Scientific Medical Literature Research Articles

ИСТОРИЯ И РЕАЛЬНОСТЬ ПРИМЕНЕНИЯ ТЕСТА 6 МИНУТНОЙ ХОДЬБЫ У ДЕТЕЙ

ntroduction. The application of the 6-minute walk test to assess the functional status of a patient is a safe, simple and easily accessible method in assessing the patient’s functional abilities, the effectiveness of treatment and rehabilitation and the prognosis of various diseases. Aim. TTo analyze the scientific medical literature containing the application of the 6-minute walk test in assessing the functional status of children and adolescents. Material and methods. The test was first described in 1963 in adult patients with diseases of the bronchopulmonary system, with subsequent improvements the test was used in patients with heart disease and became a simple objective indicator of functional physical performance. After the adoption of the standards for the 6-minute walk test by the American Thoracic Society jointly with the European Respiratory Society (2002), widespread application began not only in patients, but also in healthy adults. For the first time, the 6-minute walk test among healthy children was conducted in 2005 in China, later control test values, percentile curves, reference equations and formulas were presented by Austria, Great Britain, the USA, etc. Scientists confirmed the safety and simplicity of the 6-minute walk test, proved a high correlation of the test with gender, height, age, weight, body mass index, pulse and blood pressure, arm span, etc. They proved that the ethnicity and geographical differences of the subjects are very important indicators that affect the test results. In the Russian Federation, the implementation of the 6-minute walk test is limited to sick children and regulatory values, and we have not found reference formulas. Conclusion. The reference values obtained for the 6-minute walk test in healthy children in one country should not be used for children in other countries, since the analysis showed a significant difference in the control values of the distance traveled.

Aspects of HIV-associated cardiovascular pathology against the background of antiretroviral therapy

BACKGROUND: The detection of cardiovascular pathology in patients at various stages of HIV infection is highly relevant. Given the data presented in the scientific medical literature on the negative impact of this infection on the cardiovascular system (CVS), a higher level of mortality in this group of patients from cardiovascular diseases has recently increased several times.
 AIM: to identify cardiovascular pathology in patients at different stages of HIV infection (3 and 4), to determine the relationship with antiretroviral therapy (ART) regimens to improve the quality of medical care and disease prognosis.
 MATERIALS AND METHODS: We examined 60 patients (outpatient and inpatient) with HIV infection at different stages of the disease from June 2020 to December 2021. Retrospectively, an analysis was performed of electronic medical records of persons registered and observed at the MHC AIDS DZM (supervisor MD, prof. A.I. Mazus) based on the State Budgetary Healthcare Institution ICB No. 2 DZM. The following were analyzed: age, gender, medical history (terms of the disease, comorbidities), results of an objective examination, routine laboratory blood tests, and ART regimens. Cardiovascular pathology was identified by performing special instrumental diagnostics ECG, Echo-KG, and Doppler ultrasound of the brachiocephalic arteries followed by a consultation with a cardiologist in case of abnormalities. Categorical data were described with indications of absolute values and extensive indicators. Quantitative indicators were assessed for compliance with the normal distribution using the Shapiro-Wilk test and the Kolmogorov-Smirnov test. Statistical processing was performed using Microsoft Excel and StatTech v. 1.2.0. Differences were considered statistically significant at p 0.05.
 RESULTS: Based on the data presented, it can be noted that the observed group of HIV-infected patients was of middle age (41.38.5 years), and men accounted for 78%. Cardiovascular pathology was detected in 38 (63%), and stage 4 HIV infection was 71%. Among the pathologies of the heart, infective endocarditis (IE) with damage to the tricuspid valve (58%) was most often diagnosed, and most of them (77%) had stage 4 HIV infection. An analysis of the intake of ART showed that in patients who did not receive it for the entire period of the disease, such pathology was detected in 68.4% of cases; among patients with late initiation of ART or lack of adherence in 58% of cases; in those who received ART in a timely and regular manner, cardiovascular pathology was diagnosed five times less often in 11.8%, which indicates an obstructive effect of ART on the development of cardiovascular pathology in HIV infection. The statistical significance of the development of IE in the group of patients with intravenous use of PAS was revealed, which suggests the influence of drug addiction on the occurrence of heart pathology.
 CONCLUSION: The data obtained from this study may have specific practical significance, suggesting criteria for examining patients with HIV infection to identify cardiovascular pathology, which will affect the quality of medical care and the prognosis of the disease.

