Ultraviolet cross-linking of corneal collagen is an innovative technique designed to increase corneal strength in keratoconus by creating additional cross-links within the macromolecules of the extracellular matrix. The method is based on exposing the cornea to ultraviolet A radiation (370 nm) after saturation of the stroma with a photosensitizer (riboflavin). In the standard (Dresden) protocol—the conventional method of ultraviolet cross-linking—the minimum thickness of the de-epithelialized cornea must be at least 400 μm to prevent potential endothelial cell damage from a cytotoxic dose of ultraviolet radiation. However, in some patients with keratoconus, corneal thickness falls below this threshold, which limits the applicability of the standard clinical protocol. As a result, modified cross-linking techniques have been proposed for patients with thin corneas. This review presents various approaches developed to address this issue. In general, the safety and efficacy of modified techniques, including transepithelial, accelerated, intraoperative hypoosmotic swelling ones, or techniques involving contact lenses or donor corneal lens, have shown satisfactory outcomes: in most cases, corneal ectasia progression can be halted without serious postoperative complications. Nevertheless, each technique has its own advantages and limitations. The choice of technique depends on the resources of the clinic, the individual characteristics of the patient’s cornea, and the surgeon’s expertise. It should be noted that in practice modified cross-linking protocols for thin corneas are used much less frequently than the standard procedure, underscoring the need for further research to evaluate their clinical efficacy and safety.

Within the national program “Digital Economy of the Russian Federation,” it is relevant to examine job specifics of IT specialists and their impact on performance status. Changes in this area necessitate reviewing approaches to disease prevention. For this purpose, we performed a retrospective analysis of publications on job specifics and working conditions of IT specialists to identify relevant issues and approaches to their prevention in the current context. The search was performed in PubMed (using MeSH terms) and eLIBRARY.RU. The search depth was 1972–2024. The MeSH terms and keywords were related to work with computers and information systems, as well as occupational risk factors and outcomes. In total, 3647 publications on relevant disorders and work system components were reviewed. A more detailed analysis included meta-analyses, systematic reviews, randomized controlled studies, cohort studies, case–control studies, and the most significant cross-sectional studies (a total of 86 publications). Working with visual display terminals increases the risk of subjective complaints of visual processing disorders, dry eye, and ocular hypertension, as well as musculoskeletal discomfort, dysautonomia, sleep disorders, and psychological disorders. There was no increased risk of reproductive disorders; however, there is evidence of the impact on fertility. Priority areas for prevention programs should include control of cognitive workload and occupational stress, improved workplace ergonomics and lighting conditions, prevention of visual processing disorders, and psychological support. The programs must take into consideration the changes in workflow.

Background: Conflicts of interest (COI) of contributors to a guideline project and the funding of that project can influence the development of the guideline. Comprehensive reporting of information on COIs and funding is essential for the transparency and credibility of guidelines. Objective: To develop an extension of the RIGHT statement for the reporting of COIs and funding in policy documents of guideline organizations and in guidelines: the RIGHT-COIF checklist. Design: The recommendations of the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network were followed. The process consisted of the following steps: 1) registration of the project and setting up working groups; 2) generation of the initial list of items; 3) achieving consensus on the items; and 4) formulating and testing the final checklist. Setting: International collaboration. Participants: 44 experts. Measurements: Consensus on checklist items. Results: The checklist contains 27 items: 18 about the COIs of contributors and nine about the funding of the guideline project. Of the 27 items, 16 are labelled as policy-related as they address the reporting of COI and funding policies that apply across an organization’s guideline projects. These items should be described ideally in the organizations’ policy documents, otherwise in the specific guideline. The remaining 11 items are labelled as implementation-related and they address the reporting of COI and funding of the specific guideline. Limitations: The RIGHT-COIF checklist requires testing in real-life use. Conclusion: The RIGHT-COIF checklist can be used to guide the reporting of COIs and funding in guideline development, and to assess the completeness of reporting in published guidelines and policy documents.

