Venous ulcers are widespread. Affecting about 1% of the adult population they represent a significant social and economic burden. A special category of patients who have non-healing or recurrent ulcers after previously open or endovascular surgery on superficial varicose veins. We observed 13 such patients without diabetes mellitus – 5 men and 8 women. The average age was 58.7±5.3 years. In accordance with Russian and international clinical guidelines, compression of the affected limbs with three-layer bandages was performed. Also, adjuvant phlebotropic therapy was prescribed. After sanitation and gentle debridement, superabsorbent dressings Zetuvit Plus Silicone with a contact layer of silicone were used. Patients were treated on an outpatient basis, the dressing was changed every 3–5 days, then these periods were extended. Improvement was noted after 7–8 days. By the end of the second month, the wound had healed in 11 of 13 patients, and significantly decreased in size in one patient. Based on the presented experience, Zetuvit Plus Silicone dressings is the modern concept of moist management of chronic wounds with abundant exudation. They provide active absorption of discharge and unpleasant odor, create an optimal microclimate and conditions for healing, protect vulnerable skin around the wound, maintain temperature stability and allow for good results of conservative treatment with psychosocial comfort for patients (in particular, with previously eliminated superficial veins).

Laparoscopic Roux-en-Y gastric bypass is one of the most effective bariatric, metabolic and antireflux operations, but at the same time one of the most difficult and time–consuming. In order to reduce the duration and traumatism of surgery in patients with a high risk of anesthesia and surgery and/or concomitant severe abdominal pathology a two steps laparoscopic Roux-en-Y gastric bypass technique was used in 7 cases. The duration of the first stage varied from 90 to 190 minutes and depended mainly on the type and complexity of concomitant abdominal pathology. After 7 days all patients underwent the second stage of gastric bypass surgery. The execution time of the second stage did not exceed one hour. There were no conversions, intraoperative and postoperative complications. All patients were discharged from the hospital in satisfactory condition on the third day after the second stage of surgery. Conclusion: in bariatric patients with a high risk of anesthesia and surgery and/or concomitant severe abdominal pathology, as well as in the event of additional surgical and anesthetic risks during surgery Roux-en-Y gastric bypass can be successfully divided into two stages.

Purpose of the work: to assess the socio-psychological state and socio-medical status of a practicing physician. Health is affected by a huge number of factors, including professional ones. And this is a special area that requires a deep study of unfavorable factors of industrial activity and the development of methods for their correction. The morbidity of medical workers compared to other workers in the budgetary sectors is very high. About 30 times higher than that of teachers and 33 times higher than in the trade sector. It would seem that people armed with the most modern knowledge on how to maintain health should live longer than others, but in reality everything turned out to be exactly the opposite. What is behind this paradox? A study was conducted among 107 doctors of the therapeutic profile (therapists, general practitioners, cardiologists, endocrinologists) undergoing advanced training at the Department of Clinical Pharmacology and Therapy of the Institute of Continuing Professional Education of the Federal State Budgetary Educational Institution of Higher Education South Ural State Medical University of the Ministry of Health of the Russian Federation. We used a questionnaire method with specialized geriatric questionnaires characterizing the psycho-emotional and socio-medical status of the doctor: the questionnaire "Age is not a hindrance", a cognitive assessment scale, a WHO questionnaire for assessing the quality of life (WHOQOL-BREF), a questionnaire by S.G. Korchagina on social deprivation, a calculator of multimorbidity CIRS-G Score Calculator, an assessment of polypharmacy, and the Hawkins emotional scale. Conclusion. The health of the doctor raises serious concerns. Thus, the socio-psychological state of 100% is characterized by the status of loneliness of varying degrees of severity. Every fifth (21.50%) doctor had a significantly reduced emotional status with a predominance of negative emotions. 9 out of 10 doctors (89.73%) had clinically significant health problems. And every 12 (8.41%) had a suspicion of frailty syndrome.

The aim of the work: to analyze the activities of a clinical pharmacologist in the work of the medical commission of a medical organization and the role of this specialist in managing the quality and safety of medical care. Materials and methods: content analysis of regulatory documents and scientific publications, on the legal aspects of prescribing medicines not according to the instructions, the participation of medical commissions in ensuring internal control of the quality and safety of medical activities; mathematical-statistical. Results and conclusions. The activities of the VC subcommittee «On the rational use of medicines» on the prescription of medicines of 3 categories: «off-label», not included in the List of Vital and Essential Drugs and drugs not included in any of the categories for 2021 – 2023 were analyzed. A list of the most frequently prescribed drugs from each category has been determined. The need to revise the legislative framework in order to strictly regulate the list of off-label drugs and the scope of their application is substantiated.

