Sechenov University Research Articles

Comparative assessment of the quality of life in patients with bronchial asthma and chronic obstructive pulmonary disease before and after COVID-19

Objective. To compare the quality of life of patients with bronchial asthma and chronic obstructive pulmonary disease (COPD) before and after COVID-19. Materials and methods. 73 patients diagnosed with bronchial asthma and 78 patients with COPD who were treated at Sechenov University Clinical Hospital №4, participated in the retrospective dynamic comparative study based on the principle «from cause to effect». Assessment of the quality of the patients` life was carried out before and after COVID-19 using a visual analogue scale from 0 to 100 points and the universal EuroQol-5D questionnaire. Mobility, self-care abilities, habitual activity, severity of pain/discomfort, the presence of anxiety/depression in the post-COVID period were assessed. Results. In patients with COPD before COVID-19, the average total score on the visual–analogue scale was 89,5 [83,8; 95], and after COVID-19 it was 70 [64,5; 80] points. In the post-covid period, 91 % of people with COPD noted some mobility limitations, 33.3 % experienced difficulties with self-care, 65.4 % of patients could not engage in habitual activities, 60.3 % suffered pronounced pain or discomfort, and 29.5 % of patients had severe anxiety or depression. In patients with asthma before COVID-19, the average total score was 90 [88,4; 91] points, and after COVID-19 it was 75 [70,2; 80,2]. In the post-ovarian period, mobility limitations were noted by 71.2 % of patients, and 64.4 % had difficulties with taking care of themselves, 54.8 % could not engage in habitual activities. At the same time, 78.1 % of patients experienced pain or discomfort, and 58.9 % had moderate anxiety or depression. Conclusions. COVID-19 has led to a significant decrease in the quality of life in patients with asthma and COPD. This may be associated with a worsening of the course of the disease and increase in the number of exacerbations of these pulmonary pathologies, resulting in significant limitation of mobility, growing pain or discomfort, as well as the occurrence of severe anxiety or depression.

Neoadjuvant chemotherapy with FLOT scheme in surgical treatment of gastric cancer: short- and long-term outcomes. A retrospective cohort study

Aim. To compare the results of surgical treatment of patients with gastric adenocarcinoma and esophagogastric junction cancer (EGJC) who received neoadjuvant chemotherapy (NCT) FLOT with primary operated patients. Materials and methods. A retrospective cohort study included 177 patients who underwent radical surgical treatment at the Burdenko Faculty Surgery Clinic of Sechenov University for gastric cancer (GC) and/or EGJC Sievert Type II–III in the period from January 2018 to December 2022. The main group consisted of patients (n=28) who received NCT FLOT. Patients in both groups did not statistically significantly differ in average age (p=0.110), ASA status (p=0.541), ECOG status 0–3 (p=0.12), localization (p=0.063), depth of invasion (p=0.099) and histological structure of the tumor (p=0.787). In the main group, more patients with lesion of the regional lymph nodes were expected (p0.001). According to the most significant indicators [postoperative complications, the presence of a "positive" edge of resection (R1), recurrence and/or progression of GC], we performed a quasi-randomization by the matching procedure, taking into account the selection of the nearest neighbors. Results. In 92.9% of patients in the main group and in 94.9% of the control group, R0 resection (p=0.750) was achieved. The number of removed lymph nodes was statistically significantly higher in the main group (average 26 vs 21; p=0.010). There was no difference in intraoperative blood loss (p=0.294) and hospital stay (p=0.992). The average duration of surgery in the main group was 319 minutes, compared to 250 minutes in the control group (p0.001). In the early postoperative period, the total number of complications (CD I–IV) was higher in the main group (p=0.031), however, there was no difference in the number of small (CD I–II; p=0.094) and significant (CD III–V; p=0.142) complications. Postoperative mortality in the first 30 days after surgical treatment was 3.6 and 2.5% in the main and control groups, respectively (p=0.764). The overall 6-month survival rate in the control group was 95.9% vs 90.9% in the main group, and the 12-month survival rate was 88.8% vs 75.7%, respectively. The reccurence-free 6-month survival rate in the control group was 96%, in the main group – 100%; the reccurence-free 12-month survival rate in the control group was 92.1%, in the NCT group – 93.3%. Conclusion. NCT FLOT in the treatment of GC and EGJC Sievert Type II–III does not increase the level of intraoperative blood loss, the number of postoperative complications and the duration of hospitalization. The 6-month and one-year survival rates did not differ in the two groups. Considering that the majority of patients in the NCT group belonged to the cN+ category, with an initially less favorable treatment prognosis, it can be assumed that comparable survival results were achieved thanks to NCT.

