In 2023, the Pacific State Medical University is celebrating its 65th anniversary. The article is dedicated to the history of the University, the main stages in its formation and development. Such prominent figures as V.S. Shapkin, K.A. Meshcherskaya, P.A. Motavkin and N.S Motavkina stood at the origins of healthcare services in the Far East. The rich history of the University has formed a solid basis for its sustainable development and future advances. 

Aim. To demonstrate the possibility of using a batch culture model to study the interaction of Salmonella Enteritidis and Salmonell Typhimurium, which are currently the leading serotypes in the etiology of salmonellosis, in an in vitro experiment both among themselves and in combination with Yersinia pseudotuberculosis and Shigella flexneri.

Materials and methods. An experimental model of microorganism associations in vitro was created by co-cultivation of different microorganism strains in an LB broth. The Salmonella and Yersinia pseudotuberculosis stains stored in the museum of G.P. Somov Research Institute of Epidemiology and Microbiology at a temperature of –80 °C were used. The behavior of the associations under study was monitored for 24 h at 37 °C on a shaker. As a control, the growth curves of all the strains in monoculture were studied. The first research stage involved culturing S. Enteritidis and S. Typhimurium followed by addition of Yersinia pseudotuberculosis and Shigella flexneri strains (reference strain ATCC 12022) at the second stage.

Results. In the control experiment, the growth of the tested cultures was quite similar. However, when grown in associations, S. Typhimurium outgrew S. Enteritidis. A similar study conducted with three pathogens also revealed that, when grown in monoculture, the stains exhibit no significant differences in the growth rates. However, when grown in associations, the growth of Y. pseudotuberculosis is significantly suppressed from the onset of observation during the first hour. Under these conditions, S. Enteritidis takes the dominant position.

Conclusion. Our results demonstrate that batch culture can be used to study the interaction between different types of microorganisms, as well as their intraspecific relationships. We assume that the observed behavior of microorganisms can be explained, to a certain extent, by Gause’s law of competitive exclusion. This principle implies that two species competing for the same limited food source cannot coexist in one ecological niche.

Diabetes mellitus (DM) is a highly prevalent endocrine disease with a high risk of chronic complications. Damage to the central nervous system (CNS) is considered a serious DM complication. Diabetic encephalopathy (DE) is a specific CNS dysfunction that is characterized by impaired functioning of the brain. The root cause of DE may lie in a disrupted synthesis of various neurotransmitters. Impaired operation of the glutamatergic system is the key component of the pathophysiological mechanism responsible for the development of cerebral insufficiency in the setting of DM. Glutamine (Gln) is the main excitatory neurotransmitter of the CNS, which is involved in the processes of synaptic plasticity, learning and memory. Under physiological conditions, Gln concentrations must be kept at a minimum to ensure optimal operation of the brain. The activation of the glutamatergic system observed in DM is associated with neurotoxicity, leading to degeneration and death of neuronal cells. Excitotoxicity triggers the endoplasmic reticulum stress response, causes mitochondrial dysfunction and elevates oxidative stress. These are the three key pathophysiological mechanisms thought to underlie the development of DE. Oxidative stress is the most thoroughly studied of the pathological processes leading to DE, and is associated with damage to intracellular proteins, lipids and nucleic acids, resulting in the loss of neurons. Numerous preclinical and clinical studies have demonstrated the presence of a pathophysiological link between the activation of the glutamatergic system, excitotoxic mechanisms, and the development of DE. High levels of Gln were shown to correlate with deterioration of cognition, which intensifies with the course of the disease. Diagnosis and subsequent treatment of glutamatergic system dysfunction in patients with DM can be an important practical contribution to the minimization of clinical DE manifestations.

In this review paper, we present data on the prevalence, etiology, and diagnostic methods of adrenal incidentalomas (AIs). AIs are tumors larger than 1 cm in size that are accidentally detected using various imaging tests. AIs are known to be responsible for secondary arterial hypertension associated with the risk of cardiovascular complications. Dual-energy CT and radiomics are promising diagnostic technologies for AIs. The conducted literature review points to the problems of verifying the hormonal profile of these tumors, which is particularly relevant in cases of bilateral adrenal lesions. We discuss the diagnostic value of comparative selective adrenal venous sampling (AVS) for determining the site of hormone hyperproduction. Despite technical challenges, AVS remains the most informative diagnostic tool for pathological process lateralization.