ASSESSMENT OF DADRU BASED ON DASHAVIDHA PARIKSHA

Dadru is described under kustha in Ayurvedic Samhitas. It is included under kshudra kustha by Acharya Charaka. Acharya Sushruta and Vagbhata included it under maha kustha. Dashavidha pariksha comes under the aatur desha. In dashavidha pariksha, ten points are examined to access the roga and rogi bala. These points are prakriti, vikriti, sara, samhanana, parmana, satmaya, satwa, aaharshakti, vyayam shakti, vaya. Assessment of Dadru with the help of dashavidha pariksha. The conceptual study, i.e., reviews of Ayurvedic and modern medical science literature related to Dadru. A total of 50 patients between the age group of 16-70 years were selected. The predominant age group was 31-60 years. No patient of pravar twak sara was registered in the study; the maximum number of patients were madhyamam samhanana, madhyamam pramana, madhyamam satmya, madhyamam sattva, madhyamam aahar shakti, and madhyamam vyayam shakti. Kapha and pitta dosha are mainly dominating in Dadru. The disease is kruchasadhya. The avara twak sara person is affected primarily in Dadru. Most of the patients registered in the study had madhyamam samhanan, madhyamam parmana, and madhyamam vyayam shakti. The disease occurs mainly in the person who takes ati amla and ati lavan food. The patients who were for study have madhyamam sattva and madhyamam aahara shakti, kandu, raga and mandal present in all patients.

50-year proliferation of music medical science research: A bibliometric review

The extent to which music research has penetrated the medical science literature relative to other forms of research remains unclear. We sought to explore temporal changes in the number of music related publications relative to all medical literature as well as prespecified research subdomains of drug therapy, alternative therapy, and neuroscience between 1970 and 2019. We conducted a bibliometric review in which we quantified the number of annual publications between 1970 and 2019 using MEDLINE (PUBMED) search engine and mesh terms of “Music”; “Drug therapy”; “Alternative Medicine”; “Neuroscience”. The number of publications were quantified relative to all publications within their corresponding years. We also examined the types of journals, geographical location of publication (Based on corresponding author), and journal impact factors. To ensure appropriate content, we conducted a hand review of a random 400 abstracts to ensure they met appropriate criteria for music-medical research. We used log-linear regression, to test differences in growth rates. We determined that the relative growth in the number of music publications accelerated at a rate higher than all medical related publications or those confined to drug therapy. The proliferation of music research was attributable to higher rates of neuroscience, alternative therapy, and music therapy research. In conclusion, the temporal growth in number of music research publications relative to other comparators over the past 50 years underscores the importance, relevance, and maturation of music as an evolving discipline of contemporary medical science.

Postmenopausal Osteoporosis and Osteopenia Management with a Combination of Once-Monthly Oral Ibandronate and Cholecalciferol—A Systematic Review

Postmenopausal osteoporosis and osteopenia are chronic and uncurable conditions that invariably lead to an increased risk of vertebral, hip, and femoral neck fracture if left untreated. Clinical guidelines establish, in general, pharmacological combinations allied to lifestyle changes as the mainstay of their management, and also increasing bone marrow density, lowering fracture risk, and improving quality of life are their main therapeutic goals. The objective of this systematic review was to analyze the available data in the scientific medical literature regarding the role of the ibandronate and cholecalciferol combination in postmenopausal osteoporosis and osteopenia management. Based on our results, we concluded that the above combination is safe and feasible for the clinical control of both conditions.

Influence of chronic pain in osteoarthritis on the risk of cardiovascular diseases and modern methods of drug prevention

The purpose of the review of scientific medical literature was to evaluate the data of the epidemiology of osteoarthritis (OA) and cardiovascular diseases (CVD) with the analysis of risk factors, pathophysiological and pathobiochemical mechanisms of the relationship between OA and the risk of developing CVD in the presence of chronic pain, modern strategies for screening and management of this cohort of patients, the mechanism of action and pharmacological effects of chondroitin sulfate (CS). Conclusions were drawn about the need for additional clinical and observational studies of the efficacy and safety of the parenteral form of CS (Chondroguard) in patients with chronic pain in OA and CVD, improvement of clinical recommendations for the treatment of chronic pain in patients with OA and cardiovascular risk, with special attention to interventions that eliminate mobility restrictions in patients and the inclusion of basic and adjuvant therapy with DMOADs to achieve the goals of multipurpose monotherapy in patients with contraindications to standard therapy drugs.