The necessity and demand of machine learning in treatment and diagnostics in dentistry

Aim: to justify the necessity of machine learning technology in treatment and diagnostics in dentistry.Material and methods: the research was taken using the method of anonymous questionnaire to estimate the demand and necessity of machine learning technology in diagnostics and treatment in dentistry on the basis of the E.V Borovsky Institute of Dentistry I.M Sechenov First Moscow State Medical University (Sechenov University). 100 participants from different dental specialities aged 20 to 54 took part in the questionnaire. Wilson score interval and Student’s T Critical Values were used for the statistical analysis of the Results.Results: during the study, it was found that the majority of dentists who participated in the questionnaire (54%) have challenges in diagnosing oral mucosal diseases. Herewith dentists with work experience more than 5 years diagnose this kind of disease more frequently than specialists with less work experience (p<0.05). Surgical dentists (46,6%) and prosthetic specialists (50%) diagnose this pathology most often. Clinicians attribute diagnostic challenges to the lack of experience (85%) and low occurrence of patients with this group of diseases. During treatment and diagnostics 84% of residents mentioned that they compare their patients’ clinical cases with clinical cases from the Internet and other resources, 78% of residents believe that machine learning will help to increase the efficiency of diagnosing oral mucosal diseases in clinical work. During the held research, it was found that 85% of participating dentists would definitely use digital programs with machine learning in their clinical work for treatment and diagnostics.Conclusions: the presence of problems in treatment and diagnostics of oral mucosal diseases was confirmed, and to solve it, the demand and the need to develop and implement digital systems based on artificial intelligence using machine learning technology were substantiated.

АНАЛИЗ ОБЪЕМА ПОТРЕБЛЕНИЯ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ ПРИ ЛЕЧЕНИИ ЭПИЛЕПСИИ В СТАЦИОНАРЕ

The article presents the results of the study of the volume of consumption of medicinal drugs for the treatment of patients diagnosed with epilepsy. As a result of retrospective processing of case histories (continuous sampling for 2021-2023) obtained in the inpatient department of the Clinic of Nervous Diseases named after A.Y. Kozhevnikov of Sechenov University, we identified medicines with the highest NDDD value (number of defined daily doses) for each of the 8 allocated clinical and statistical groups. Among all clinical and statistical groups, the G40.0 group had the highest consumption. In clinical and statistical groups G40.0, G40.8 and G40.9, valproic acid and levetiracetam were found to have the highest NDDD value. In addition, the consumption volume analysis showed that in clinical and statistical group G40.8, the neuroleptics quetiapine and teraligene are used relatively more frequently than in other diagnoses. In clinical and statistical groups G40.1, G40.2, and G40.4, the medicines valproic acid, levetiracetam, and lamotrigine were used, respectively. B vitamins accounted for the highest consumption among all clinical and statistical groups, except for G40.2. The results obtained may become the basis for the development of recommendations to optimize the use of medicines and improve the quality of drug care for patients with epilepsy at the inpatient stage.

Pre-vocational education as a factor in the development of human resources in the healthcare system

Pre-professional medical education in high school provides not only a more in-depth study of individual subjects of general education programs, but also expands the opportunities for self-determination of students, ensures continuity of the educational process, allows boys and girls to adapt more successfully mastering higher medical professional education programs and is the basis for a successful career.Aim. To evaluate the results of the introduction and implementation of the model of pre-professional medical and pharmaceutical education using the example of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) (hereinafter referred to as the Pre-University) as a means of developing the human resources potential of the healthcare system on the territory of the Russian Federation.Materials and methods. During the work, a theoretical analysis of domestic and foreign literature on the problem of developing the human resources potential of the healthcare system was carried out. A study was conducted in the comparative aspect of the basic readiness of students in grades 8-11 at the Pre-University and specialized medical and biological classes of regional educational institutions to the choice of medical specialties using a test questionnaire with the identification of three key aspects: readiness to master medical specialties; self-assessment of capabilities and erudition in the field of modern medicine. 1465 people took part in the survey. The reliability of the results was carried using the Mann-Whitney U test. Assessment of the statistical significance of differences between the means was carried out at a critical level of p = 0.05.Results. Studying at the Pre-University of Sechenov University allowed the majority of adolescents to achieve higher levels of formation of the main indicators of basic readiness to choose medical specialties. The share of students with a high level of readiness to master medical specialties at the Pre-University is 13.8 % higher compared to students of specialized medical and biological classes, with high erudition – 13.8 % and 6.7 % higher those who highly assess their prospects for entering a medical university.Conclusion. Pre-professional education based on close interaction between the Pre-University and Sechenov University allows students to develop motivation to choose a medical profession, as well as a clear understanding of the learning process in the chosen profession and is an important link in the system of continuous educational trajectory «pre-university–university–clinic».