BACKGROUND: Modern thread-lifting techniques aim to achieve an immediate mechanical lifting effect and provide a prolonged biostimulatory action directed at remodeling dermal structures. AIM: This study aimed to perform a histomorphological evaluation of the effects of monofilament P(LA/CL)-HA-nano threads on skin remodeling in a biomedical experiment and compare their outcomes with those of P(LA/CL)-HA threads and intact skin. METHODS: The study included five clinically healthy female Large White pigs aged 4 months weighing 40 ± 1.2 kg on average. Each animal underwent implantation of two types of threads: P(LA/CL)-HA and P(LA/CL)-HA-nano. Euthanasia of the animals and histomorphological analysis were performed on days 7, 21, 30, 90, and 180. Intact skin was considered the control. The following parameters were assessed: dermal thickness, content of type I and type III collagen fibers, and elastin levels. Histological staining included hematoxylin and eosin, Weigert–Van Gieson, and Picrosirius Red with polarized light analysis. Statistical analysis was conducted using the Wilcoxon signed-rank test. Differences were considered significant at p 0.05. RESULTS: P(LA/CL)-HA-nano thread implantation resulted in significantly increased dermal thickness (day 180, p = 0.0431), increased type I collagen density in the dermis (day 90, p = 0.0431) and hypodermis (all time points, p 0.05), and enhanced type III collagen synthesis in the hypodermis from day 21 (p = 0.0431). A significant increase in elastin levels in the dermis was observed on days 90 and 180 (p = 0.0431). Distinct kinetics of tissue remodeling were noted compared with non-modified P(LA/CL)-HA threads. CONCLUSION: P(LA/CL)-HA-nano threads exhibit pronounced bioactive properties, promoting structural remodeling of skin tissues.

BACKGROUND: Surgical advances in breast cancer contribute to improving the postoperative quality of life. AIM: The study aimed to evaluate the short-term and long-term outcomes of breast-conserving surgery. METHODS: The study included the treatment outcomes reported for 194 patients diagnosed with breast cancer who had been admitted to the Samara Regional Clinical Cancer Hospital between 2011 and 2020. Group 1 (n = 96) included patients who had undergone conventional breast-conserving surgeries. For group 2 (n = 98), a modified approach, described as “Choosing the extent of surgery for patients diagnosed with breast cancer,” was used. This technique involved the placement of the lateral adipocutaneous flap in the axillary region, with the free edge positioned as close to the nervus thoracicus longus as possible. The analysis focused on operative time and intraoperative blood loss. The disease-free and overall survival probabilities were estimated using the Kaplan–Meyer method. The patients were also asked to complete the Breast-Q questionnaire prior to surgery and six months after the treatment. The statistical analysis was performed using the parametric (Student’s t test) and non-parametric (Mann–Whitney test, chi-squared test [χ2], and Fisher’s exact test) methods. The significance level was set at p 0.05. RESULTS: The short-term surgical outcomes were not significantly different between the groups. The mean operative time was 76.3 ± 23.3 minutes in group 1 and 65.5 ± 18.3 minutes in group 2 (p 0.001), with the intraoperative blood loss recorded at 53.1 ± 26.2 mL and 49.0 ± 14.3 mL, respectively (p = 0.18). Postoperatively, persistent non-infected seroma (14 days) was identified in 19 patients from group 1 and 7 patients from group 2 (p = 0.009). CONCLUSION: The proposed method provides a significant reduction in the incidence of complications, with long-term outcomes comparable to those observed in the conventional treatment group.

