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ORIGINAL RESEARCH

Development of hepatotoxic reactions during treatment of patients with pulmonary tuberculosis with various degrees of tuberculous intoxication severity Abdullaev R.Yu. (Russia, Moscow), Shorokhova V.A. (Russia, Moscow), Komissarova O.G. (Russia, Moscow), Merzlikina P.D. (Russia, Moscow) P. 7

Facial sympathalgia: Clinicopathogenetic features and diagnostic criteria Abdullaeva M.B. (Uzbekistan, Tashkent), Yadgarova L.B. (Uzbekistan, Tashkent), Khidoyatova D.N. (Uzbekistan, Tashkent), Khikmatullaeva Sh.Sh. (Uzbekistan, Tashkent), Tairova D.Z. (Uzbekistan, Tashkent), Akiljanova N.A. (Uzbekistan, Tashkent), Bakhriev B.R. (Uzbekistan, Tashkent) P. 16

Assessment of changes in the qualitative composition of skin microbiota in patients with psoriasis under different treatment regimens Arsenyeva A.A. (Russia, Samara), Lyamin A.V. (Russia, Samara), Migacheva N.B. (Russia, Samara), Ismatullin D.D. (Russia, Samara), Marchenko V.V. (Russia, Samara), Kaiumov K.A. (Russia, Samara), Alekseev D.V. (Russia, Samara) P. 23

Predictors of myocarditis in children with acute respiratory infections across different age groups Gafarova F.M. (Uzbekistan, Tashkent), Mannabov S.A. (Uzbekistan, Tashkent), Aripov O.A. (Uzbekistan, Tashkent) P. 30

Photodynamic therapy and its impact on microbial load in periodontal pockets in aggressive periodontitis Gaybullaev E.A. (Uzbekistan, Tashkent) P. 38

Comprehensive assessment of association between abdominal fat depot, hepatic steatosis, and inflammatory serum biomarkers in patients with non-alcoholic fatty liver disease Djuraeva N.M. (Uzbekistan, Tashkent), Ibadov R.A. (Uzbekistan, Tashkent), Ibragimov S.Kh. (Uzbekistan, Tashkent), Urinov B.I. (Uzbekistan, Tashkent), Abdukhalimova Kh.V. (Uzbekistan, Tashkent), Muchiashvili O.R. (Uzbekistan, Tashkent) P. 44

Effect of specialized inpatient motivational counseling on long‑term outcomes in cardiology patients: Results of a 2‑year follow‑up Dovlatukaeva Kh.R. (Russia, Moscow), Lebedeva A.Yu. (Russia, Moscow), Faradzhov R.A. (Russia, Moscow), Yufereva Yu.M. (Russia, Moscow), Shevchenko A.O. (Russia, Moscow) P. 55

Clinical significance of preoperative vascular mapping in reduction mammaplasty Kiziun Ya.V. (Uzbekistan, Andijan), Madazimov M.M. (Uzbekistan, Andijan), Turaev F.F. (Uzbekistan, Tashkent), Pustovetova M.G. (Uzbekistan, Tashkent), Akramova N.A. (Uzbekistan, Tashkent) P. 63

Enhancing the efficacy of facial lipofilling in aesthetic and post‑traumatic deformities using cell‑based technologies Madazimov M.M. (Uzbekistan, Andijan), Turaev F.F. (Uzbekistan, Tashkent), Mohamed Kh.Y. (Uzbekistan, Andijan), Pustovetova M.G. (Uzbekistan, Tashkent), Akramova N.A. (Uzbekistan, Tashkent) P. 69

Experimental quantitative morphometric assessment of morpho-functional changes in the liver following long-term dipsacoside administration Mamataliev A.R. (Uzbekistan, Andijan), Azizov Yu.D. (Uzbekistan, Andijan), Isanova D.T. (Uzbekistan, Andijan), Reymnazarova G.D. (Uzbekistan, Tashkent), Saydaliev S.S. (Uzbekistan, Andijan), Don A.N. (Uzbekistan, Tashkent) P. 75