Typical clinical practice of treating patients with chronic migraine

Currently, effective methods for the treatment of chronic migraine (CM) have been developed, but it remains unclear how they are used in real clinical practice and how often. The typical practice of treating patients with CM in our country has not been sufficiently investigated, which formed the basis for conducting this study.Objective: to evaluate the quality of treatment of patients with CM in real-life neurological practice.Material and methods. The study included 200 patients with CM (63 men and 137 women, mean age – 33.1±7.1 years) admitted to A.Ya. Kozhevnikov Clinic of Nervous Diseases (CND) of Sechenov University for frequent headaches, who were previously treated by neurologists in other medical institutions on an outpatient and/or inpatient basis. All patients were clinically interviewed to establish a diagnosis and analyze their previous treatment.Results. All patients had an experience of incorrect or inadequate treatment, including ineffective drug and non-drug methods. All patients were taking painkillers to relieve migraine, but less than half of them was satisfied with their effectiveness. Only 12 (8.5%) patients with medication overuse headache had previously received treatment for drug overuse. None of the patients who were admitted to CND had previously received cognitive-behavioral therapy and treatment with an interdisciplinary approach that included not only pharmacotherapy but also psychological and behavioral methods and kinesiotherapy.Conclusion. In real-life clinical practice, ineffective methods are often used to treat migraine, and an interdisciplinary approach that includes effective pharmacotherapy and non-pharmacological methods is lacking.

Diagnosis of chronic migraine and comorbid neurological disorders in real-life clinical practice

Chronic migraine (CM) is a neurological disorder whose diagnosis requires not only knowledge of its diagnostic criteria, but also the physician's ability to differentiate between various forms of primary and secondary headache (HA), as well as to recognize comorbid neurological disorders that aggravate the course of CM. Timely and correct diagnosis of CM and comorbid disorders allows to prescribe effective treatment to a patient and convert the migraine from a chronic to an episodic form. The diagnostics of CM and comorbid neurological disorders has not been sufficiently investigated in our country, which formed the basis for this study.Objective: to evaluate the quality of diagnostics of CM and comorbid neurological disorders in real-life neurological practice.Material and methods. The study included 200 patients with CM (63 men and 137 women, mean age 33.1±7.1 years) admitted to A.Ya. Kozhevnikov Clinic of Nervous Diseases (CND) of Sechenov University, complaining of frequent headaches. They had previously been examined and treated by neurologists in other medical institutions on an outpatient and/or inpatient basis. A clinical interview was conducted with all patients to establish a diagnosis and analyze their previous treatment, and a psychometric test was performed to assess symptoms of anxiety and depression.Results. Only 6% of patients had been previously diagnosed with CM, the remaining 94% were incorrectly diagnosed with secondary HA. All patients had previously been prescribed additional examinations, mainly neuroimaging of the brain and ultrasound of the cerebral vessels, although there were no "red flags". None of the patients had been previously assessed for their emotional state, while almost all patients had high situational anxiety (n=190; 95%) and high personal anxiety (n = 180; 90%), there were symptoms of depression (n=190; 95%) of varying severity. Comorbid neurological disorders (medication overuse HA), insomnia, musculoskeletal pain etc.) were diagnosed in 91.5% of patients in CND and in only in 8% of patients in other medical centers.Conclusion. In real-life clinical practice, CM and comorbid neurological disorders are inadequately diagnosed and excessive and unjustified additional examinations are prescribed.