MODERN VIEW FROM UKRAINE ON ETIOLOGY, PATHOGENESIS AND CLINICAL-DIAGNOSTIC ASPECTS OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN

Pneumonia is a disease characterized by lung tissue inflammation and the development of respiratory failure. Pneumonia is the most common infectious cause of childhood mortality, occurring every 43 seconds worldwide. Despite advancements in medicine and the use of cutting-edge diagnostic, treatment, and preventive technologies, the incidence of pneumonia remains relatively high, especially in resource-poor countries, adversely affecting the socio-economic life of society. Objective: To summarize contemporary scientific perspectives on the classification, etiology, pathogenesis, and clinical-diagnostic aspects of community-acquired pneumonia in children. Materials and Methods: The literature search was conducted using PubMed, Scopus, Web of Science, WHO, UNICEF databases, international protocols, as well as domestic scientific manuals and professional publications, and medical care standards. Search terms included "community-acquired pneumonia," "pneumonia in childhood," and "pneumonia in children." The analysis utilized methods such as a systemic approach, epidemiological analysis, bibliosemantic analysis, and graphical representation. Results: It was conducted the search and analysis of modern scientific medical literature on community-acquired pneumonia in childhood. Pneumonia is a leading infectious cause of illness and hospitalization in children worldwide. Bacteria, viruses, and mixed infections are identified among the main etiological agents, with cases of non-specific pathogens also observed. The variation in pathogens is presented based on age groups. It is discussed major risk factors for community-acquired pneumonia and pathways of pathogen penetration. Modern insights into the disease's pathogenesis are analyzed, involving a complex process with stages characterized by the development of infectious toxemia, respiratory failure, and disturbances in water-electrolyte balance. The main clinical symptoms are described according to the child's age, along with contemporary methods of laboratory and instrumental diagnostics of community-acquired pneumonia. Conclusions: Information from scientific literature is provided on the contemporary definition, classification, epidemiology, etiology, pathogenesis, clinical presentation, and diagnostics of community-acquired pneumonia in childhood. Currently, severe and non-severe forms of pneumonia are distinguished based on respiratory rate and additional threatening symptoms. The increasing incidence of viral-bacterial pneumonia is noted, with bacteria remaining the primary etiological factor. Pneumococcus and Haemophilus influenzae type B predominate among bacteria. It is also observed an increase in cases of viral pneumonia, attributed to respiratory syncytial and coronavirus infections. The disease's pathogenesis involves multiple phases with the involvement of other organ systems. Clinical features of community-acquired pneumonia include fever, respiratory failure, and cough. Laboratory diagnostic methods include a complete blood count, determination of C-reactive protein levels, and procalcitonin. Among diagnostic methods, chest X-ray, computed tomography, and ultrasound diagnostics of the chest organs are considered the most conclusive.

Acute epiploic appendagitis - a rare differential diagnosis of acute abdomen.