The dissemination activity of malignant neoplasms largely determines the prognosis in patients with tumors of various localizations. Tumor growth depends on the intensity of formation of new blood and alternative vessels. Vasculogenic mimicry (VM) differs from the conventional neoangiovasculogenetic process involving vascular endothelium. VM is an alternative type of blood supply independent of endothelial vessels, which refers to the formation of vessels lined with tumor cells. Several methods are currently available for detecting VM in vivo; however, immunohistochemical staining of specific antigens remains the gold standard. The main criteria for diagnosing the VM structure have been identified. The successful development of anticancer therapy requires special attention to the preclinical study of the effect of new antitumor compounds on the VM process. Although the specific mechanisms triggering VM formation remains to be elucidated, the strategy of studying this process at the preclinical stage will contribute to the development of new domestic antitumor and antimetastatic drugs with a multifactorial action.

Pelvic floor and perineum muscles play an important role in the formation of an apparatus supporting pelvic organs. The functional insufficiency of myofascial structures frequently leads to the development of urinary and fecal incontinence, erectile dysfunction, prolapse of internal organs, and perineal hernias formation. Back in the 20th century, morphologists focused on the skeletal muscles in pelvic floor and perineum, highlighting their leading role in supporting organs and creating intraabdominal pressure. However, in the past two decades, particular attention has been paid to the smooth muscle structures and their relationship with the musculoskeletal system in the pelvic outlet area. The new concept of the striated–smooth muscle complex provides the basis for revising various aspects of pelvic organ prolapse and urinary and fecal incontinence pathophysiology. We believe that this may lead to improved early diagnosis and prevention of diseases of the pelvic floor and perineum.

Aim. To evaluate the dynamics of structural and functional changes in the lungs of pulmonary sarcoidosis patients using computed tomography (CT) densitovolumetry with the purpose of predicting the course of the disease.

Materials and methods. Patients with respiratory sarcoidosis were examined at the starting point (n = 101) and at the end of one-year follow-up (n = 79). The function of external respiration was assessed according to the spirometry of forced expiration, body plethysmography, and the study of diffusion capacity and lung volumes. All the examined patients underwent a two-stage CT of the lungs in the inspiratory and expiratory phases using the CT densitovolumetry method. The dynamics of quantitative indicators of structural and functional changes in the lungs was assessed.

Results. At the end of the follow-up period, the patients showed a negative, stable, and positive radiological dynamics. Changes were observed not only in the qualitative signs of radiological patterns specific to sarcoidosis, but also in the quantitative data obtained by CT densitovolumetry. The CT densitovolumetry indicator (the inspiratory index of both lungs) and spirometry indicators (the peak expiratory flow rate and the FEV1/FVC ratio) with respect to the normal values can be used as independent predictors for pulmonary sarcoidosis progression during a year with high accuracy.

 Conclusion. CT densitovolumetry indicators can be used to quantify the structural and functional changes in the lungs and to predict the progressive course of pulmonary sarcoidosis with the purpose of modifying the therapy.

Aim. To present a method for surgical correction of senile entropion by excision of a triangular musculocutaneous flap in non-hospital setting.

Material and methods. We analyzed the outcome of surgical treatment of 11 patients aged 60–83 years diagnosed with senile entropion (3 men and 8 women). Out of the studied group, 3, 5 and 3 patients suffered from a mild, average and pronounced entropion degree, respectively (Bystrov’s classification, 1979). The results were assessed based on the presence of complications and the occurrence of relapses.

Results. The recovery was observed in 9 patients; the disease recurrence – in 2 cases.

Conclusion. The proposed method of surgical correction of senile entropion implies excision of a triangular musculocutaneous flap with the base to the outer or inner commissure of the eyelid with the movement of the sliding skin flap. The method showed high efficiency (81.8%) in eliminating the horizontal and vertical weakness of the musculocutaneous plate of the lower eyelid.

Aim. To study the structure and antibiotic resistance of microorganisms isolated from the lower respiratory tract of patients with community-acquired pneumonia associated with COVID-19 in the period from 2020 to 2022.

Materials and methods. In total, 1714 medical records of patients admitted to the Alperovich City Clinical Hospital No. 3. The study included cases with the documented diagnosis of community-acquired pneumonia associated with COVID-19. Respiratory samples were collected from patients within the first 24 hours of admission to the hospital.