Typical tactics of treatment of patients with chronic non-specific back pain and tension-type headaches

Non-specific (musculoskeletal) back pain (NBP) and tension-type headache (THA) are among the most common conditions in neurological practice that significantly impair patients' ability to work. The typical practice of treating patients with NBP and THA has not been sufficiently investigated, which formed the basis for conducting this study.Objective: to evaluate the quality of diagnosis and treatment of chronic NBP and THA in real-life neurological practice.Material and methods. The study included 120 patients with chronic NBP and combined THA of different frequency (32 men and 88 women, mean age 38.4±9.6 years) who were treated in A.Ya. Kozhevnikov Clinic of Neurologic Diseases (CND) of Sechenov University with complaints of back pain and headache and who had previously been examined and treated by neurologists and therapists in other medical institutions on an outpatient and/or inpatient basis. All patients underwent a clinical interview to establish a diagnosis and analyze previous treatment, a neurological and neuro-orthopedic examination and a psychometric examination to assess anxiety and depression symptoms.Results. Prior to contacting CND, only 10% of patients had a diagnosis of chronic NBS, only 7% had a diagnosis of THA and the remaining patients had other misdiagnoses. All patients had previously undergone additional examinations, mainly neuroimaging of the spine and brain, ultrasound examination of the neck vessels, even if there were no "red flags" – signs of danger in back pain and headache. None of the patients had previously had their emotional state assessed, while 75% of patients had symptoms of depression of varying severity and all patients suffered from anxiety of varying severity. Neuro-orthopaedic examination was performed in only 10% of patients. All patients received nonsteroidal antiinflammatory drugs for back pain, and most patients received vascular and nootropic medication for headaches. Of the non-pharmacological methods, massage and passive physiotherapy were most frequently prescribed. Only 9% of patients were recommended kinesiotherapy, and only 5% of patients performed it.Conclusion. In real-life medical practice, chronic NBP and THA are inadequately diagnosed, excessive and unjustified additional examinations are prescribed, unsatisfactory level of treatment, and patients with chronic NBP and THA are rarely prescribed kinesiotherapy.

Analysis of the impact of pre-professional education on the health of medical students

BACKGROUND: Education in a higher educational institution is critical for students due to the vulnerability of the young body and the exposure of young men and women to the impact of adverse factors that contribute to health disorders. The solution to the problem of the observed deterioration of the health of students of medical higher educational institutions is currently very acute, since this problem is directly related to the health of future health workers and determines the future of the country. AIM: To assess the health status of students of the Institute of Clinical Medicine named after N.V. Sklifosovsky of Sechenov University on the example of graduates of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) in a comparative aspect with graduates of other educational institutions. METHODS: A single-stage selective comparative study of the morbidity rate of students of the N.V. Sklifosovsky Institute of Clinical Medicine of Sechenov University was carried out. The data of the registration form «No 025/у» 1–6-year students for the period from 2018 to 2024 (n=2229, including 414 graduates of the Pre-University) were used. Data analysis was performed using Pearson's χ2 test with Yates correction. The significance level was set as p 0.05. Numerical data are presented with absolute and relative values. RESULTS: It was shown that the number of students assigned to the first and second health groups among Pre-University graduates was higher overall, and the number of those assigned to the third health group was lower compared to their peers who were not Pre-University graduates (p 0.01). An increase in the overall morbidity of students by the sixth year was noted, but to a lesser extent among Pre-University graduates (p 0.001). All students have more frequent eye and apparatus diseases. The second and third places were occupied by diseases of the nervous system and diseases of the respiratory organs. Diseases of the musculoskeletal system and connective tissue were less common. CONCLUSION: The lower morbidity rate among the graduates of the Pre-University is presumably due to the promotion of a healthy lifestyle and rejection of harmful habits during the pre-professional education phase. The data obtained show the need to strengthen work on the identification and prevention of factors of educational environment, reducing the effectiveness of medical and educational measures for the formation of health status of students at the stage of pre-specific education.

Chronicles of A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDС was founded on October 4, 1891) Bulletin of the MSDС № 1157

On April 16th we held our last meeting of A.I. Pospelov Moscow Society of Dermatologists and Cosmetologists in person. There were 102 participants and 5 applicants. Our agenda included two clinical cases: the first one was a clinical case of fulminant acne (Miderm Clinic); the second one was about gangrenous pyoderma as a possible marker or paraneoplasia in intestinal oncological diseases (Sechenov University). We present clinical cases of patients with fulminant acne and periorbital oedema in the first report, and ascending colon tumour and T3N0M0 rectal cancer in the second report. Three reports were presented in the scientific part of the meeting: the effectiveness of therapy for severe psoriasis (Sechenov University), the effectiveness of Janus kinase inhibitors in atopic dermatitis (Sechenov University), the molecular genetic aspects of the fungal mycosis pathogenesis (State Scientific Center of Dermatovenerology and Cosmetology). The authors presented the results of their own clinical studies of the effectiveness of therapy of diseases, including in the report on molecular-genetic aspects of the pathogenesis of mycosis fungoides the author assessed the changes in the expression levels of genes of the JAK-STAT signalling pathway and transcription factors both in visually unaffected skin and in the focus of clinically detectable lesions.

