Background. Respiratory symptoms of bronchial asthma (BA) comorbid with gastroesophageal reflux disease (GERD) may provoke duodenogastroesophageal reflux (DGER) via aggressive agents like pepsinogens and bilirubin.

Objectives. A clinical and functional study of the saliva pepsinogen and bilirubin-associated BA-comorbid GERD for non-invasive DGER diagnosis.

Methods. A total of 29 patients with an allergic BA phenotype, comorbid GERD and 50,2 ± 2,4 years mean age have been examined. Biochemical blood panel included bilirubin, C-reactive protein and allergen-specific IgE. Saliva bilirubin was estimated in colorimetry, and the pepsinogen-1, -2 content — in immunological tests. Grade A–D reflux oesophagitis (RO) in oesophagoscopy was assigned to erosive reflux disease, and grade N–M oesophageal mucosa (OM) lesions — to non-erosive reflux disease. External respiratory function (ERF) was assessed with forced expiratory volume (FEV1, L/s), forced vital capacity (FVC), Tiffeneau index (FEV1/FVC), pre- and post-berodual FEF1 and FVC dynamics.

Results. The BA–GERD patients were markedly polymorbid. Cough and chest tightness associated with age, and the tight chest rate — with a higher body mass index and lower FEV1/FVC. The association between higher pepsinogen-I and lower FEV1/FVC–FVC in response to inhaled berodual, as well as between higher saliva bilirubin and lower FVC–FEV1 after berodual intake reflects a significant high-DGER effect on BA representation.

Conclusion. In BA–GERD patients, saliva pepsinogen and bilirubin are biomarkers of both DGER and respiratory inflammation with bronchospasm.

Background. Recent years have witnessed a 1.5–1.8-fold growth of chronic palatine tonsillitis. Choosing optimal treatment remains relevant in this illness despite ample research and improvement in therapy and diagnosis.

Objectives. An analysis of oropharyngeal microflora in chronic tonsillitis patients receiving a polyvalent pyobacteriophage treatment.

Methods. A total of 126 patients diagnosed with compensated chronic tonsillitis were followed up over 2018–2021. Qualitative and quantitative traits of oropharyngeal microflora have been assessed at baseline, immediately upon completion and past 3 months of treatment. The patients were separated between two cohorts: the main one (n = 65) had palatine tonsil lacunae irrigation with a Tonsillor MM unit and received polyvalent pyobacteriophage, while the comparison cohort (n = 61) only had palatine tonsil lacunae sanitation with Tonsillor MM. The trial included a control healthy volunteers cohort. Pearson’s chi-square method was used for statistical analyses with the SPSS 23 software. Statistical significance was obtained at p < 0.05.

Results. Quantitative comparisons of microbiotic strain persistence in tonsillar mucosa (isolation rate, microbial colonisation density) showed a significant prevalence of enterobacterial staphylococci and ß-haemolytic streptococci, Gram-negative anaerobic bacteria and fungi in chronic tonsillitis patients compared to the control cohort (p < 0.05). Therapy positively impacted microbiota vs. control, but the best effect was observed with polyvalent pyobacteriophage. Microbiological assays in dynamic patient follow-up demonstrated stability of the results attained. The Tonsillor MM sanitation cohort revealed a 2–3 degree dysbiosis in 47.5% (29) patients in 3 months, while the polyvalent pyobacteriophage cohort only had 7.7% (5) such patients (p <  0.01).

Conclusion. The trial demonstrates efficacy and relevance of pyobacteriophage treatment in chronic tonsillitis, primarily at the microenvironmental level.

Background. An evidence-based diagnostic tactics for follicular thyroid gland neoplasia is lacking to date. First-line priority are radiography diagnostic techniques, which vary in capacities and therefore must be regulated in use.

Objectives. An efficacy evaluation of multiparametric ultrasound (US), sonoelastography (SEG) and radionuclide scintigraphy (RS) in diagnosis of follicular thyroid neoplasms (FTN).

