Russian Medicine

Background: Despite significant advances in the treatment of patients with inflammatory maxillofacial diseases, there have been cases of secondary cicatricial deformities in the face and neck area in patients with purulent and inflammatory diseases. The share of such cases in maxillofacial surgery hospitals is 77.5%–89.3% of total patients. The medical acoustic test used to diagnose abnormal scarring in patients with purulent and inflammatory maxillofacial and neck diseases allows for localizing the identified lesions based on anisotropic parameters, which is certainly relevant for treatment and prevention of soft tissue deformities in healthcare practices.

Aim: To substantiate the relevance of acoustic screening to improve diagnosis and prevention of secondary soft tissue deformities of the face and neck in patients with maxillofacial diseases.

Methods: The clinical study included 30 patients undergoing inpatient and outpatient observation in the maxillofacial surgery department and rehabilitation office of a multidisciplinary clinical hospital. The patients were divided into two groups. Group 1 comprised 15 patients with maxillofacial phlegmon of various origin, location, and localization of the affected tissue plane; group 2 comprised 15 patients after scheduled surgeries without signs of inflammation.

The study included physical examination; interviews to identify complaints, anamnesis morbi, and anamnesis vitae; investigations; radiological imaging and functional tests, acoustometry, and examination by a physician and anesthesiologist.

Integumentary tissues were evaluated using an acoustometer on postoperative days 1, 14, and 60. The mechanical skin properties were assessed around the wound by measuring the velocity V_p in orthogonal directions, including V_у along the vertical axis of the face and V_х along the horizontal axis of the face. Based on the measured values, the anisotropy coefficient K = V_у/V_х was calculated. V_n was simultaneously assessed in a similar region on the healthy side.

Results: Group 1 velocity changes during the study were more than 2.5 times higher than those in group 2.

The study proved that the velocity measured by an acoustic device in patients with purulent and inflammatory maxillofacial diseases is 2.5 times higher than the wave velocity in patients without signs of inflammation.

Conclusion: Changes in acoustic parameters recorded at different stages of wound healing in maxillofacial surgery objectively reflect the regeneration progress and allow for studying the type of abnormal scarring. Early diagnosis helps prevent the abnormal scarring and determine the medical, physical, or radiation therapy strategies.

Background: Calcifications are frequently observed in the brain during radiologic evaluations and postmortem histologic examinations, most commonly in the pineal gland and choroid plexus. An increase in the number and size of calcifications has been associated with various neurologic, oncologic, infectious, and other diseases. Current evidence suggests a potential role of calcifications in the pathogenesis of conditions such as vascular dementia, Alzheimer disease, Parkinson disease, astrocytomas, posttraumatic epilepsy, and migraine. However, the causes and mechanisms of calcification formation in the brain remain unclear.

Aim: This study aimed to examine the morphologic features of calcium concretions in the pineal gland and choroid plexus—the two primary sites of their occurrence—to identify possible microstructures associated with calcification.

Methods: The study was conducted on 14 samples of choroid plexus tissue (from individuals aged 20–63 years) and 12 samples of pineal gland tissue (aged 16–61 years). Histological sections were stained with alum hematoxylin and aniline blue. Immunohistochemical analysis was performed using monoclonal anti-Vimentin antibodies (clone SP20).

Results: Calcifications were identified in all pineal gland samples and in 13 of 14 choroid plexus samples. In the pineal gland, calcification size varied widely (5–20 µm to 150 µm), predominantly occurring in lobules among pinealocytes, and much less frequently within connective tissue trabeculae. In the choroid plexus, calcifications ranged from 30 to 70 µm (occasionally up to 100 µm) and were primarily located within the connective tissue stroma, rather than the villi. Brain sand was found exclusively in the pineal gland, but not in the choroid plexus. A Vimentin-positive capsule was found around psammoma bodies in both the pineal gland and choroid plexus, but was absent around amorphous calcifications of the choroid plexus.

Conclusion: The predominant localization of choroid plexus calcifications in collagenrich connective tissue, and beyond this tissue in the pineal gland, supports the hypothesis of two distinct calcification mechanisms: one collagen-associated and the other independent of collagen. The presence of brain sand in the pineal gland—but not in the choroid plexus of adults—suggests that pineal calcification is a continuous process, whereas calcification in the choroid plexus may predominantly occur post-puberty. The presence of two types of calcifications that differ in both structure and the presence/absence of a capsule, i.e., psammoma bodies and amorphous calcifications, respectively, may indicate a possible pathologic (mechanical) effect on the surrounding tissues by psammoma bodies, but not amorphous calcifications, which is prevented by the formation of an insulating layer.

Antimicrobial resistance is a most challenging global public health problem. Today, the number of antibiotic-resistant bacterial strains has been increasing to the point of economic and social disaster. Thus, it is necessary to find alternative effective approaches to antimicrobial therapy and prevention. The most promising alternative antimicrobial therapies include antibodies; bacteriophages and bacteriophage-derived enzymes; antivirulence agents; probiotics and microbiome-modulating agents; immunostimulants; host-protective antimicrobial peptides; nanoparticles and liposomes, etc. A comprehensive approach to treating infections without exacerbating the antimicrobial resistance problem provides for combining these alternative treatments with strategies to maintain the efficacy of existing antimicrobial agents.