The miR-338-3p expression level in pemphigus diagnosis

BACKGROUND: Pemphigus is a group of potentially fatal chronic cutaneous diseases in which blisters appear on the skin and mucous membranes as a result of IgG autoantibodies binding to desmosomes in the epidermis, leading to keratinocytes acantholysis. Currently, methods to monitor disease activity and therapy efficiency using various biomarkers are being investigated. MicroRNA expression, in particular miR-338-3p, has been one of these biomarkers, as changes in miR-338-3p expression may trigger the Th1/Th2 cell imbalance and possibly be involved in the pathogenesis of the disease. AIM: This study aimed to design a protocol to evaluate the level of miR-338-3p expression in peripheral blood mononuclear cells and verify the diagnostic value of miR-338-3p expression in pemphigus. MATERIALS AND METHODS: Experimental prospective comparative study was conducted from February 2023 to February 2024 at the Dermatology Department of Sechenov University. The study included 10 patients with pemphigus in the active stage of the disease, 3 patients in remission, and 9 participants of the control group. The expression of miRNA-338-3p was analyzed by real-time polymerase chain reaction, cDNA was obtained using StemLoop method. The evaluation of miRNA-338-3p expression level was based on its comparison with the expression of U6 gene using 2-ΔΔСt method. RESULTS: The expression level of miR-338-3p was analyzed in 10 patients in the active stage of the disease (5 men, 50%; 5 women, 50%; mean age 46±10.7 years), 3 patients in remission (2 women, 66.7%; 1 man, 33.3%; mean age 57±8 years), 9 control group (8 women, 88.9%; 1 man, 11.1%; mean age 36±16.8 years). The mean expression level of miR-338-3p was 8.64 (SD±5.72) in patients with active disease, 3.38 (SD±1.44) in patients in remission, and 1.48 (SD±1.12) in controls. A statistically significant increase in the expression level of miR-338-3p was found in patients in the active disease stage compared to the control group (p=0.002). A statistically significant correlation was found between the level of miR-338-3p expression and the PDAI index score (p 0.001). CONCLUSION: Based on the data obtained in this study, it can be assumed that microRNAs are important in pemphigus, and miR-338-3p expression in particular may serve as a key element in pemphigus pathogenesis. More detailed study of microRNAs and analysis of expression variability according to clinical data may provide the basis for developing new diagnostic methods and severity scoring, allowing more accurate and less invasive diagnostic methods, as well as monitoring and predicting disease progression.

Relationship of conflict resolution culture and personal characteristics of future doctors

Introduction. The article is devoted to the study of the relationship between conflict resolution culture and the personal characteristics of future doctors.Aim. The present research aimed to examine the relationship between the conflict resolution culture of medical university graduates and the key personality traits that influence a doctor’s professional activities: trust and aggressiveness.Methodology and research methods. The testing method employed various psychological tools, including O. I. Shcherbakova’s methodology for assessing the level of conflict resolution culture in individuals, J. B. Rotter’s Interpersonal Trust Scale, and the Bass-Darkey test, a standardised questionnaire designed to measure aggressive and hostile reactions developed by A. Bass and A. Darkey. Descriptive statistics, correlation analysis, regression analysis, and factor analysis were utilised to process the data. The study sample consisted of 300 graduates from the medical faculty of Sechenov University, aged between 22 and 28 years.Results. Graduates exhibit an average level of conflict resolution culture (46.6), an average level of interpersonal trust (78.6), and elevated indices of hostility (52.73) and aggressiveness (53.09), along with a high level of resentment (59.58). Correlation analysis of the study data identified 14 statistically significant relationships between the components of conflict resolution culture and various forms of aggression; however, no statistically significant relationships were found with the level of interpersonal trust. The multiple regression model developed by the authors indicated that 22.8% of the high level of conflict resolution culture can be attributed to the low levels of physical aggression and suspicion.Practical significance. A significant contribution of this study is the identification of the relationship between conflict resolution culture and the personal characteristics of medical university graduates, such as trust and aggressiveness. This research lays the groundwork for developing programmes aimed at enhancing the professionally important personality traits of future doctors. It emphasises the prevention of aggressive behaviour, the cultivation of conflict resolution skills, and the promotion of effective communication with patients and colleagues, ultimately leading to an improvement in the quality of medical care.