BACKGROUND: The preservation and promotion of children’s health remain pivotal aspects of the Russian healthcare. AIM: The study aimed to identify prevalent health patterns among preschool and school-age children in the Novo-Savinovsky district of Kazan between 2018 and 2022. METHODS: The analysis included screening reports from 32 preschool education and care facilities and 20 schools in the Novo-Savinovsky district of Kazan. The reports were provided by medical professionals from the regional child health center and detailed laboratory tests and clinical investigations covering the years 2018 through 2022. In 2018 and 2022, the number of preschool-age children (3–7 years old) examined was 7257 and 6362, respectively. The health status of grade 1–11 students was assessed by analyzing medical statistical data collected between 2018 and 2022. A total of 14,917 and 18,141 schoolchildren were examined in 2018 and 2022, respectively. The population included adolescents aged 15–17 years (2775 and 3841, respectively). A comprehensive health assessment included the distribution of health groups and allocation to special medical groups, physical development, and primary and overall incidence (per 1000 age-matched children). The statistical analysis was performed using StatTech software, with the Mann–Whitney U test used for quantitative variables and the χ2 test used for qualitative variables, with a significance level of p = 0.05. RESULTS: The study period showed a decrease in the proportion of healthy children (p = 0.04) and an increase in the number of preschool children with structural and functional impairments (p = 0.001). The overall incidence demonstrated a 24.3% increase. The most significant increase was observed for respiratory, musculoskeletal, visual, gastrointestinal, and neurological, genitourinary, psychiatric, and behavioral disorders (p = 0.001). Schoolchildren demonstrated a decrease in the proportion of healthy individuals and an increase in the number of children with structural and functional impairments (p = 0.001). The overall incidence decreased by 24.7% (p = 0.001), yet the prevalence of psychiatric disorders (p = 0.03), congenital anomalies, deformities, and chromosomal abnormalities increased (p = 0.0011). The study found a significant increase in school-related diseases throughout the years of school (p = 0.001). CONCLUSION: Between 2018 and 2022, a decline in the overall health of preschool and school-age children in the Novo-Savinovsky district of Kazan was observed, as indicated by a decrease in the proportion of healthy children, an increase in the incidence of structural and functional impairments, and a higher prevalence of school-related diseases.

BACKGROUND: Stomach cancer is associated with systemic disturbances, including impaired hemostasis, which may result in thrombosis and bleeding, significantly affecting the prognosis, quality of life, and risk of fatal outcome. AIM: The study aimed to identify risk factors for thrombosis and bleeding in patients with stomach cancer, assess the prognostic value of existing risk scores using a retrospective analysis of our own findings, and propose ways to improve them. METHODS: The study analyzed medical records of 178 patients with stomach cancer who were treated at Sechenov University in 2021–2023. The medical records were grouped based on two independent variables: the presence of thromboembolic events (25 patients with and 150 patients without thromboembolic events) and the presence of bleeding (23 patients with and 155 patients without bleeding). The outcomes were assessed by examining imaging findings (ultrasound and computed tomography) specified in medical records, which allowed confirming or ruling out thromboembolic events, as well as initial examination findings and discharge summaries following hospitalization for chemotherapy. Qualitative variables are presented as mean ± standard deviation, whereas categorical variables are presented as absolute values and percentages. Intergroup differences were assessed using the Mann–Whitney and Pearson’s chi-squared tests. Significant associations for thromboembolic events and bleeding were identified using multivariate regression analysis. The prognostic value of scores was assessed using ROC analysis (AUC, sensitivity, specificity). SPSS 23.0 was used for statistical analysis. RESULTS: Patients with chronic heart failure had an 11-fold greater risk of thromboembolic events than patients without chronic heart failure (odds ratio [OR] 11.12; 95% confidence interval [CI] 3.14–38.74; p = 0.001). Chronic kidney disease was associated with more than a 5-fold greater risk (OR 5.07; 95% CI 2.02–12.71; p = 0.002), and varicose veins with more than an 8-fold greater risk (OR 8.12; 95% CI 2.87–22.94; p = 0.001). Adding these factors to the Khorana score improved its prognostic value: in ROC analysis, AUC was 0.823 compared to 0.615 at baseline. This indicates a high discriminatory capability of the modified model (AUC 0.8). The REACH score showed a high prognostic value for assessing the risk of bleeding (AUC = 0.738). CONCLUSION: Adding chronic heart failure, chronic kidney disease, and varicose veins to the Khorana score improves its prognostic value for assessing the risk of thromboembolic events. The REACH score was effective in predicting the risk of bleeding.