The review is aimed to summarize data on the causes and mechanisms underlying the development of resistance; limitations of standard treatments; alternative resistance-inhibiting treatments, their advantages and disadvantages; and future challenges. The paper presents summary of alternative antimicrobial agents at different stages of pharmaceutical development.

This review presents data on the physiology of sleep, the pathophysiological basis of sleep disturbances, and the epidemiology of these disorders. Major hypotheses concerning the development of depressive disorders are discussed, including the monoamine, inflammatory, and neuroendocrine models. Current findings from clinical studies and meta-analyses are summarized, highlighting key factors by which sleep deprivation affects human somatic and mental functions. Sleep monitoring using electroencephalography has demonstrated a common pathophysiological link between rapid eye movement sleep behavior disorder in patients with depressive disorders and sleep deprivation. The role of sleep deprivation as an experimental and controversial method for treating depressive disorders is discussed.

The main preclinical models of disease in laboratory animals—total and paradoxical sleep deprivation—are presented and classified. Behavioral patterns observed in various paradigms, such as the Morris water maze and Y-maze tests, are analyzed. Changes in gene expression during disease modeling and alterations in neurometabolites following different sleep deprivation techniques are presented. The review outlines future directions in preclinical sleep disorder research, emphasizing unexplored areas, particularly the therapeutic potential of sleep deprivation in various depression models.

Human papillomavirus (HPV) is the primary pathogen involved in the development of cervical cancer. HPV infection is widespread worldwide. Comprehensive prevention of high-risk oncogenic HPV infection is the main strategy for reducing the incidence of cervical cancer. Raising awareness of the issue, expanding vaccination coverage, developing modern vaccines and diagnostic methods, and increasing public education all contribute to a more rapid achievement of this goal.

This review presents the latest data on current HPV prevention and diagnostic methods, as well as future prospects for addressing this issue in the near term. It highlights recent findings from both Russian and international studies. The review analyzes current approaches to the issue and provides statistics on the prevalence, morbidity, and mortality of cervical cancer in the Russian Federation and other countries. A consistent downward trend in the incidence of cervical cancer has been observed in the countries that have implemented screening and HPV vaccination programs. The main risk factors are identified, including those related to the virus itself and to individual lifestyle. Key mechanisms of HPV-driven oncogenesis are presented, along with preventive screening programs aimed at detecting dysplastic changes and preventing the development of invasive cancer. The currently approved vaccines worldwide are discussed in terms of efficacy and safety, as well as ongoing research on new vaccine development.

Psoriasis is a systemic immune-mediated inflammatory disease that affects target organs and manifests primarily through skin lesions resulting from keratinocyte hyperproliferation. This condition can significantly reduce the quality of life. Psoriasis is widespread: according to the scientific data, it affects approximately 2% of the global population. Research in the psoriasis pathogenesis and its systemic effects remains a relevant focus in dermatology. Numerous recent studies have identified a correlation between psoriasis and inflammatory bowel diseases.

Psoriasis has been found to reduce both the qualitative and quantitative diversity of the gut microbiota, as well as to increase in opportunistic bacteria such as Escherichia coli, Helicobacter spp., and Mycobacterium spp. In addition, patients with psoriasis exhibit an increased abundance of Firmicutes and a decrease in Bacteroides. A decrease in Bacteroides, in turn, reduces the production of butyrate, which plays a key role in protecting the intestinal epithelium. Alterations in the gut microbiota may contribute to the stimulation of autoimmune inflammation in psoriasis. Many researchers also agree that severe psoriasis is characterized by significantly altered microbiota in the study groups compared with controls. Intestinal dysbiosis may serve as a trigger for psoriasis relapse. Increased intestinal epithelial permeability contributes to the entry of a greater number of bacterial metabolites into the bloodstream, which in turn aggravates the course of psoriasis.

Clinical observations confirm the improvement of psoriatic skin lesions following the use of antibiotics, probiotics, or fecal microbiota transplantation. A detailed investigation of the relationship between psoriasis and the gut microbiota may serve as a potential marker for therapy assessment, improve treatment quality, and enhance the quality of life in affected patients.

Introduction: The treatment of patients with severe (aplasia) congenital fibular hemimelia (CFH) remains a major clinical challenge. In many cases, these patients are offered amputation or receive no medical attention at all. This article aims to demonstrate the effectiveness of our approach using the Ilizarov method in patients with CFH, based on clinical and radiographic findings as well as contemporary scoring systems and questionnaires.

Clinical case description: An analysis was conducted of the treatment of a child with severe CFH (fibular aplasia), considering clinical and radiological data along with modern assessment criteria and scoring systems. Due to a 10 cm shortening of the affected limb, the child’s family was offered only amputation by local specialists. We performed bifocal lengthening and deformity correction of the right lower leg and foot using the Ilizarov apparatus. The evaluation criteria for the tibial lengthening stage included the external fixation index, the amount of lengthening (cm, %), the results according to the Lascombes classification, and the scoring system of the Association for the Study and Application of the Method of Ilizarov. Ambulatory function was assessed using the Gillette questionnaire. Functional outcome was also evaluated according to the Association for the Study and Application of the Method of Ilizarov score. This method enabled safe and reliable lengthening, reconstruction, and preservation of the affected limb as an alternative to amputation. Long-term follow-up confirmed the stability of the treatment outcome.

Conclusion: The outcome of treating a child with severe CFH demonstrated the high effectiveness of our approach, which should be considered a treatment option in similar cases.