Allergic respiratory diseases in children aged 6-7 and 13-14 years: Five-year trends and behavioral risk factors Medvedeva O.S. (Russia, Tyumen) P. 86

Dental implantation in adolescents with congenital agenesis of the maxillary lateral incisors: A 10‑13‑year follow‑up of marginal bone stability and success factors Nikitina L.I. (Russia, Cheboksary), Dzhuraeva Sh.F. (Russia, Cheboksary) P. 93

Magnetic resonance imaging and machine learning in the differential diagnostics of ovarian cancer grades and stages Khayitboeva M.R. (Uzbekistan, Tashkent), Tairova M.I. (Uzbekistan, Tashkent), Ibraimov K.Sh. (Kyrgyz Republic, Bishkek), Beksultanov T.B (Kyrgyz Republic, Bishkek), Oginsky A.A. (Kyrgyz Republic, Bishkek), Karimova Yu.A. (Uzbekistan, Tashkent), Mirtadzhieva Z.D. (Uzbekistan, Tashkent) P. 100

Comprehensive rehabilitation of patients following tooth extraction Chumakov I.V. (Russia, Cheboksary), Moskovsky A.V. (Russia, Cheboksary) P. 105

Assessment of changes in clinical and laboratory findings in older post-COVID-19 patients with hypertension Shadieva A.A. (Russia, Astrakhan), Chernysheva E.N. (Russia, Astrakhan), Lyalyukova E.A. (Russia, Omsk) P. 112

REVIEWS

Controlled adaptability index: A cybernetic model for assessing the national anti-drug system (Part II) Akhokhova A.V. (Russia, Nalchik), Mishkhozheva A.T. (Russia, Nalchik), Khamzhueva M.M. (Russia, Nalchik), Atabaeva I.R. (Russia, Nalchik) P. 122

Modern approaches to the prevention of hemostatic disorders to improve pregnancy outcomes Karpova I.A. (Russia, Tyumen), Platitsyn V.A. (Russia, Tyumen), Pavlenko A.S. (Russia, Yekaterinburg), Mateykovich E.A. (Russia, Tyumen), Polyakova V.A. (Russia, Tyumen), Nekrasova M.R. (Russia, Tyumen), Sozonov A.I. (Russia, Tyumen) P. 131

International strategies for combating the spread of antibiotic resistance in microorganisms: A review of scientific literature Cherkasova V.V. (Russia, Tyumen), Knysh O.I. (Russia, Tyumen) P. 140

CLINICAL CASE

Long-term follow-up and management of a patient with multiple coronary artery aneurysms (a case report) Galyavich A.S. (Russia, Kazan), Baleeva L.V. (Russia, Kazan), Galeeva Z.M. (Russia, Kazan), Sabirzyanova A.A. (Russia, Kazan), Khairullin R.N. (Russia, Kazan), Safina E.G. (Russia, Kazan), Rafikov A.Yu. (Russia, Kazan) P. 149

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ORIGINAL RESEARCH

УДК: 616.24-002.5-006:616.379-008.64

DOI: 10.20969/VSKM.2026.19(4).7-15

 Development of hepatotoxic reactions during treatment of patients with pulmonary tuberculosis with various degrees of tuberculous intoxication severity

Rizvan Yu. Abdullaev1,Violetta A. Shorokhova1, Oksana G. Komissarova1,2, Polina D. Merzlikina1