Results. Enterobacterales predominated in the overall structure of microorganisms (46%). Among this group, K. pneumoniae and K. oxytoca were the most common strains. K. pneumoniae was distinguished by a high frequency of resistance to carbapenems. Pseudomonadaceae ranked second in the overall structure of microorganisms (21%). The proportion of P. aeruginosa isolates insensitive to imipenem, meropenem, and ertapenem was 30%, 23%, and 25%, respectively. The study showed high resistance of S. pneumoniae to levofloxacin (30%), erythromycin (60%), and ampicillin (60%). Staphylococcus ranked fourth in the overall structure, represented by S. aureus. All strains were susceptible to vancomycin, linezolid, and tigecycline.

Conclusions. The identification frequency of bacterial pathogens in patients with community-acquired pneumonia associated with COVID-19 did not exceed 8%. Gram-negative bacteria, mainly representatives of the Enterobacterales family, prevailed in the structure of microorganisms. Among gram-positive bacteria, Streptococcaceae were the leading pathogens. The obtained isolates were quite diverse in structure and exhibited an unfavorable profile of resistance to antimicrobial therapy.

Aim. To assess the level of potassium intake among the adult population in Western Siberia.

Materials and methods. The actual level of potassium intake from food products was assessed by surveying a representative sample of 441 adults in the Omsk region (Russia) using a questionnaire of food consumption frequency in 2019–2020.

Results. The median daily potassium intake in the studied sample was 2620.9 mg/day (2005.97; 3456.10), which corresponded to the level of potassium intake in other Russian regions and other countries. This level was found to be significantly lower than that recommended by WHO. The share of adult population with a potassium consumption below physiological requirements in the Omsk region was 39.2 ± 2.3%. No significant differences were observed in potassium intake between men and women (except for the age group of 65 years and older), as well as between different age groups. The main potassium sources were established to be vegetables (37.8%), fruits (16.5%), potatoes (9.2%), fresh tomatoes (8.7%), fresh apples (8.0%), and soups (6.9%). An increase in age was associated with a decrease in potassium intake from confectionery and beverages. At the same time, the contribution of such food groups as ‘porridge and pasta’ and ‘fish and seafood’ increased. In women, vegetables and fruits made a slightly greater contribution as potassium sources. In men, these were bakery and meat products.

Conclusion. Insufficient potassium intake among the large share of adult population in the Omsk region can be a significant risk factor in the development of arterial hypertension, which requires preventive measures.

Aim. A clinical analysis of the efficacy of eliminating the risk of acute glaucoma attack by performing preventive minimally invasive cataract surgery in patients at such a risk.

Materials and methods. In total, 70 eyes with a short anteroposterior axis and a thickened lens shape, and an increased risk of acute glaucoma attack were investigated. The main group included 45 patients subjected to preventive phacoemulsification (PE), and the reference group included 25 patients not subjected to PE. According to the position of the ciliary body (middle and posterior), each group was divided into two subgroups. The parameters of lens cross-sectional area (CSA) and anterior chamber cross-sectional area (ACCSA) were studied using B-scan ultrasonography of the anterior eye segment.

Results. On the 2–3rd day after PE, the main group showed an increase in the anterior chamber depth and ACCSA values, along with an opening of the anterior chamber angle (ACA) to grade 3. These indicators remained at the same level by the end of the 4–5 year observation period. After 1–3 years, the reference group demonstrated a statistically significant decrease in the anterior chamber depth and ACCSA values, a narrowing of the ACA width, as well as an increase in intraocular pressure. After 4–5 years, the ACA was completely closed (0°), and the CSA indicator significantly increased.

Conclusion. Immediately after preventive surgery, all patients of the main group showed a statistically significant improvement in the studied parameters, which remained stable following the period of 4–5 years.

Aim. To study the impact of distance learning on the quality of life (QoL) indicators of primary school children.

Materials and methods. Primary school children and their parents were surveyed using the international questionnaire Pediatric Quality of Life Inventory PedsQL 4.0TM (block for children 8–12 years old). The research group included 182 children (and the same number of parents) undertaking distance learning. The control group consisted of 234 primary school pupils (and the same number of parents) undertaking traditional offline learning.

Results. All QoL indicators in schoolchildren in the setting of distance learning differed significantly from those undertaking offline education. The greatest decrease in indicators was observed on the scale of physical functioning. The indicators of school functioning in distance learning amounted to 65.89±12.63 points (p = 0.04). Distance learning led to a reduction in social contacts among younger schoolchildren, which was reflected in a decrease in the level of social functioning and a decrease in the corresponding indicators to 66.90±10.18 points. The study of the respondents’ emotional well-being and psychological comfort established that changes in QoL indicators were accompanied by a drop in the QoL emotional component during distance learning by 17.98 points. The parents’ attitude to the QoL of their children during distance learning was characterized by anxiety about the indicator of school functioning. The parents also noted a deterioration in emotional functioning and assessed its decrease even at a lower level (64.36±29.37 points) than their children (70.74±19.32; p = 0.03).

