Relevance. Impaired vascular wall stiffness and structural and functional myocardial remodeling in patients with arterial hypertension are associated with common pathogenetic mechanisms and determine the prognosis of a patient with high blood pressure. The aim of the study. To determine the relationship between arterial stiffness and diastolic dysfunction indices according to tissue Doppler data in patients with arterial hypertension. Materials and methods. The study included 75 patients with arterial hypertension, aged 53.3±15.5 years. A study was conducted of the level of cardiovascular risk, arterial stiffness indices, type of left ventricular remodeling and diastolic dysfunction. Results and conclusions. A reliable relationship was found between arterial stiffness and tissue Doppler indices (the correlation is significant when comparing diastolic dysfunction with the augmentation index, the time of reflected wave propagation and the augmentation index in the aorta).

The aim of the study: to study the histology of the placenta in its presentation and accreta. Materials and methods. A morphological study of the placenta of women who gave birth in the obstetric hospital of the Clinic of the South-Urals State Medical University in Chelyabinsk was carried out (sample size 53 preparations): group 1 — 21 preparations of normally located placenta; group 2 — 17 preparations of placenta previa without signs of placenta accreta spectrum (PAS); group 3 — 15 PAS preparations (7 cases of placenta accreta, 5 — placenta increta, 3 — placenta percreta, invasion degree 3a). For histological examination, the obtained tissue fragments were fixed in formalin solution, embedded in paraffin, plane-parallel sections were made from the paraffin blocks, stained with hematoxylin and eosin, with subsequent viewing and photography of micropreparations. Results and conclusions. Morphological examination of PAS preparations at the site of germination revealed significant thinning of the uterine wall due to aplasia or pronounced hypoplasia of the spongy and basal layers of the endometrium, the absence of a fibrinoid layer in the basal plate zone, and replacement of the myometrium with connective tissue. Wide spurs of the basal plate were recorded, deeply penetrating between the terminal villi of the placenta, many of which penetrated the entire thickness of the myometrium.

Introduction. Preventive medical examinations, medical examination and dispensary observation play an important role in the timely detection of NCDs, risk factors for their development, effective management to improve the quality of life, preserve the health of the able-bodied population. A prerequisite for this is the improvement of knowledge and experience in the implementation of preventive work, dispensary observation of medical workers.
Purpose. Scientific substantiation and development of a model for the formation of sustainable knowledge, practical skills and improvement of competence in conducting medical preventive examinations and medical examination of the adult population for all participants in the process.
Materials and methods. A sociological study was carried out among employees of medical organizations, graduates of the Faculty of Medicine, an analysis of the results of the audit of medical organizations within the framework of internal and departmental control of the quality and safety of medical activities. The database was formed in Microsoft Excel, statistical analysis was carried out using IBM SPSS Statistics 19. Data is visualized using tables.
Outcomes. Analysis of the results of the study revealed problems associated with the lack of competencies among medical workers — participants in the process of organizing medical examination, preventive medical examination, dispensary observation. The data obtained showed the need to improve the training of specialists in the organization and conduct of medical examinations and preventive medical examinations, dispensary observation.
Conclusion. The analysis made it possible to scientifically substantiate and develop proposals for the formation and improvement of competencies in the organization and conduct of medical examinations, preventive medical examinations, dispensary observation differentially depending on the role of the participant in the process of medical examination, preventive medical examinations.

The aim of the present study was to modify the alloplasty of inguinal hernia known as the Lichtenstein operation by forming a cuff around the spermatic cord at the site of the opening in the mesh, which protects it from the proliferation of scar tissue and subsequent deformation. Materials and methods. In the experiment on rats, the surgical intervention was performed according to the type of operations for congenital inguinal hernias. In this case, in the control group, the spermatic cord was in direct contact with the opening in the polypropylene mesh, while in the experimental group, the cuff was formed due to the muscular membrane and peritoneum of the peritoneal process. Operations on rats were performed under general anesthesia. For alloplasty, a polypropylene mesh measuring 2×2 cm was used with an incision along one edge for the passage of the spermatic cord. The mesh was fixed to the anterior abdominal wall in an on-line manner, the spermatic cord was located above the mesh. Results and conclusions. After the operation, the testicle stopped moving into the abdominal cavity on the right, which indicated the completeness of the performed plastic surgery. The modified method of alloplasty of inguinal hernias allows to significantly level out the swelling and scarring at the site of contact of the spermatic cord with the hole in the polypropylene mesh, and the implementation of additional measures to prevent the cicatricial process in the form of laser irradiation allows to improve the results of operations. The combined use of laser therapy in the treatment method in the experimental group prevents the observed early and late complications. Laser irradiation in the infrared spectrum due to deep penetration into the tissue promotes the resorption of wound infiltrate and improves local blood circulation. Improved local microcirculation leads to early and rapid healing of this wound.