1 Central Research Institute of Tuberculosis, 2 Yauzskaya Alley, 107564 Moscow, Russia

2 N. I. Pirogov Russian National Research Medical University, 1 Ostrovityanov str., 117997 Moscow, Russia

Abstract. Introduction. Hepatotoxic reactions to anti-tuberculosis drugs are more common in the first months of treatment for newly diagnosed pulmonary tuberculosis. In addition to the drugs, severity of tuberculosis intoxication also affects the development of hepatotoxicity. It is important to study the relationship between the degree of intoxication at the start of treatment and subsequent hepatotoxic reactions. Aim. To study the dynamics of changes in markers of hepatotoxic reactions in relation to the laboratory manifestations of tuberculous intoxication in patients with newly diagnosed drug-sensitive pulmonary tuberculosis during treatment. Materials and Methods. 60 patients with newly diagnosed drug-sensitive pulmonary tuberculosis were examined and divided into 2 groups: 30 patients with mild and 30 patients with severe tuberculous intoxication. The levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, C-reactive protein, and erythrocyte sedimentation rate were analyzed at 4 control points: Before starting anti-tuberculosis chemotherapy and after 1, 2, and 3 months of treatment. Results and  Discussion. It was found that hepatotoxic reactions occurred significantly more frequently in the group with severe intoxication after one month of treatment, compared to the group with mild intoxication, due to the high frequency of increased hepatocyte cytolysis and cholestasis levels, as well as a significant increase in the medians of these indicators. At the same time, most patients in the severe intoxication group and all patients in the mild intoxication group developed grade 1 hepatotoxicity. By this time, the indicators of intoxication had been significantly higher in the group with severe intoxication than in the group with mild intoxication. Two months later, despite a significant decrease in the laboratory indicators of tuberculous intoxication in the severe intoxication group, the number of patients with newly detected hepatotoxic reactions in form of cytolysis significantly decreased and did not differ significantly from the mild intoxication group. At the same time, hepatotoxic reactions had been observed in the severe intoxication group by that time. Conclusions. In patients with newly diagnosed tuberculosis with severe intoxication, the most pronounced hepatotoxic reactions occur after 1 month of treatment, probably because of both anti-tuberculosis drugs and tuberculous liver intoxication. During the course of treatment, the incidence of hepatotoxic reactions decreases significantly.

Keywords: tuberculosis, hepatotoxic reactions, tuberculosis intoxication, systemic inflammation, treatment, and antituberculosis drugs

For citation: Abdullaev, R.U.; Shorokhova, V.A.; Komissarova, O.G.; Merzlikina, P.D. Development of hepatotoxic reactions during treatment of patients with pulmonary tuberculosis with various degrees of tuberculous intoxication severity. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 7-15. DOI: 10.20969/VSKM.2026.19(4).7-15.

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УДК: 616.831-009.7:616.833

DOI: 10.20969/VSKM.2026.19(4).16-22

 Facial sympathalgia: Clinicopathogenetic features and diagnostic criteria

Muborak B. Abdullaeva1, Lola B. Yadgarova1, Dilbar N. Khidoyatova1, Shakhnoza Sh. Khikmatullaeva1, Dilyaram Z. Tairova1, Nigora A. Akiljanova1, Bakhriddin R. Bakhriev1

1Tashkent State Medical University, 2 Farobiy Street, Admazar District, 100109 Tashkent, Uzbekistan

