In 2025, it will be 120 years since the first successful full-fledged telemedicine communication. This article describes the main stages of telemedicine development. The first attempts to provide remote medical care are inextricably linked with the invention of the telegraph. Throughout the 20th century and the first quarter of the 21st century, telemedicine technologies have been progressively developing. The authors analyzed the general chronological dynamics of the distribution of scientific publications on telemedicine — a significant increase in publication activity occurred during the COVID-19 pandemic, which became an important stage in the development and transformation of this area of medical services. Using cluster analysis, a classification of areas in which telemedicine is actively used was carried out. Promising areas were identified, one of which is the combination of telemedicine with artificial intelligence. The active development of telemedicine is changing approaches to medical care and forming a new understanding of the relationship «doctor–patient», «doctor–doctor» and «patient–patient».

Relevance. In modern society, the spectrum of cardiac surgical pathology that develops in chronic drug users has expanded significantly and is not limited only to infectious lesions of the heart valves. This dictates the need for an in-depth study of the pathophysiological mechanisms of the effects of various narcotic substances on cardiac structures in order to develop a differentiated approach to the treatment of these patients. The literature review concerns the need of development of approach to the treatment of cardiac surgical patients with comorbid past or current drug abuse, depending on the type of narcotic substance used.

Conclusion. The development of a differentiated approach that considers the mechanisms of cardiovascular toxicity of various narcotic substances might help elaborate the ways to reduce the pathological changes yielding in significant improvement in treatment of these patients.

Superficial vein thrombosis (SVT) is a common clinical condition that carries with it significant risk of propagation of thrombus, recurrence, and, most concerning, subsequent venous thromboembolism (VTE). Conservative therapy with nonsteroidal antiinflammatory medication and heat does not prevent extension of thrombus or protect against recurrent or future VTE in patients with extensive SVT thrombotic segment of at least 5 cm in length. To prevent future thromboembolic events, anticoagulation has become the treatment of choice for extensive SVT. The aim of the review was to provide evidence-based, up-to-date information on the epidemiology, risk factors, diagnosis, and treatment of patients with SVT. A comprehensive literature search was conducted to identify all randomized controlled trials (RCTs) that addressed the epidemiology and treatment of SVT. RCT publications were identified using the MEDLINE database of English-language medical literature from 2002 to February 2025. The key search terms used were superficial vein thrombosis, treatment of superficial vein thrombosis, medical and surgical treatment of SVT. The search was performed using both single and combinations of terms.

The aim of the study was to improve the treatment results of patients after anterior non–tensioning hernioplasty using endoprostheses with a nafion coating.

Material and methods. A prospective, non-randomized study involved 120 people divided into 2 groups. The main group (n = 60) consisted of patients operated on using a polypropylene endoprosthesis with a nafion coating. The control group (n = 60) consisted of patients with classical hernioplasty. For subgroups A, the operation was performed using the “in-lay” method. Subgroups B (n = 30) — posterior separation hernioplasty. All patients were examined in the standard volume. The follow-up period was 6 months. The number, nature, and timing of purulent complications and infiltrates, as well as the volume of lymphorrhea, were recorded. The SPSS 17.0 software was used for statistical data processing.

Results. The use of nafion coating on endoprostheses used in hernia repair, regardless of their size, showed a statistically significant reduction in the number of complications. The use of modified endoprostheses in preperitoneal plastic surgery improves the results of its implementation, making them comparable to TAR plastic surgery. The use of a modified endoprosthesis in posterior separation hernioplasty significantly reduces the number of postoperative infiltrates and seromas in the surgical area compared with the use of a similar material in preperitoneal plastic surgery. There was no pathogenic microflora in the crops from the wound discharge in the main group.

Conclusion. The use of a polypropylene endoprosthesis with a nafion coating in performing various posterior abdominal wall surgeries in patients with postoperative ventral hernias leads to a statistically significant decrease in the frequency of postoperative lymphorrhea and purulent-inflammatory complications.

The purpose of the study was to examine the differences and commonality of the gut microbiota and urobiota in patients with liver cirrhosis (LC), depending on the presence of urinary tract infections (UTI).

Material and methods. A prospective cohort study was conducted on 125 patients with LC, including 41 — without UTI, 22 — with asymptomatic bacteriuria (ABU), and 62 — with UTI.

The results and their discussion. The beta diversity of the gut microbiota and urobiota differs in LC without UTI, with ABU, and with UTI (p = 0.002 and p = 0.001). In the gut microbiota in LC without UTI — with ABU — with UTI, there is an increase in the abundance of Pseudomonadota taxa (1.25 [0.49; 3.15]% — 5.76 [1.34; 10.29]% — 6.40 [1.78; 31.23]%, p = 0.0003), Gammaproteobacteria (0.57 [0.05; 2.59]% — 4.06 [0.63; 7.16]% — 4.47 [0.9; 29.82]%, p = 0.0004), Bacilli (2.52 [1.28; 7.96]% — 6.75 [2.51; 15.91]% — 13.86 [3.5; 26.52]%, p = 0.006) and decreased Bacteroidota density (42.94 [31.77; 67.78]% without UTI, 25.38 [0.95; 44.58]% with UTI, p = 0.003). Urobiota in LC without UTI — with ABU — with UTI are characterized by an increase in Pseudomonadota taxa (68.48 [38.7; 90.69]% — 71,57 [20,3; 88,4]% — 80.51 [8.85; 93.07]%, p = 0.029), Gammaproteobacteria (33.59 [26.5; 48.95]% — 38.95 [14.08; 78.94]% — 52.8 [5.25; 86.88]%, p = 0.004) and a decrease in Actinomycetota (2.89 [1.24; 5.59]% — 1.63 [0.22; 4.08]% — 0.5 [0.08; 3.8]%, р = 0.03), Clostridia (0.94 [0.07; 2.36]% — 0.4 [0.06; 5.98]% — 0.24 [0.03; 0.93]%, p = 0.011). The commonality between the urobiota and the gut microbiota in patients with LC with UTI ranges from 96% at the department level to 61.5% at the species level.