Methods. Preoperative examination was interpreted in 222 FTN patients (86 with follicular thyroid adenoma, FTA, and 136 with follicular thyroid cancer, FTC) with subsequent surgery. A retrospective statistical data analysis was performed for B-mode US, colour Doppler imaging (CDI), power Doppler imaging (PDI), sonoelastography and Tc-99m pertechnetate scintigraphy.

Results. Novel FTN descriptive evidence has been obtained. Particularly, an FTA vs. FTC trait comparison showed no reliable US marker of a node assignment to FTA or FTC. Trials of the national-manufactured TI-RADS system showed its good diagnostic potential: FTN sensitivity 89.55, specificity 77.58 and accuracy 83.52%. A SEG picture of FTN was typically motley-colour and mosaic. Young’s modulus in FTA was 27.5 ± 7.1 kPa, a higher stiffness (62.1 ± 12.1 kPa) in FTC indicated a higher likelihood of malignancy. Scintigraphy exhibited a modest capacity for FTN diagnosis (sensitivity 86.67, specificity 48.08 and accuracy 56.72%). AUC values (0.617) indicate its limited use for differential FTN diagnosis, mainly in hyperfunctioning nodules. Our experience elaborated an original algorithm for radiographic techniques application in FTN diagnosis.

Conclusion. Several radiographic methods are warranted in suspected FTN. First-line is multiparametric US B-mode imaging to detect FTN priority markers and US symptom complexes. Sonoelastography is second-line in ambiguous cases to further clarify structure (stiffness) of the thyroid nodule examined. Unlike SEG, scintigraphy assesses the functional traits of thyroid nodule and so has limited indications, an important factor to consider in FTN.

Background. Medical facility visualisation systems comprise navigation, information panels and visual operation control elements. Visual perception surveys in medical institutions are of great value in medical sociology. Knowing the today’s visitor intent towards visual content inside healthcare facilities will allow a better formulation of most comfortable arrangement of medical services and improvement of healthcare delivery to various visitor categories.

Objectives. An assessment of modern public intent towards medical visualisation systems in the Russian Federation.

Methods. A total of 7,356 citizens across 85 country subjects contributed to a sociological survey. Data of a formalised multistage stratified territorial random sampling survey were taken as main information source. The Kano model was used to organise intent towards attributes of medical visualisation systems. Depending on two parameters (functionality and satisfaction), the attributes were assigned between the categories of attractive, linear, obligatory, indifferent or undesirable.

Results. The highest approval level among the visualisation attributes was found towards accuracy of the information panel content. The high-level of respondent approval were external navigation, compliance to the Russian language style and rules, good-making of the element, content structuring and use of modern information technologies. The lowest approval level was in a visually unified medical institution design. The most contentious respondent intent was observed in relation to colour-coding of visualisation objects.

Conclusion. The survey recovered a generally similar public intent profile towards main visualisation system attributes in the Russian Federation. The mandatory included two attributes, “compliance to the Russian language style and rules” and “good-making of visualisation element”. Mandatory attributes are baseline to medical visualisation systems. They do not improve the visitor’s satisfaction, but their absence negatively impacts perception of healthcare visualisation systems.

Background. Aesthetic medicine and plastic surgery accrue with new methods for aging correction by year. Research is aimed at reducing the acute complications risk of aesthetic surgeries and finding effective routes of their diagnosis and treatment. Vascular and non-vascular contouring complications imaging, thread implantation, atrophic postacne scars, postpartum striae, posttraumatic and postoperative scars remain the topical issues.

Objectives. A review of current imaging techniques in aesthetic medicine to outline promising avenues in the diagnostics of atrophia cicatrix using high-resolution ultrasound methods.

Methods. Bibliography was mined and analysed in the PubMed, eLibrary, Web of Science, Cyberleninka and Cochrane Library databases for the period of 2017–2021. Content analysis was used with the keyword queries: facial ultrasound [ультразвуковая диагностика кожи], ultrasound in dermatology [диагностика в косметологии], contouring complications [осложнения контурной пластики], complications in cosmetology, complications of hardware rejuvenation [осложнения аппаратного омоложения], atrophic scar diagnostics [диагностика рубцовых атрофий].