α-Klotho is associated with cardiovascular and all-cause mortality in patients with stage3band 4 chronic kidney disease(CKD): a long-term prospective cohort study.

α-Klotho deficiency may increase cardiovascular risks and worsen survival. We evaluated the association of α-Klotho with cardiovascular and all-cause mortality in pre-dialysis chronic kidney disease (CKD) patients. In this prospective study, 75 non-diabetic CKD stage 3b-4 patients werefollowed-up for a median of 8years. Primary and secondary outcomes were all-cause and cardiovascular mortality, respectively. Human soluble α-Klotho ELISA Assay (IBL-Takara 27,998-96Well), Human Fibroblast Growth Factor-23 ELISA Assay (intact FGF23, Merck Millipore MILLENZ FGF23-32K), and Human Sclerostin ELISA kits (Biomedica, Vienna, BI-20492) were used to measure serum α-Klotho, FGF23 and sclerostin levels in the certified laboratory at the Sechenov University according to the manufacturers' protocols.All patients underwent echocardiography to evaluate left ventricular mass index (LVMI), left ventricular ejection fraction by Simpson method, and cardiac (valve) calcification score by a semi-quantitative point scale. Lateral abdominal radiography by Kauppila method was used to estimate calcificationof the abdominal aorta.Cox multivariate regression and receiver-operating characteristic curve (ROC)-analysis were used to evaluate risk factors for death and their cut-off values. Primary and secondary endpoints were reached in 15 (20%) and 9 (12%) patients, respectively. Median α-Klotho levels in deceased and surviving patients were 344 and 484pg/ml, respectively (p = 0.002). In a multivariate Cox regression model, baseline α-Klotho levels (HR 0.99, 95% CI 0.98-1.00, p = 0.023), aortic calcification (HR 1.18, 95% CI 1.02-1.36, p = 0.029) and left ventricular mass index (LVMI) (HR 1.04, 95% CI 1.00-1.08, p = 0.033) were associated with the primary endpoint, whereas α-Klotho (HR 0.99, 95% CI 0.98-1.00, p = 0.029), aortic calcification (HR 1.23, 95% CI 1.07-1.42, p = 0.003) and LVMI (HR 1.04, 95% CI 1.00-1.08, p = 0.021) were associated with the secondary endpoint. α-Klotho levels had the highest area under the curve (AUC)by ROC analysis, that is, 0.766 (95% CI 0.70-0.82) for the primary endpoint and 0.842 (95% CI 0.79-0.90) for the secondary endpoint with cut-off values of 412pg/ml (HR 3.06, 95% CI 1.36-6.89, p = 0.007) and 368pg/ml (HR 4.84, 95% CI 1.59-14.73, p = 0.005), respectively. In pre-dialysis CKD patients, α-Klotho levels areassociated with all-cause and cardiovascular mortality and may be considered an early prognostic marker.

РОЛЬ НАСТАВНИКА В СТАНОВЛЕНИИ В НАУЧНОЙ ДЕЯТЕЛЬНОСТИ СТУДЕНТОВ

The article highlights theoretical approaches to the study of the current task of developing students' interest in science. As part of the study, in which 737 students of Sechenov University took part, it was revealed that at the stage of school education, the presence of a scientist-mentor with authority among students has a significant positive impact on the process of developing young people’s readiness to engage in scientific work, increasing the level of confidence to the scientific community, as well as to science in general. These results highlight the importance of authoritative mentoring in fostering scientific aspirations and belief in scientific achievement among younger generations

Chronicles of A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDС was founded on October 4, 1891) Bulletin of the MSDС № 1156

On February 20th we held our last meeting of A.I. Pospelov Moscow Society of Dermatologists and Cosmetologists in person. There were 115 participants and 3 applicants. Our agenda included four reports. The first speaker reported a clinical case of cytostatic therapy ineffectiveness in a patient with pustular psoriasis (State Scientific Center of Dermatovenereology and Cosmetology); the second case was about the adverse dermatological reactions in patients receiving pembrolizumab and nivolumab for hepatocellular cancer (Sechenov University). Two reports were presented in the scientific part of the meeting: the first report was about the clinical features of perianal dermatoses (Russian Medical Academy of Continuous Professional Education), the second one was based on the diagnosis of erythroderma (Sechenov University).