Acute epiploic appendagitis is a rare differential diagnosis of unclear or acute abdomen. To describe - by means of a scientific case report - the extraordinary diagnosis of acute epiploic appendagitis along with contained diverticulitis and incarcerated herniation of the greater omentum into the hernial sac of a former trocar site (medical history, significant for laparoscopic ovarian cyst removal) in a 29-year-old female based on experiences obtained in the successful clinical case management, and on selective references from medical scientific literature. Medical history: A 29-year-old female was admitted with abdominal pain in the lower left quadrant. She reported a laparoscopic ovarian cyst removal 3 years prior. Physical examination of the abdomen revealed tenderness in the lower left quadrant without a palpable mass.Leading diagnoses were found using transabdominal ultrasound and confirmed by an abdominal CT scan; namely, incarcerated trocar hernia, diverticulitis of sigmoid colon, and acute epiploic appendagitis. Therapeutic approach was comprised of an explorative laparoscopy (because of the incarcerated hernia), adhesiolysis, removal of a tip of the greater omentum out of the hernial sac, closure of the hernial orifice, and removal of an unclear, inflamed, and bloody fatty tissue from the wall of the descending colon (histopathological investigation confirmed acute epiploic appendagitis). This was flanked by conservative treatment of diverticulitis of the sigmoid colon.Further clinical course was uneventful, with discharge on the 3rd postoperative day with favorable long-term outcome, characterized by no further complaints for 15 months. Acute epiploic appendagitis is an inflammatory, usually self-limiting condition of the epiploic appendages of the colon. It typically manifests with abdominal pain in the lower left quadrant. Imaging is an important diagnostic tool to determine whether the patient has, in fact, acute epiploic appendagitis, so recognizing the characteristic oval lesions with the surrounding inflammation and central fat attenuation on CT, as well as the hyperechoic oval lesions with a hypoechoic peripheral band on ultrasound images is crucial. Nevertheless, it is often overlooked in patients and confused with other differential diagnoses, such as appendicitis or diverticulitis. Although the condition appears infrequently, it is essential to be proficient in the diagnostic evaluation, as a misdiagnosis may lead to unnecessary treatment and even surgical intervention. , the patient was initially diagnosed with an incarcerated abdominal hernia, and therefore subsequently underwent surgery. The inflamed epiploic appendage was discovered in laparoscopic exploration, removed, and confirmed through the histopathology report. This is an approach to be performed with great caution so as not to 1. : misinterpret an inflamed diverticula or covered perforation of it as well as not 2. : overlooking a peritoneal tumor lesion.

‘A medical case history … ’: Huntington’s disease and psychiatry

An important insight arising from the work of Michel Foucault is greater attention to the ways medical science produces subjects. In the case of Huntington's disease, the subjectivity produced has historically been constructed as dysfunctional and threatening, while the subjectivity of the researcher was unscrutinised. This paper describes a Foucauldian analysis of 20th century medical and social scientific literature on the social consequences of Huntington's disease. It identifies three features of Huntington's disease as central to its discursive construction: its genetic transmission pattern, its age of onset and its behavioural symptoms. These qualities, converted into medical and psychiatric knowledge, facilitated the absorption of Huntington's disease into eugenicist discourse, a connection reflected throughout the literature. Through various techniques of power, especially genetic pedigrees, and the normalised appropriation and exploitation of patients' identities and data within psychiatry, affected individuals were subjectified as contaminated and threatening, and implicated in the intergenerational transmission of social dysfunction.

To tweet or not to tweet in otorhinolaryngology, that is the question

ObjectiveTo describe the scientific medical literature devoted to the various interactions between otorhinolaryngology (ORL) and social networks. Material and methodsA literature search, conducted on December 15, 2021, using the search engine of the United States National Library of Medicine (PubMed) and the key-words “otorhinolaryngology”, “social network”, and “Twitter”, retrieved 321 articles for which Abstracts were read for selection of articles with qualitative and quantitative data regarding the various relationships between ORL and social media. ResultsForty-four articles were selected and analyzed. Thirty-nine originated from the USA and none from France or French-speaking countries. Only 1 article was a prospective randomized study. Schematically, two main types of publication were identified. The first dealt with user interactions, topics discussed, teaching of the ORL specialty and publicizing research. The second dealt with the limits and dangers of this new means of publicizing scientific thinking in our specialty. Reading these articles highlighted the role of social media in publicizing ORL research, and suggested distinct options to improve interactions between otorhinolaryngologists, patients and society as a whole. ConclusionAt a time when society is demanding rapid access to medical research findings, just as it is mandatory to master and adhere to the rules for medical writing in research, it is also now necessary to learn how to communicate via social media and send a tweet if one wishes to publicize its research and/or exchange with patients.