Abstract. Introduction. Facial sympathalgia is a pain syndrome in the facial region, primarily associated with dysfunction of the sympathetic nervous system. This condition develops under the influence of various etiological factors, including traumatic insults, adjacent somatic and visceral diseases, and pathologies of the central nervous system. Facial sympathalgia holds particular clinical significance in neurology, as it often coexists with neuropathic pain and presents considerable diagnostic challenges. Aim. To define diagnostic criteria for facial sympathalgia with respect to pathogenetic features, clinical presentation, and differential diagnosis, as well as to improve the treatment efficacy. Materials and Methods. A prospective analysis was conducted on the clinical characteristics and treatment outcomes of 100 patients with facial sympathalgia, examined at the Salomat Hayot Clinic and the Outpatient Consultative Clinic of the National Medical Center. Patients were categorized into five groups according to the type of sympathalgia. Pain severity was assessed using the visual analog scale (VAS), autonomic dysfunction was evaluated using a specialized scale, and levels of inflammatory biomarkers (C-reactive protein, IL-1β, IL-6, TNF-α) were measured. Results and Discussion. All patients (n=100) were divided into three clinical groups. A pronounced and severe pain syndrome according to the VAS was observed in 78% of patients (54% – severe pain, 24% – very severe pain), with the mean pain intensity scores of 8.42±1.07, which showed a tendency to decrease in the chronic phase (down to 5.84±1.8 according to the mimic scale). Levels of proinflammatory cytokines before treatment did not exceed reference values: IL-1β – 2.90-3.69 pg/mL, IL-6 – 12.61-14.85 pg/mL, and TNF-α – 4.40-5.24 pg/mL (p>0.05), indicating the absence of systemic inflammation and the predominance of neurogenic mechanisms in the pathogenesis of facial sympathalgia. Conclusions. The pathogenesis of facial sympathalgia is multifactorial and primarily linked to sympathetic nervous system dysfunction. Clinical and diagnostic features allow differentiation from other pain syndromes, while systemic levels of inflammatory cytokines remain within normal ranges, indicating no pronounced systemic inflammatory process. Local cytokine activity within trigeminal ganglia or peripheral nerve nodes, as well as neuropathic mechanisms, such as demyelination, neurovascular compression, or central sensitization, determine the pain intensity and necessitate an individualized therapeutic approach.

Keywords: sympathology, nasociliary, auriculotemporal, glossalgia, prosopalgia, paroxysm.

For citation: Abdullaeva, M.B.; Yadgarova, L.B.; Khidoyatova, D.N.; et al. Facial sympathalgia: Clinicopathogenetic features and diagnostic criteria. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 16-22. DOI: 10.20969/VSKM.2026.19(4).16-22.

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3. Балязина Е.Б. Классическая невралгия тройничного нерва: монография. - Новочеркасск: Лик; 2015. – 278 с. Balyazina EB. Klassicheskaya nevralgiya troynichnogo nerva: monografiya [Classical trigeminal neuralgia: Monograph]. Novocherkassk: Lik [Novocherkassk: Lik]. 2015; 278 p. (In Russ.)

4. Балязина Е.В. Возрастные особенности клиники классической невралгии тройничного нерва // Медицинский вестник Юга России. – 2014. – № 3. – С. 65–70. Balyazina EV. Vozrastnye osobennosti kliniki klassicheskoy nevralgii troynichnogo nerva [Age-related features of classical trigeminal neuralgia]. Meditsinskiy vestnik Yuga Rossii [Medical Bulletin of South Russia]. 2014; 3: 65–70. (In Russ.)

5. Балязина Е.В., Исаханова Т.А., Балязин В.А., Бондарева О.И. Физический механизм формирования двух типов нейроваскулярного конфликта у больных классической невралгией тройничного нерва // Неврологический журнал. – 2017. – № 22(4). – С. 190–197. Balyazina EV, Isakhanova TA, Balyazin VA, Bondareva OI. Fizicheskiy mekhanizm formirovaniya dvukh tipov neyrovaskulyarnogo konflikta u bol’nykh klassicheskoy nevralgiyey troynichnogo nerva [Physical mechanism of formation of two types of neurovascular conflict in patients with classical trigeminal neuralgia]. Nevrologicheskiy zhurnal [Neurological Journal]. 2017; 22(4): 190–197. (In Russ.)

6. Зайцев А.Ю., Светлов В.А., Дубровин К.В., [и др.] Внеротовая стволовая регионарная анестезия в реконструктивно-восстановительной челюстно-лицевой хирургии // Журнал анестезиология и реаниматология. – 2012. – № 5. – С. 50–53. Zaytsev AY, Svetlov VA, Dubrovin KV, et al. Vnerotovaya stvolovaya regionalnaya anesteziya v rekonstruktivno-vosstanovitelnoy chelyustno-litsevoy khirurgii [Extraoral stem regional anesthesia in reconstructive maxillofacial surgery]. Anesteziologiya i reanimatologiya [Anesthesiology and Reanimatology]. 2012; 5: 50–53. (In Russ.)