Conclusion. Distance learning affects all aspects of the QoL of younger schoolchildren. The greatest decrease in the indicators of physical, school, and social functioning was observed. The parents’ and their children’s opinions of QoL differed. Thus, primary school pupils suffer from insufficient social contacts, while their parents are concerned about a reduced emotional background.

Aim. To assess the health-related quality of life of the rural and urban population in Western Siberia.

Materials and methods. The study was conducted by simple random sampling of 205 people (97 men and 108 women) from residents of rural areas of the Omsk region (n = 132) and the city of Omsk (n = 73). The method of active survey in the form of an interview was used. The MOS SF-36 health survey questionnaire was used in combination with a specially developed questionnaire for sociological studies of the health of rural populations.

Results. The highest scores were found on the scales of physical (PF), role physical (RF), and social functioning (SF). For the majority of questionnaire scales, the values obtained for rural residents were lower than those for urban residents. These concerned the PF, General Health (GH), Vitality (VT), SF, and mental health (MH) scales. The values characterizing the physical and psychological components of health were also lower in rural residents. A similar pattern was established when comparing the indicators of rural and urban men on the VT, SF, and MH scales. When comparing the indicators of rural and urban women, significant differences were found on the PF, GH, VT, SF, and MH scales. On all these scales, indicators were also higher among urban women. The respondents’ answers to questions about physical well-being and mental state showed a greater severity of characteristics indicating the development of emotional exhaustion among rural residents.

Conclusion. The established low levels of the health-related quality of life among the rural population of the region indicate the relevance of developing and implementing respective targeted preventive programs.

Aim. To assess the level of body image satisfaction and the prevalence of maladaptive eating behavior (МEB) among students of a sports university with different types of nutritional status (NS).

Materials and methods. 278 students of the Volga Region State University of Physical Culture, Sports and Tourism were surveyed using a body image questionnaire and the Eating Disorder Inventory scale. The body composition of participants was assessed. The distribution of students by NS types was carried out on the basis of BMI data, percentage of fat mass, and the discrepancy between actual and ideal weight.

Results. The study showed that 47.5 ± 3.0% and 38.5±2.9% of the respondents had an insufficient and normal NS, respectively. Only 14.0±2.1% of the students had an excessive NS. Among those extremely dissatisfied with their appearance, individuals with an insufficient NS prevailed (69.5±4.5%), with 21.0±3.9% having an excessive NS and only 9.5±2.9% having a normal NS. The largest number of individuals with clinical manifestations of MEB was established among the students with an insufficient NS (61.8±6.1%).

Conclusion. Among the surveyed sports university students, individuals with insufficient and normal NS prevailed; the share of students with excessive NS was insignificant. Insufficient NS was often associated with a distortion in the perception of the body image and maladaptive EB symptoms. The majority of individuals with an adequate attitude towards their appearance had a normal NS. Psychological characteristics and behavioral stereotypes typical of people with MEB were found in students not only with insufficient, but also with normal NS types.

Aim. To study the topography and expression of cell cycle markers, as well as those of inflammation and immune response, by the method of immunohistochemistry using an experimental model of endometrial hyperplasia.

Materials and methods. Endometrial hyperplasia was modeled in laboratory rats by ovariectomy and transdermal administration of estrogen to form hyperestrogenism. Morphological changes were verified by a histological method. The immunophenotypic profile was assessed by immunohistochemistry. The obtained digital values were processed by mathematical and statistical methods.

Results. The modelled endometrial hyperplasia indicated an increase in the glandular component, a decrease in the expression of estrogen receptors in the uterine horns, an increase in the mitotic activity of epithelial cells in the uterine body, an activation of cell apoptosis in all its departments, as well as a decrease in the expression of plasmocyte markers (CD138) in the stroma of all parts of the uterus and T-lymphocytes (CD8) in the stroma the body of the uterus.

Conclusion. Structural changes in endometrial hyperplasia in the setting of hyperestrogenism are caused by cell cycle dysregulation. At the same time, intracellular autoregulation systems are more effective in the uterine horns, with no changes being observed in the expression of estrogen receptors in the uterine body and the mitotic activity of cells being increased. Given the deficiency of immunocompetent T cells, the risk of tissue and cellular transformations increases in this area.

Aim. To develop a screening and prognostic algorithm for the risk of retinal vein occlusion in geomagnetic disturbances in patients with arterial hypertension.

