENTIFIC-PRACTICAL INTERACTION OF A MEDICAL STUDENT AND A TEACHER
Abstract
Objective. To study the opinion of the participants of the second thematic student Olympiad to assess the level of its organization, content, practical significance in terms of the history of medicine, clinical practically oriented from the point of view of students and teachers. Methods. Development of two questionnaires for direct participants of the student thematic Olympiad in dermatovenereology: 1) for students who took part in the competition and 2) teachers - leaders of student teams of medical universities (Smolensk, Vitebsk, Grodno and Gomel), jury members from among the faculty and management of medical and preventive institutions. Smolensk and the Smolensk region. Conducting an anonymous survey of all participants after the completion of the competitive event based on the data of a continuous sample (33 students and 9 jury members) with subsequent evaluation of the results using a descriptive method of comparative data analysis. Results and conclusions. An analysis of an anonymous survey of participants in a scientific and practical educational event (a thematic student competition) showed a high assessment of the organization of the Olympiad, the activity and sufficient motivation of students in making a decision to participate and self-prepare for the competition; the practical significance of the Olympiad in terms of clinical practice of a future graduate of a medical university.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):274-278
274-278
ETHICAL ASPECTS OF CLINICAL ANALYSIS IN MEDICAL EDUCATION
Abstract
The educational function of clinical analyses implies the formation of clinical thinking in future doctors. At the same time, the main emphasis is usually placed on theoretical knowledge, analytical and practical skills of students, ignoring the skills of positive clinical communication. Ethical and deontological standards for conducting clinical analysis, approved by the management of the medical university, will allow future doctors to develop communication skills for interacting with the patient, which are uniform for medical workers at all stages of training. An example of successful corporate standards of professional behavior in a medical appointment is the Calgary-Cambridge model of interaction with the patient.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):279-284
279-284
THE PLACE OF MEDICAL SCIENCE AND THE SMOLENSK STATE MEDICAL UNIVERSITY DURING THE IMPLEMENTATION OF THE NATIONAL PROJECT "NEW TECHNOLOGIES FOR SAVING HEALTH" (2025-2030)
Abstract
The article briefly describes the main results of SSMU in the field of research and innovation activities for the period 2020-2024 within the framework of the National Project "Science and Universities" and the federal project "Medical Science for Humans". The main tasks in the implementation of the new National project of the Russian Federation for the coming period (2025-2030) in the field of biomedicine and pharmacy - "New technologies for saving health", as well as an analysis of the possibilities of SSMU to take an active part in the implementation of this project are presented.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):285-290
285-290
COMPARATIVE ANALYSIS OF THE RESEARCH ACTIVITIES OF THE DEPARTMENTS AND SCIENTIFIC DEPARTMENTS OF THE SMOLENSK STATE MEDICAL UNIVERSITY (2020-2024)
Abstract
April 2025 is a Jubilee year for Smolensk State Medical University (SSMU) - the 105th anniversary of the University's establishment. Objective: to evaluate the effectiveness of research work in the departments of Smolensk State Medical University over a five-year period (from 2020 to 2024). The methodology. The study was conducted using the methods of comparative analysis of absolute and standardized indicators, a calibrated equal-dimensional assessment scale of qualitative integrated assessment. In the analysis process, methods for evaluating specific indicators and coefficients are presented in the text of the article. According to the functional uniformity of research activities, all departments of the university were represented by three groups: "Theoretical divisions", "Clinical divisions" and "Scientific divisions". The overall rating of the divisions was based on the average value of their total result for 5 years (2020-2024), calculated for one rate, for "All analyzed areas of work." Results. A comparative analysis of the results of the research activities of the departments is presented in two blocks: basic and additional performance indicators. The parameters of the "Main work" assessment are represented by the indicators "Printed scientific production", "Innovative projects and technologies" and "Training of scientific personnel". In the section "Training of scientific personnel" two groups of reference parameters are used for the analysis: indicators "Results of intellectual activity" and "Dissertation research". Conclusion. Thus, the analysis of the dynamics of the results of the university's research activities as a whole over the five years (from 2020 to 2024) indicates a 5-fold increase in the average amount of points per rate in all areas. A comparative analysis of this indicator between 3 reference groups confirmed a more significant contribution to the development of science and innovation of the SSMU scientific divisions.
Vestnik of the Smolensk State Medical Academy. 2025;24(2):291-300
291-300