Trajectories of a doctor's professional development: a narrative interview. Part 1

BACKGROUND: Medical education is one of the most prestigious and in demand at the present stage, which, first of all, is reflected in the high competition rates for admission to a medical university. At the same time, the digital development of the Institute of Medicine determines the increasing academic load and the need to expand the range of disciplines studied at a medical university. AIM: To study of the trajectories of professional development of a young doctor in the Russian healthcare system in modern conditions. METHODS: The study of the trajectories of professional development of young doctors was carried out by the method of narrative interview (n=52) in September–December 2022 on the basis of the Institute of Social Sciences of Sechenov University. The study involved young internists (n=11), pediatricians (n=11), obstetricians and gynecologists (n=10), dentists (n=10), surgeons (n=10). RESULTS: The analysis of the array of narratives allowed us to identify three key semantic and semantic data blocks (including seven subgroups), which served as the empirical basis of the standard narrative plot: the pre-university stage ["playing the profession" (3–7 years), "premonition" of professional choice (8–11 years), professional self-determination or the formation of professional intentions (12–17 years)]; university stage [obtaining medical education as the "foundation" of professional socialization (1–2 years), determining the desired trajectory of the professional path (3–6 years)]; postgraduate stage [debut of professional activity (residency), "challenges of professional autonomy"]. CONCLUSION: The analysis of the corpus of narratives of young doctors made it possible to identify the key temporal points of the trajectory of their professional formation in the modern situation, and showed that the formation and professional self-determination of a medical specialist is determined not only by internal motivation, but also by the influence of social agents (specific for each stage), the conditions of the social and professional environment.

Comparative study of orbital volumes according to multispiral computed tomography data

BACKGROUND: It is believed that accurate reconstruction of the correct anatomy of the orbital bony walls, restoration of symmetry and volume are necessary for a favorable functional prognosis and elimination of an aesthetic defect. The main problem when estimating orbital volume is its complex anatomy. Scientists use various methods to determine orbital volume, and in reviews comparing various methods for calculating orbital volumes, there is no data on which orbital volumetric method is the most accurate, since each of them has both advantages and disadvantages. AIM: The aim of this study is the analysis and the comparison of orbital volumes according to multispiral computed tomography data of healthy patients without bone-traumatic changes of orbital walls. MATERIALS AND METHODS: To measure the volume of orbits, 50 random patients were selected who were examined in the radiology department No. 2 of the University Clinical Hospital No. 1 of the Sechenov University from 2023 to 2024 and who underwent multispiral computed tomography of the facial skeleton for indications unrelated to orbital conditions. Computed tomography data from 25 women and 25 men of different ages (from 18 to 85 years old) were analyzed. A total of 8 groups were formed depending on gender and age: group 1 — women 18–25 years old, group 2 — men 18–25 years old, group 3 — women 26–35 years old, group 4 — men 26–35 years old, group 5 — women 36–50 years old, group 6 — men 36–50 years old, group 7 — women 51 and older, group 8 — men 51 and older. Multispiral computed tomography of the facial skeleton was performed using the Aquilion One 640 CT scanner (Japan) with 0.5 slice thickness in bone and soft tissue windows, to be able to calculate orbital volumes at the workstation, all bone contours of the orbits were marked on each axial slice, starting from the upper wall to the bottom of the orbit with a representation of the orbital volumes in ml. RESULTS: The difference in the volumes of the right and left orbits of 0.5 ml or more was detected in 5 women out of 25 cases, among men the difference was present in 12 cases out of 25; a difference in volumes of more than 1 ml was noted in 1 woman and 2 men; a difference of more than 1.5 ml was not observed in any study group. The orbital asymmetry coefficient in women ranged from 0 ml to 1.21 ml, in men — from 0.08 ml to 1.19 ml, in women, the average volume of both orbits is less than in men. It was also detected that the volume of orbits increases with age, both in men and women. CONCLUSIONS: Considering that the majority of patients had differences in orbital volumes of up to 1.0 ml, we agree with studies that indicate the possibility of using a healthy contralateral orbit as a guideline when planning reconstructive surgery. However, for planning surgical treatment, it is recommended to use manual contouring, as this allows the most accurate reproducibility of the bone boundaries of the orbit, although it requires more time than semi- and automatic segmentation. Also, the advantages of the used method for calculating the volumes of orbits in this study include reproducibility on any workstation from different manufacturers, since the method is carried out on a standard tomograph workstation and does not require any additional software.