Work purpose is to remind primary care physicians about epidemiology, methods of early diagnosis and verification of lung cancer and its prevention. Material and Methods. To write this review, 60 scientific publications on epidemiology, early diagnosis, verification and prevention of lung cancer were involved, but the article directly included information from 22 sources, of which 20 were published not earlier than 2019. The method of material processing was content analysis. Results and discussion. In the Russian Federation after 2020, up to 60 thousand new cases of lung cancer were registered annually (about 80% of them were among males). Up to 1.7 million people die of malignant neoplasms of the lung in the world annually, with lung cancer being the main cause of death from malignant neoplasms in men. The most optimal organizational method of early diagnosis of lung cancer is mass screening of the population with fluorography. Currently, innovative non-invasive methods of verification of malignant lung neoplasms are used: analysis of air exhaled from the lungs with the detection of biomarkers in the blood of lung cancer patients; electrospray ion cyclotron resonance ionization mass spectrometry method. The final stage of morphological diagnosis of lung cancer is the testing of biomarkers of malignant tumor to determine its subtype in order to select individual therapy for a particular patient. The World Health Organization, recognizing the serious implications of lung cancer for global health, has assigned a major role in lung cancer prevention to tobacco control, early detection of malignancies, and improved access to quality cancer care. Conclusion. Analysis of domestic and foreign scientific publications devoted to the current state of oncoepidemiologic situation with lung cancer, its diagnosis and prevention allows us to state that there is a serious imbalance between high morbidity and mortality and “one-sidedness” of its primary and secondary prevention, directed mainly against tobacco smoking, with complete disregard for the factor of occupational and environmental hazards.

Relevance. Colorectal cancer is one of the most common oncological diseases in Russia. For its treatment, the surgical method is most often used exclusively, but its combination with complex antitumor methods of influencing the area of the surgical field allows to reduce the risk of sudden relapse and peritoneal carcinomatosis. The Aim of the study. This work studies a combined method for the treatment of locally advanced colon cancer using an intraoperative laser photodynamic therapy with the Photolon photosensitizer. Materials and methods. 38 patients were divided into two comparable groups: the control group included 18 patients who had only surgical treatment, the experimental group consisted of 20 patients who additionally had intraoperative photodynamic therapy. PDT included: the photosensitizer injection, laser irradiation and photodynamic diagnostics. PDD was carried out by the absorption method, implemented in our own complex, and was used to develop tactics for irradiating various tissues. Results. The obtained primary and long-term treatment results show that all indicators (except for the duration of the operation) in the experimental group are better than in the control group, and such important indicators as mortality, recurrence, purulent complications and persistent remission are significantly better in the experimental group with a high level of significance. Conclusion. Intraoperative photodynamic therapy of locally advanced colon cancer with Photolon under photodynamic control significantly improves the results of complex treatment of patients with this pathology.

Modelling of cerebral stroke plays a key role in studying the mechanisms of pathogenesis, diagnosis and development of new effective therapies. The aim of the study is to critical analysis of data on methods of modeling ischemic and hemorrhagic stroke presented in peer-reviewed sources indexed in the databases Pubmed and the Russian Science Citation Index for the period 2020-2024.. Results and conclusions. Experimental modeling of cerebral stroke includes in vitro, in vivo and in silico approaches. In vitro modeling allows us to study the molecular and cellular mechanisms of damage to nervous tissue, but does not fully reflect the complex intercellular interactions in response to the action of a damaging factor. In silico modeling is based on computational neuroscience methods, allowing to develop mathematical models for predicting the course and outcomes of acute cerebrovascular injury and to study individual mechanisms of damage to nervous tissue In vivo modeling is an economically profitable, highly reproducible approach, due to the wide availability of laboratory animals and provides low financial costs for their maintenance. The most preferred models of ischemic and hemorrhagic stroke are endovascular filamentous occlusion of the middle cerebral artery, collagenase and balloon models of parenchymal hemorrhage induction, since they allow the most accurate modeling of acute cerebrovascular damage to the human brain in animal models.