Marketing analysis of the domestic pharmaceutical market of antiherpetic medicines

Aim. To conduct the marketing research of the pharmaceutical market of Ukraine in the segment of medicinal products (MP) used for the treatment and prevention of infections caused by HSV-1 and HSV-2.
 Materials and methods. To achieve this aim, methods of logical and meaningful problem formation, desk marketing research, content analysis of publications in scientific and practice-oriented medical and pharmaceutical literature, comparative analysis were used.
 Results. The paper presents the results of the marketing analysis of the Ukrainian pharmaceutical market of antiherpetic MP. For the study, according to the ATC classification, 5 groups of medicines registered at the domestic market were selected. In the drug package leaflets for these medicines herpes infection was one of the indications for use. As of October 1, 2021, the range of antiherpetic MP includes 194 trade names for systemic and local use. The market segmentation of these groups of medicines by manufacturing countries, drug form, conditions of dispensing, origin and composition was carried out. It has been found that the share of herbal medicinal products is 14.43 % (6 positions) and is represented by products for systemic use.
 Conclusions. The research of the market of antiherpetic medicines conducted can be considered as the basis for the search and development of new effective antiviral herbal medicinal products of domestic production for the local treatment of the herpes virus.

Suture Aneurysms - Aetiopathogenesis, Symptomatology, Diagnostic Testing, Treatment, Outcome and Influencing Factors after Open Vascular Surgical and Image-guided Interventional Reconstruction

To illustrate incidence, aetiopathogenesis, symptomatology, diagnostic testing, peri-interventional/-surgical management and outcome of SA based on selective references from the scientific medical literature and our own clinical experiences in diagnostic and therapeutic care. Narrative overview RESULTS: CONCLUSION: SA as relevant quantity of care has become a substantial part of basic vascular surgical or image-guided radiology treatment. The vascular surgeon or radiologist (for image-guided interventions) needs to be adequately focused on the demanding diagnostic and therapeutic management, demanding her/his complete competence and expertise.

Malignant Transformation Rate of Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis.

Oral submucous fibrosis (OSF) is a chronic progressive condition affecting the oral cavity, oropharynx and upper third of the oesophagus. It is a potentially malignant disorder. The authors collated and analysed the existing literature to establish the overall malignant transformation rate (MTR). A retrospective analysis of medical and dental scientific literature using online indexed databases was conducted for the period 1956 to 2021. The quality of the enrolled studies was assessed by the Newcastle-Ottawa Scale (NOS). A meta-analysis using a random effects model of a single proportion was performed along with statistical tests for heterogeneity. The overall proportion of malignancy across all studies was 0.06 (95% CI, 0.02–0.10), indicating an overall 6% risk of malignant transformation across all studies and cohorts. Sub-group analyses revealed strong differences in proportion of malignancy according to ethnicity/cohort; Chinese = 0.02 (95% CI 0.01–0.02), Taiwanese = 0.06 (95% CI, 0.03–0.10), Indian = 0.08 (95% CI, 0.03–0.14) and Pakistani = 0.27 (95% CI 0.25–0.29). Overall, the MTR was 6%; however, wide heterogeneity of the included studies was noted. Geographic variations in MTR were noted but were not statistically significant. Further studies are required to analyse the difference between cohort groups.

Analysis of the use of PR-technologies by domestic pharmaceutical enterprises in the implementation of socially oriented marketing in the conditions of the global COVID-19 pandemic

Today, leading foreign and domestic pharmaceutical companies are aware of the importance of using socially oriented tools of marketing communication to achieve economic stability, strengthen competitive positions and form a positive image at the pharmaceutical market. Aim. To study PR-technologies used by domestic pharmaceutical companies as part of the implementation of the concept of socially oriented marketing in the global COVID-19 pandemic. Materials and methods. The methods of logical and meaningful problem formation, desk marketing research, the content analysis of publications in scientific and practice-oriented medical and pharmaceutical literature were used in the work. Results and discussion. The issues of social responsibility of pharmaceutical industry enterprises as a key factor in the successful development of companies under the conditions of coronavirus infection have been highlighted. The specificityhas been considered, and the features of modern PR-tools of pharmaceutical companies have been determined. The Internet resources play an important role among them. The content analysis of the web-sites of the TOP-5 major manufacturers of drugs at the pharmaceutical market of Ukraine has been conducted; the social responsibility areas and the main PR-technologies have been analyzed. Conclusions. It has been found that the leading domestic pharmaceutical companies take an active public position and constantly implement various social programs aimed at supporting the society welfare, especially in the conditions of the COVID-19 pandemic. The information content of the sites of the enterprises under study fully reflects the activities of companies in the field of public relations on the principles of openness, relevance, reliability and social responsibility. Considerable attention is paid to the quality, safety and availability of pharmaceutical products and the provision ofappropriate assistance to healthcare institutions in the fight against COVID-19.