Conclusion. In patients with LC with UTI, there is a change in the beta diversity of the gut microbiota and urobiota, an increase in the abundance of pathogenic taxa (Pseudomonadota, Gammaproteobacteria, Bacilli), and a decrease in the abundance of commensal taxa (Bacteroidota, Actinomycetota, Clostridia) compared to the group without UTI.

Research objective: to identify the main components of mental health of outpatient medical workers using questionnaires to develop ways to prevent burnout syndrome and to evaluate the effectiveness of rehabilitation measures.

Material and methods. The study included 50 outpatient medical staff of a healthcare facility. The median age was 49.5 [44.2; 58.8] years. General clinical, laboratory and instrumental studies were used. According to the results of the Hospital Anxiety and Depression Scale questionnaire, after rehabilitation, the severity of symptoms of anxiety and depression in those examined decreased.

Results. The study showed an improvement in the psychological component of the quality of life of medical staff after individual rehabilitation. According to the results of the Boyko questionnaire, the number of medical staff with an unformed exhaustion phase after rehabilitation increased by 40%, in the resistance phase, the number of doctors with a formed phase after rehabilitation significantly decreased from 46% to 16%. An unformed stress phase before rehabilitation was registered in 62%, and after in 90% of those examined. According to the results of the Hospital Anxiety and Depression Scale questionnaire, the severity of anxiety and depression symptoms in those examined decreased after rehabilitation.

Conclusions. This study demonstrates the need to monitor health status and the importance of implementing individual rehabilitation programs for medical staff to reduce staff outflow and maintain the prestige of the medical profession.

Acquired hemophilia A (AHA) is a rare but life-threatening autoimmune disorder caused by the development of inhibitors against coagulation factor VIII. This article presents a clinical case of an 82-year-old female patient who was admitted with intracerebral hemorrhage and multiple spontaneous hematomas and was subsequently diagnosed with AHA. The diagnosis was confirmed by prolonged activated partial thromboplastin time (aPTT) and significantly decreased factor VIII activity level of 3.5%. The patient received hemostatic and immunosuppressive therapy with a positive clinical response. This case emphasizes the importance of early diagnosis and a personalized therapeutic approach, especially in elderly patients without a previous history of bleeding disorders. The observation illustrates the diagnostic challenges of AHA when masked by other clinical conditions and highlights the need for interdisciplinary collaboration among healthcare providers.

Hemochromatosis is a disease associated with excess iron in the body. Primary (hereditary) hemochromatosis, occurs due to mutations in genes encoding iron metabolism proteins. Elevated serum iron concentrations can lead to iron accumulation in parenchymatous organs and tissues, especially in the liver, pancreas, heart, pituitary gland, and testicles, resulting in the development of fibrosis and failure of these organs. Diagnosis of hereditary hemochromatosis includes genetic testing, evaluation of serum iron metabolism parameters, and imaging data. The article describes a case of Takotsubo syndrome development in a patient with primary hemochromatosis. Takotsubo syndrome is characterized by transient regional systolic dysfunction, dilation and edema of the apical and/or middle segments of the left ventricle (LV), in the absence of coronary artery obstruction during coronary angiography. At the age of 49, an examination revealed an increase in ferritin, genetic testing revealed a homozygous mutation C282Y in the HFE gene, hereditary hemochromatosis was diagnosed, erythrocytapheresis was performed, and she is being monitored by a hematologist. At the age of 56, she was hospitalized with suspected acute coronary syndrome with ST segment elevation, an increase in troponin I levels to 1.8 ng/ml. Coronary angiography did not reveal any hemodynamically significant stenosis. Echocardiography revealed hypoand dyskinesis of the apical segments, a decrease in the LV ejection fraction to 45%. Dynamically, normalization of the troponin level, ECG, and restoration of LV function were noted. Takotsubo syndrome was diagnosed in a patient with primary hemochromatosis, the combination of which was not mentioned in previously published works.

The article provides documentary information about the history of the creation of the first pharmacies in St. Petersburg, their location and connection to the districts of the city. Historical plans of St. Petersburg of the XVIII century are used.

The life and work of the academician of the USSR Academy of Medical Sciences N.F. Gamaleya is analyzed. Little-known facts from the scientist’s life are noted. It is shown that with his scientific works and organizational activities he enriched many chapters of microbiology and epidemiology, successfully studied the biology of pathogens, pathogenesis, substantiated the prevention of such most dangerous infectious diseases as rabies, plague, cholera, smallpox, anthrax and typhus. The scientific creative activity of N.F. Gamaleya lasted almost 65 years: he published his first work at the age of 26 (1885), and his last at the age of 90 (1949). The scientific, pedagogical and practical work of N.F. Gamaleya fully developed only under Soviet power. It is noted that during the civil war N.F. Gamaleya worked on the anti-epidemic front in difficult conditions, providing the population and the Red Army with vaccination material, and persistently carried out work to eliminate smallpox. It is no exaggeration to say that N.F. Gamaleya’s research determined the directions in which various sections of applied microbiology developed in our country.