Materials and methods. In total, 1512 patients with arterial hypertension of 1–4 stages were included in the study. Within three years, 391 patients developed retinal venous occlusions. A comparative study of the parameters of systemic and regional hemodynamics, microcirculatory parameters of the eyes of these patients was carried out both in a magnetically calm environment and during geomagnetic disturbances. To simulate the response of microcirculatory bed to stress, a functional pharmacological instillation test was performed with a 10% irifrin solution. To assess the geomagnetic situation, the К_р-index was used, which objectively characterizes fluctuations of the Earth’s magnetic field over a three-hour time interval. The International Classification of К_р values was used.

Results. For statistical analysis, 78 studied signs of systemic, regional hemodynamics and microcirculation were selected. The prognostic significance of 30 studied signs was revealed. A training group (1434 people) and an examination group (78 people) were formed. Based on the training group, a predictive algorithm was formed. A number of regularities were established that made it possible to create a system for identifying the risk of retinal vein thrombosis during geomagnetic disturbances in patients with hypertension. To determine the risk of retinal vein occlusion, a coefficient was developed. The sensitivity of algorithm was 89%, the specificity was 94%.

Conclusion. A prognostic algorithm for determining the risk of occlusive lesions of the retinal veins during geomagnetic disturbances for patients with arterial hypertension with high sensitivity and specificity (88% и 90%, respectively) was developed.

This article presents clinical cases of progression of diabetic retinopathy (DR) in pregnant women with type 1 diabetes. The manifestation of pre-proliferative DR was related to the formation of focal macular edema in both eyes with nonperfusion areas of perimacular localization. Both eyes underwent laser coagulation of the retina. Following one month, the regression of macular edema in the left eye and hemorrhagic phenomena in both eyes with the appearance of new nonperfusion areas were observed. DR progression during pregnancy and in the postpartum period is determined by a number of factors, including compensation for diabetes mellitus, stabilization of retinopathy, and the presence of concomitant pathologies. In the aggressive course of proliferative DR, local traction retinal detachment and partial hemophthalmos of the left eye were revealed. Three stages of panretinal laser coagulation of both eyes were conducted, along with an endovitreal intervention with silicone tamponade on the left eye. At 28 weeks of gestation, progression of retinal neovascularization with extensive areas of nonperfusion in the posterior pole was observed in the right eye. Compaction of the laser coagulation areas of the retina in the right eye was performed.

Laser technologies are increasingly used in medicine for treating various clinical conditions. In this article, we aim to review the evolution of laser ophthalmic therapy and its current prevalence in the Far East of Russia. Laser coagulation of the retina is recognized as a highly effective noninvasive treatment for diabetic retinopathy, central serous chorioretinopathy, some types of peripheral retinal degeneration, post-thrombotic retinopathy, retinoschisis, local retinal detachment, and retinal ruptures. Laser therapy reduces the probability of low vision and blindness in patients. The efficacy, accessibility, as well as the absence of complications, make laser treatment methods attractive for patients.

Aim. To analyze the work of the pediatric ophthalmological department of eye microsurgery of Regional Clinical Hospital No. 2 (Vladivostok, Russia) during the COVID-19 pandemic.

Materials and methods. The research materials included reports of the chief freelance pediatric ophthalmologist of the Primorsky Krai, as well as outpatient and inpatient records of the pediatric ophthalmological department of Regional Clinical Hospital No. 2, compiled during 2020 and 2021. A retrospective analysis of the incidence structure in 2020 and 2021 was carried out. In total, 1498 patients who received hospital treatment during the specified period were included in the study. Data analysis was carried out using MS Excel methods of descriptive statistics. The data were displayed using charts, as well as in the form of absolute numbers and a percentage of the total number of operations.

Results. In 2020, the average length of patient stay in the hospital was lower than that in 2021. During this period, the number of hospitalized children decreased by more than twice, which is reflected in Table 1 and Fig. 1. The share of patients with eye trauma requiring emergency conservative and surgical care increased. In 2021, out of 924 treated patients, 506 needed surgical treatment, which was performed according to indications.

Conclusion. During the COVID-19 pandemic, planned hospitalization was suspended followed by introduction of a special sanitary and epidemiological regime. In 2020–2021, 1498 children received ophthalmological inpatient care. In comparison with 2020, the number of surgical interventions, including elective operations, increased by 193 and amounted to 62%. This was related to lifting of the restrictions on planned hospitalization. Overall, 40% fewer children received treatment compared to pre-COVID years.