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УДК: 616.517-002.1-085:579.61-092.4

DOI: 10.20969/VSKM.2026.19(4).23-29

 Assessment of changes in the qualitative composition of skin microbiota in patients with psoriasis under different treatment regimens

Antonina A. Arsenyeva1, Artem V. Lyamin1, Natalia B. Migacheva1, Danir D. Ismatullin1, Varvara V. Marchenko1, Karim A. Kaiumov1, Dmitriy V. Alekseev1

1 Samara State Medical University, 89 Chapayskaya str., 443099 Samara, Russia

Abstract. Introduction. Psoriasis is considered a systemic immune inflammatory disease, in which skin microbiome disruptions play a significant role in pathogenesis. Effect of various treatment  modalities on the composition of skin microbiota in psoriasis has been poorly studied. Aim. To assess the biological diversity of the skin microbiota in patients with psoriasis vulgaris and to analyze the dynamics of its changes under three types of therapy: Topical glucocorticosteroids, methotrexate, and interleukin‑17 inhibitors. Materials and Methods. The study included 155 adult patients with psoriasis vulgaris, divided into three groups: topical glucocorticosteroids (n=52), methotrexate (n=51), and IL‑17 inhibitors (n=52). Swabs from lesional skin were plated and incubated under aerobic, microaerophilic, and anaerobic conditions. Microorganisms were identified using MALDI‑ToF mass-spectrometry. To assess the structure of the microbiota, a constancy coefficient was calculated and microorganisms were classified into resident, additional, and transient fractions. Results and Discussion. Before treatment, 31 genera and 85 species of microorganisms were isolated from the patients’ skin; after treatment, 50 genera and 127 species were identified. In group 1, after therapy, there was a significant increase in the frequency of isolation of Staphylococcus epidermidis, Staphylococcus capitis, Micrococcus luteus, and Moraxella osloensis, along with a decrease in the frequency of Staphylococcus aureus isolation. In group 2, no statistically significant changes in the microbiota were observed. In group 3, during therapy with IL‑17 inhibitors, the frequency of Staphylococcus hominis isolation increased significantly, and Streptococcus vestibularis, Pseudomonas stutzeri and Corynebacterium simulans were detected for the first time. These microorganisms are  representatives of the normal skin microbiota. Conclusions. Topical glucocorticosteroids and IL‑17 inhibitors promote the restoration of the skin microbiota in psoriasis by increasing the representation of commensal coagulase‑negative staphylococci and reducing the frequency of S. aureus isolation. Methotrexate did not demonstrate a significant effect on the structure of the skin microbiota. The obtained data indicate the potential of using microbiological markers to assess the effectiveness of psoriasis therapy at the level of the skin microbiome.

Keywords: psoriasis, skin microbiota, Staphylococcus aureus, methotrexate, topical glucocorticosteroids, interleukin‑17 inhibitors.

For citation: Arsenyeva, A.A.; Lyamin, A.V.; Migacheva, N.B.; et al. Effects of different therapies on the biological diversity of the skin microbiota in patients with psoriasis. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 23-29. DOI: 10.20969/VSKM.2026.19(4).23-29.