МЕТОДЫ РЕГИОНАРНОГО ОБЕЗБОЛИВАНИЯ У ПАЦИЕНТОВ С ТРАВМАМИ

Introduction. Trauma patients are a special group in which pain control is often a challenge for the anesthetist and resuscitator. In recent years, the role of regional anesthesia in the anesthesia of patients with injuries has been growing and the methods of regional blockades have been improved. Aim. Analysis of scientific medical literature on the pain relief of patients with traumatic injuries. Material and methods. The review and analysis of modern scientific data about the problem of pain relief in patients with trauma in the search databases PubMed and Google Scholar is carried out. Results and discussion. Multimodal anesthesia consisting of ultrasound guided regional anesthesia methods contributes to better pain relief. Good quality pain relief for traumatic injuries reduces the body's stress response to trauma, reduces the opioid consumption and consequently their side effects, significantly reduces the risk of development of chronic pain and improves the quality of life. Therefore, today, regional anesthesia methods are integrated into the protocols of Enhanced Recovery after Surgery (ERAS). This review highlights the literature data on the possibilities of using current regional anesthesia methods for injuries, in particular, combined and multiple traumas. The advantages and disadvantages of various regional blocks in trauma patients are described. Along with the methods of regional anesthesia of the extremities, relatively new methods of fascial blocks which are successfully used for anesthesia of the chest and abdomen are discussed. Conclusion. Personalized multimodal pain therapy aimed at the area of injury using ultrasound navigation is a promising direction in the treatment of pain in trauma patients.

Анализ системы фармацевтической помощи населению Новосибирской области

Introduction. Uneven placement of pharmacy organizations on the territory of the Novosibirsk region, want of pharmaceutical staff, especially in remote areas, falling living standards, an increase in general morbidity of the population, limited material and financial health care resources in the Novosibirsk region necessitated an assessment of the pharmaceutical care system in order to develop measures to improve it, preserve constitutional rights and guarantees for residents. Aim. Development and testing of a methodology for analyzing the system of pharmaceutical care for the population of the Novosibirsk region. Materials and methods. SWOT analysis was used for the assessment. Based on the content analysis of scientific medical and pharmaceutical literature, regulatory documents of the Government of the Russian Federation, the Ministries of Health of the Russian Federation and the Novosibirsk region, a questionnaire was compiled in which various aspects of the pharmaceutical care to the population of the Novosibirsk region were characterized. A group of experts (heads of pharmacy chains, heads of pharmacies, chiefs or deputies, specialists of the Department of Drug Provision of the Population of the Ministry of Health of the Novosibirsk region – a total of 35 people) were asked to evaluate (rank) the proposed characteristics in a SWOT matrix. Results. It has been established that the strengths of pharmaceutical care to the population of the Novosibirsk region (the top among them are the developed infrastructure for providing the population with pharmaceutical care; the approval and implementation of federal programs on the strategy of drug provision to the population and the development of healthcare in the Russian Federation and the Novosibirsk region) exceed by 1.26 times the weaknesses of the system (insufficient financing of drug provision to the population of the region; insufficient provision of the population with pharmacy organizations and medical and obstetric stations in rural settlements of the Novosibirsk region, etc.). Possibilities of the pharmaceutical care system in the Novosibirsk region (organization of dispensing medicines by medical staff through out-patient clinics in rural settlements of the Novosibirsk region, in which there are no pharmacy organizations; an increase in the proportion of municipal and urban districts provided with medicines dispensing outlets in relation to all municipal and urban entities of the Novosibirsk region to 100%, etc.) by 1.13 times prevails over threats (an increasing staff shortage in the pharmaceutical industry, a pandemic of a new coronavirus infection, etc.). Conclusion. Pharmaceutical care for the population of the Novosibirsk region is characterized by the predominance of strengths over weaknesses, while potential opportunities exceed threats. This imples the necessity to further improve pharmaceutical care, use its resource capabilities and enhance its strengths.