Assessment of the safety culture of the Clinical Center of Sechenov University

Formation of safety culture is a basic requirement of international standards and Roszdravnadzor’s Proposals (Practical Recommendations) for quality and safety of medical activities in Russian Federation. A developed safety culture influences the reduction of undesirable events in medical organization. Aim. To assess the level of safety culture of the Clinical Center of Sechenov University with the subsequent development of a strategy for its improvement. Materials and methods. The study was conducted using the Hospital Survey on Patient Safety questionnaire adapted by the authors according to the methodology of the Agency of Healthcare Research and Quality. A total of 1049 medical workers of the Clinical Center of Sechenov University participated in the survey. Statistics To assess the reliability and consistency of the obtained results, the Cronbach’s Alpha coefficient was calculated in IBM SPSS program, statistical analysis was performed, and comparative analysis with international databases was carried out.Results. Middle medical personnel 45.2 % (n = 474), physicians 40.6 % (n = 426), junior medical personnel 11.7 % (n = 123), residents 2.5 % (n = 26) participated in the survey. Representatives of the most high-risk specialties participated more actively: anesthesiology and resuscitation 12.3 % (n = 129), surgery 9.6 % (n = 101), cardiology 8.3 % (n = 87). The strongest component of safety culture was teamwork within departments 83.1 % (n = 872). Nine components were found to be neutral. Two components were the weakest requiring improvement: staffing 44,5 % (n = 467) and non-punitive response to adverse events 47.1 % (n = 495). The overall safety culture level of the Clinical Center was 64 %. Comparative analysis with foreign data showed that the level of safety culture of the Clinical Center is higher than the average of the Organization for Economic Cooperation and Development countries and Saudi Arabia (52 %), and is on par with the indicators of medical organizations in the United States of America (65 %). The strategy for improving the safety culture of the Clinical Center has been to develop a culture of reporting: anonymous collection of reports of adverse events electronically, role-playing training of employees in a game format on how to report and deal with adverse events, and launching a competition, “Sechenovtsy for Safety. Incidents”.

Sechenov University and Izhevsk Radio Plant Entered into an Agreement on the Development and Production of a Domestic Device for Diagnosing Bacterial Overgrowth

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Difficulties in diagnosis of non-conventional dysplasia in inflammatory bowel disease

Purpose: To provide a morphological characterization of dysplasia occurring against the background of inflammatory bowel disease (IBD), considering the new classification of dysplasia. Materials and methods. A retrospective analysis was conducted, and biopsies were reviewed from 257 patients with IBD treated at Sechenov University clinics from 2018 to 2023. Patients' ages ranged from 19 to 63 years. Diagnosis was based on a combination of clinical, laboratory, and instrumental methods. Multiple biopsies were taken during colonoscopy, processed using standard metods. Results. Non-traditional dysplasia was diagnosed in 5 patients, accounting for 1.95% of cases over a 6-year period. Two cases involved hypermucinous dysplasia in patients aged 35 and 43 with ulcerative colitis, with disease durations of 12 and 9 years, respectively. crypt cell atypia/dysplasia was diagnosed in two patients aged 40 and 30, with ulcerative colitis durations of 5 and 10 years, respectively. In a 51- year-old patient with Crohn's disease for over 15 years, dysplasia resembling a dentate lesion was found in the ascending intestine. Dysplasia diagnosis was confirmed using immunohistochemical (IHC) staining with TP53 antibodies (clone DO-7 Leica RTU, Germany), showing positive staining of tumor cell nuclei, indicating TP53 gene mutation. Two out of five cases exhibited total colon involvement in inflammatory process, and one ulcerative colitis case was combined with primary sclerosing cholangitis. Conclusion. Before the appearance of the latest classifications of dysplasia in IBD, we rarely diagnosed dysplasia in biopsies from IBD patients. We now understand that the spectrum of potential neoplastic precursor lesions of colorectal cancer in IBD patients is much wider and this understanding can ensure that clinically important but rare lesions will not be undiagnosed. Future studies of their natural course may eventually determine that some lesions are more clinically important than others.