Results. Among 351 studied, 57 sources were included in the review. An analysis of past-decade national and foreign literature revealed prevalence of surface linear array 12 and 14 MHz transducers in ultrasonic (US) cosmetology. High-frequency transducers in dermatology and aesthetic medicine have actively developed in recent years. Evidence is published on vascular and non-vascular facial contouring complications diagnosis, aesthetic thread implantation, aging dynamics, psoriasis and onychomycosis control. Scar imaging studies are sparse and not uncovering the full US potential to control their various-stage treatment.

Conclusion. A dynamic advancement of high-resolution US in aesthetic medicine paves the promising ways of research into the US capacities for various-origin atrophic scar diagnosis, informative diagnostic criteria elaboration and the development of prognostic and treatment efficacy control techniques.

Background. The ongoing COVID-19 pandemic is building up a population of previous SARS-CoV-2 patients with non-transient multiorgan failures having diverse stable symptoms and/or delayed complications. Proper measures should be defined in public healthcare to tackle patients’ diagnosis, treatment and rehabilitation.

Objectives. A systematic review of recent evidence in epidemiology and pathophysiology of organ-specific COVID-19 aftereffects and their routes of correction.

Methods. Sources were mined in eLibrary and Medline/PubMed using the keywords “post-covid syndrome” [постковидный синдром], COVID-19, SARS-CoV-2, “organ lesions”, pathogenesis, treatment; the article type were “Clinical Trial”, “Meta-Analysis”, Review and “Systematic Review” published in English or Russian during 01 January 2020–10 July 2021. All study designs considered reflected the current understanding of epidemiology, pathogenesis, late manifestations and complications of old systemic and organ COVID-19, as well as their correction measures. Full-text peer-reviewed high-impact journal articles had preference.

Results. A screening of 1,163 sources selected 480 most relevant full-text articles for analysis, with 131 included in the final review. A number of 2020–2021 studies reported persistent COVID-19 representations, including pulmonary, cardiovascular, renal complications, haematological disorders, neuropsychiatric and endocrine aftereffects. Gastrointestinal, hepatobiliary and dermatological complications of SARS-CoV-2 are less elaborated. Insights are emerging into the pathogenesis of weeks-to-months persisting post-acute COVID-19 organ and systemic lesions. Understanding their pathophysiology will enable targeting measures towards a comprehensive treatment of post-COVID syndrome. Clinical trials are currently underway that will evidence-ground the prevention and therapy of COVID-19 complications in discharged patients.

Conclusion. COVID-19 patients should be managed beyond hospital discharge, as many of them require comprehensive inter-specialty medical care in outpatient follow-up. A rapid enrichment of databases and professional evidence for post-COVID syndrome lays the grounds for successful treatment and rehabilitation of patients who had coped with this disease.

Background. The ever-growing rate of man-made accidents and disasters entails high traumatism. Traumas and other injuries, including purulent necrotic lesions, often lead to extensive wound defects requiring special surgeries for closure and to restore skin integrity.

Objectives. A comparative inter-specialty review in trauma surgery on the vacuum therapy application in healing wounds of different locality and aetiology.

Methods. The review includes relevant cases of use experience in vacuum-assisted healing of various locality and aetiology wounds, indexed in the PubMed, ScienceDirect and eLibrary databases for years 2014–2020. The following research techniques were employed: online, content, historical and descriptive analyses with a focus on specific issues in aetiology, pathogenesis and vacuum-assisted healing of various-locality wounds.

Results. Vacuum-assisted healing of various locality and aetiology wounds is a current standard acting in complex with adequate surgical treatment, antibiotic therapy and early rehabilitation measures.

Conclusion. Manifold literature sources, colleagues’ publications and guidelines for vacuum-assisted closure (VAC®-therapy Guidelines) substantiate the effect and promise of the vacuum-based approach in complex treatment of various-aetiology wounds. Further studies into the mechanisms of action and the elaboration of indications list are warranted for this method.