Risk factors for suicidal behavior in older adults

Background. Geriatric population is growing rapidly around the world. Suicidal behavior in older adults is an actual concern in both the public health and socio-economic field. The cause of suicidal behavior is represented by the interaction of biopsychosocial factors, the study of which is necessary for the development of programs for the prevention of suicidal behavior in older adults. The objective of this review is: to provide actual information of suicidal mortality in Russian Federation, to analyze the terminology describing auto-aggressive behavior, to consider the factors of suicidal risk and protective factors in older adults. Materials and methods. An extensive search was conducted on the following databases: https://pubmed.ncbi.nlm.nih.gov, https:// www.sciencedirect.com, https://www.scopus.com/search/form.uri, https://scholar.google.ru, https://cyberleninka.ru/. The number of cited sources — 65. Results: the literature review showed that the Russian Federation is one of the countries with an unfavorable suicidological situation. Suicide rates are higher among older adults compared to other age groups. This trend is typical for both sexes, but more pronounced in men. Among the elderly, the most important are risk factors associated with barriers to health care, stigma and discrimination, access to means of suicide, and abuse. The majority of older adults who attempt or die by suicide suffer from affective disorders, in the structure of which the symptoms of depression and anxiety are of particular importance. The presence of a physical illness, chronic pain syndrome, functional impairment and a feeling of helplessness significantly increase the suicidal risk, especially in combination with depression. Suicidal risk factors and protective factors have their own characteristics in the group under consideration, therefore, when developing prevention programs, older adults should be considered as a separate age risk group. Conclusion. The article presents a systematic review of scientific medical literature on the problem of suicidal behavior in older adults.

Clavicle Dislocations in Family Physians Practice

Dislocations of the clavicle are one of the most common injuries in people of different age groups, which require prompt diagnosis and timely treatment to prevent the development of complications, therefore, acknowledgment of general practitioners-family doctors in diagnosis and medical care for patients with dislocations of the clavicle is a necessary component of the professional competence. Aim: to provide up-to-date information for distance self-learning of general practitioners – family doctors on the diagnosis and treatment of clavicle dislocations and conduct a test assessment of the acquired knowledge. Materials and methods. The analysis of scientific and methodological medical literature and clinical cases from the practice of orthopedic traumatologists, concerning anatomy, classification, mechanisms of development, diagnosis, clinical picture, conservative and principles of surgical treatment of patients with dislocated clavicle is given in the article. Results. A team of authors – orthopedic traumatologists – presented a review of the literature data and clinical cases of dislocation of the clavicle, on the basis of which educational material was formed for distance self-learning of the general practitioners – family doctors. The modern data on the mechanisms of development of dislocation of the clavicle, classification, clinical picture, depending on the type of dislocation are presented; recommendations for conservative treatment and indications for surgical intervention are given. Tests for self-control of knowledge after studying the presented material are given. Conclusions. Knowledge of the management of patients with clavicle dislocation is a necessary component of the formation of professional competencies of a general practitioner – family doctor. The presented article for distance learning provides all the necessary up-to-date information to provide such knowledge.

The seeking medical attention in the urban adult population prior and during the coronavirus pandemic (COVID-19)

Introduction. The appeal of the population for medical care in the conditions of a pandemic and strict quarantine measures has not been sufficiently analyzed in the scientific medical literature to date. The purpose of the work. Analysis of the urban adult population’s access to medical care before and during the COVID-19 pandemic. Material and methods. Based on the materials of the consolidated statistical reports of Krasnoyarsk, the indicators of the appeal and morbidity of the adult population for 2017-2020 were studied. The obtained information was analyzed using absolute and relative values. Results. The analysis of the adult population’s appeal indicators in the pre-pandemic period and the COVID-19 pandemic period showed a decrease of 43.8%. The decrease in the population’s treatment for preventive purposes occurred in all points, except for points Z20-Z29 (potential health hazard associated with infectious diseases), the indicators of which increased by 67.4% or 11.4%. The decrease in the overall morbidity rate during the pandemic was due to a decrease in the frequency of referrals with previously known diseases by 80.4%. The primary morbidity rate increased by 64.3%. Discussion. The indicators of the incidence of the adult population of COVID-19 obtained by us have differences but do not contradict the data obtained by other researchers. As our study showed, the measures taken did not lead to a significant decrease in the population’s appeal to medical institutions. Conclusion. The comparative data obtained allows assessing the impact of the COVID-19 pandemic and the ongoing anti-epidemic measures on the treatment and morbidity of the adult population.