BACKGROUND: Healthy biological maturation in young girls is crucial for their future reproductive health. The continuous monitoring of their physical development is critical for early identification of any health problems. AIM: This study aimed to identify the 100-year trend of girls’ growth and development in the city of Moscow. METHODS: The study focused on the physical characteristics of Moscow schoolgirls over a period of 100 years (1920–2020), including their body height and weight, chest circumference, right-hand grip strength, and time of menarche. In this study, a total of 4581 girls aged 8–17 years were observed from 2003 to 2020. The obtained data were compared with those documented in “Materials on the Physical Development of Children and Adolescents in Urban and Rural Areas of the USSR (Russia),” covering the period from 1920 to 2013. The Kolmogorov–Smirnov normality test was used to determine the normality of distribution. The differences were considered significant at t ≥ 2.0 (p 0.05). RESULTS: Comparative analysis of the physical development of Moscow schoolgirls across decades showed an increase of 3–5 cm in the body height and a significant increase in the chest circumference among all age groups of girls at the beginning of the 21st century compared with their peers in the 1960s and 1980s, indicating the completed processes of gracilization that had been observed since the 1980s. The mean body height of 8-year-old schoolgirls in 2003 was 129.12 ± 0.47 cm compared to 125.66 ± 0.32 cm in those in the 1960s (p 0.001). Additionally, the mean chest circumference was 62.34 ± 0.44 cm in 2003 and 60.50 ± 0.22 cm in the 1960s (p 0.008). Moreover, a decrease in the right-hand grip strength has been noted in all age groups (9-year-old girls: 13.2 ± 0.2 kg in the 1960s and 6.9 ± 0.1 kg in 2003; p 0.001). Earlier menarche has been documented in modern Moscow schoolgirls, with an average age of 12 years and 9 months. This phenomenon is accompanied by a shift in the chronology of growth patterns toward earlier stages. The age of first menstruation (menarche) varies with family income. CONCLUSION: Over a century-long period, Moscow schoolgirls have shown increased total body size and earlier biological maturation.

BACKGROUND: Intestinal microcirculatory injuries in patients with severe acute pancreatitis result in neuroendocrine dysregulation, intestinal epithelial cell dysfunction, and impaired intestinal motility. AIM: This study aimed to assess the efficacy of enteral corrective therapy of intestinal failure in patients with severe acute pancreatitis using an enteral saline solution. METHODS: A multicenter, non-randomized clinical study included 146 patients with severe acute pancreatitis (112 [76.7%] males and 34 [23.3%] females, mean age: 50.8 [SD ± 13.7] years). The patients were divided into two groups. The control group included 52 patients (35 [67.3%] males and 17 [32.7%] females, mean age: 50.9 [SD ± 15.0] years) who received standard of care. The treatment group included 94 patients (69 [73.4%] males and 25 [26.6%] females, mean age: 46.6 [SD ± 9.5] years) who additionally received enteral therapy using an enteral saline solution. The solution’s composition was identical to that of chyme from the first part of the small intestine in apparently healthy individuals. Its acidic environment (pH 5.0–5.8) has a bacteriostatic effect and inhibits the growth of opportunistic and pathogenic microorganisms. Enteral therapy was provided via a nasointestinal tube, which was placed along the endoscopic instrument channel and attached to the ligament of Treitz. The solution (1500 mL) was administered at a rate of 6–10 mL/min with intra-abdominal pressure monitoring, which did not exceed 16 mmHg. The Mann–Whitney U test was used for intergroup comparisons. Differences were considered significant at p 0.05. RESULTS: The treatment group showed a decrease in intestinal injury marker (I-FABP) levels the day after starting enteral therapy. On days 2 and 7, there was a significant decrease in intestinal fatty acid binding protein (I-FABP) levels to 1.52 ng/mL (p = 0.049) and 1.42 ng/mL (p = 0.01), respectively. These values were comparable to the median I-FABP level in the control group (1.40 ng/mL), which was used as a reference. On day 2, the threshold value was comparable to the reference (p = 0.049), with a significant decrease on day 7 (p = 0.01). CONCLUSION: The findings confirm the efficacy of the enteral saline solution in patients with severe acute pancreatitis.