The aim is to analysis of the results of surgical interventions for stenotic conditions of the internal carotid artery.
Materials and methods. This cohort, comparative, prospective, open study for the period from January 2010 to September 2022 included 2724 patients with chronic cerebral vascular insufficiency of degrees I–IV according to A. V. Pokrovsky and operated on for stenotic lesions of the internal carotid artery. Depending on the type of revascularization performed, all patients were divided into 3 groups: group 1 — glomus-sparing carotid endarterectomy, 1464 (53.8%) patients; group 2 — eversion carotid endarterectomy, 145 (39%); group 3 — classic carotid endarterectomy, 158 (7.2%).
Glomus-sparing carotid endarterectomy was performed as follows: the patient was under endotracheal anesthesia, the patient was positioned on his back with a bolster under his head, turned in the opposite direction. A skin incision was made along the inner edge of the sternocleidomastoid muscle, starting from the angle of the lower jaw and ending at the level of the thyroid cartilage, 5 cm long. The fascia of the neck was crossed layer by layer, the facial vein was ligated and entered into the fascial space of the neurovascular bundle of the neck in the area of the carotid triangle. The arteries are isolated from the paravasal tissue: the common carotid artery is isolated below the level of the bifurcation for 4.0 cm, the internal carotid artery is isolated immediately distal to the atherosclerotic plaque, the external carotid artery is isolated above the bifurcation by 2.0 cm, the arteries are isolated with the condition of preserving the structures of the carotid glomus. 5000 units of heparin are administered intravenously. The carotid arteries are compressed. The common carotid artery is crossed below the bifurcation by 1.5 cm, then atherosclerotic plaques are removed from the internal and external carotid arteries using an endarterectomy spatula by peeling, then the atherosclerotic plaque is peeled off from the common carotid artery to its residual height of 4.0 cm and formed anastomosis. Hemostasis, wound drainage, and layer-by-layer suturing of the wound are performed. Apply aseptic dressings.
Results. During the hospital period, in the group of patients who underwent glomus-sparing carotid endarterectomy, the least number of complications was detected (p<0.001). When analyzing survival curves, the greatest number of cardiovascular complications was identified in the group of classical and eversion carotid endarterectomy.
Conclusion. Performing glomus-sparing carotid endarterectomy meets modern standards of medical care for patients with stenotic lesions of the internal carotid artery, combined with minimal risks of developing adverse cardiovascular complications. The effect of revascularization with preservation of the carotid glomus is based on precise skeletonization of the carotid arteries, reduced occlusion time, as well as maintaining the stability of hemodynamic parameters in the postoperative period.

The aim of the study is to descript of a clinical observation of the impact of electrical trauma on a patient with the induction of paroxysmal supraventricular tachycardia in real time using an implantable cardiac monitor Confirm Rx and a remote ECG monitoring system MerlinNet. Materials and methods. A modern electrophysiological diagnostic method was used: an implantable cardiac monitor connected to the remote ECG monitoring network MerlinNet. Results and conclusion. Direct exposure of the patient to alternating electric current led to the induction of a stable paroxysmal supraventricular tachycardia, recorded in real time. In the world literature, isolated clinical cases with the induction of cardiac arrhythmia (supraventricular tachycardia, atrial fibrillation and even ventricular tachycardia) are described, but on the other hand, there are known cases when such an impact on the patient's body did not lead to the occurrence of cardiac arrhythmia, which is probably due to the influence of individual predisposing factors (genetically determined) of the body itself.