Myths and reality about the effects of glutamate. Compilation of scientific data of modern world literature

The aim of our scientific work was to study the existing experimental models of glutamate effects on the body and to understand the mechanisms of this effect and its possible consequences. To achieve this goal, we have studied different sources of scientific medical literature. Results. In a healthy body, glutamic acid is secreted by brain neurons in the required amount as a neurotransmitter and participates in the main information flows of human body. Sodium glutamate, which enters the body with food in large quantities, affects the body, causing general toxic effects and has a local effect on the stomach, intestines, salivary glands and pancreas and so on. Based on the scientific literature, experimental models that study the effects of glutamate are divided into two types: models in which glutamate enters the body orally and when glutamate is administered subcutaneously and intraperitoneally in the neonatal period of life. In the first route of administration, glutamate causes a toxic effect, which is manifested in increased catalytic activity in the blood serum of alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltranspeptidase in 2.5; 1.6; and 1.5 times, respectively, while the activity of alkaline phosphatase remained at control levels, indicating a pronounced hepatotoxic effect of monosodium glutamate as a dietary supplement. It causes an increase in content of total and tyrosine-containing peptides in the blood serum, increase of substances of low and medium molecular weight, as well as an increase in the values of intoxication, which indirectly indicates a violation of the detoxification of endogenous metabolites in the liver of experimental animals. Ingestion of sodium glutamate within the recommended doses has not been shown to cause marked pathological changes in the mucous, muscular and serous membranes of the gastric wall, but there is a slight fullness of the vessels of the submucosal membrane. It has been found that in high doses, sodium glutamate has a local pathogenic effect on the tissues of the stomach, which consists in thinning all layers of its wall, desquamation of the mucous membrane and its disorganization by reducing the size of gastric glands, increasing the number of vessels and their fullness with blood. One of the mechanisms of pathogenic effect of sodium glutamate is the contact local and free radical oxidizing effect on gastric tissues. In the oral route of administration of glutamate there are no phenomena of fat growth (obesity) as epidermal, which is characteristic of the abdominal form of obesity, so and pararectal, parallelic, pararenal and retroperitoneal, which is characteristic for the visceral form of obesity. In the subcutaneous and intraperitoneal routes of administration of glutamate in the neonatal period of life in experimental animals, glutamate causes hypersecretion of hydrochloric acid, the development of lesions manifested by hemorrhage, erosions and ulcers in the gastric mucosa and obesity. Prolonged administration of monosodium glutamate significantly enhances the striking effects of stress on the gastric mucosa. Morphological studies of the submandibular salivary glands of rats on the background of glutamate-induced obesity confirm the development of pathological changes, as evidenced by the detected vacuolar dystrophy in the acinar region, perivascular and periductal edema. On the background of abdominal obesity, dystrophic processes were found in the acinuses and minor dystrophic changes in the intraparticle inserts. Conclusion. In the subcutaneous and intraperitoneal routes of administration of glutamate in the neonatal period of life in experimental animals, glutamate causes hypersecretion of hydrochloric acid, the development of lesions manifested by hemorrhage, erosions and ulcers in the gastric mucosa and obesity. Prolonged administration of monosodium glutamate significantly enhances the striking effects of stress on the gastric mucosa. Morphological studies of the submandibular salivary glands of rats on the background of glutamate-induced obesity confirm the development of pathological changes, as evidenced by the detected vacuolar dystrophy in the acinar region, perivascular and periductal edema. On the background of abdominal obesity, dystrophic processes were found in the acinuses and minor dystrophic changes in the intraparticle inserts. There is no doubt in the fact, which is based on the results of numerous experimental studies and covered in professional scientific litefrature, that the abdominal form of glutamate-induced obesity is possible only with subcutaneous and intraperitoneal routes of its administration in the neonatal period of life and while intraorall way of administration does not occur.