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1. Chakith MRS., Pradeep S, Gangadhar M, et al. Advancements in understanding and treating psoriasis: a comprehensive review of pathophysiology, diagnosis, and therapeutic approaches. PeerJ. 2025; 13: e19325. DOI: 10.7717/peerj.19325

2. Goel N, Wallace EB, Lindsay C. Hot Topics: Depression in Individuals with Psoriasis and Psoriatic Arthritis. J Rheumatol. 2024; 51 (2): 43–50. DOI: 10.3899/jrheum.2024-0362

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4. Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021; 397 (10281): 1301–1315. DOI: 10.1016/S0140-6736(20)32549-6

5. Lwin SM, Azrielant S, He J, Griffiths CEM. Curing Psoriasis. J Invest Dermatol. 2024; 144 (12): 2645–2649. DOI: 10.1016/j.jid.2024.09.012

6. Lee HJ, Kim M. Challenges and Future Trends in the Treatment of Psoriasis. Int J Mol Sci. 2023; 24 (17): 13313. DOI: 10.3390/ijms241713313

7. Faulk CT, Pittelkow MR, Feldman SR, Swanson DL. The most powerful topical anti-inflammatory: the cautionary and enlightening story of SKIN-CAP. Dermatol Online J. 2024; 30 (6): 10.5070/D330664682. DOI: 10.5070/D330664682

8. Шушарин А.Г., Половинка М.П., Прохоренко В.М. Голимумаб, ингибитор ФНО-α, в комплексной методике лечения асептического некроза головки бедренной кости у пациентов с псориатическим артритом // Сибирский научный медицинский журнал. – 2017. – Т. 37, вып. 5. – С.26–32. Shusharin AG, Polovinka MP, Prokhorenko VM. Golimumab, ingibitor FNO-α, v kompleksnoj metodike lecheniya asepticheskogo nekroza golovki bedrennoj kosti u pacientov s psoriaticheskim artritom [Golimumab, a TNF-α inhibitor, in a combined treatment regimen for aseptic necrosis of the femoral head in patients with psoriatic arthritis]. Sibirskij nauchnij medicinskij zhurnal [Siberian Scientific Medical Journal]. 2017; 37 (5): 26–32. (In Russ.).

9. Gupta M, Weinberg JM, Yamauchi PS, et al. Psoriasis: Embarking a dynamic shift in the skin microbiota. J Cosmet Dermatol. 2022; 21 (4): 1402–1406. DOI: 10.1111/jocd.14273

10. Соломай Т.В., Семененко Т.А., Ведунова С.Л., [и др.] Роль активной герпес-вирусной инфекции в формировании атопического дерматита и псориаза // Сибирский научный медицинский журнал. – 2022. – Т. 42. Вып. 3. С.94–102. Solomai TV, Semenenko TA, Vedunova SL, et al. Rol` aktivnoj gerpes-virusnoj infekcii v formirovanii atopicheskogo dermatita i psoriaza [The role of active herpesvirus infection in the development of atopic dermatitis and psoriasis]. Sibirskij nauchnij medicinskij zhurnal [Siberian Scientific Medical Journal]. 2022; 42 (3): 94–102. (In Russ.). DOI: 10.18699/SSMJ20220312

11. Xue M, Deng Q, Deng L, et al. Alterations of gut microbiota for the onset and treatment of psoriasis: A systematic review. Eur J Pharmacol. 2025; 998: 177521 p. DOI: 10.1016/j.ejphar.2025.177521

12. Jiraskova Zakostelska Z, Reiss Z, Tlaskalova-Hogenova H, Rob F. Paradoxical Reactions to Anti-TNFα and Anti-IL-17 Treatment in Psoriasis Patients: Are Skin and/or Gut Microbiota Involved? Dermatol Ther (Heidelb). 2023; 13 (4): 911–933. DOI: 10.1007/s13555-023-00904-4

13. Ellepola AN, Samaranayake LP. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis. 2001; 7 (4): 211–216.

14. Tingting L, Zhang P, Yang L, et al. The effects of topical antimicrobial-corticosteroid combination therapy in comparison to topical steroids alone on the skin microbiome of patients with atopic dermatitis. J Dermatolog Treat. 2025; 36 (1): 2470379 p. DOI: 10.1080/09546634.2025.2470379

15. Widmer G, Ferrer L, Favrot C, et al. Glucocorticosteroids and ciclosporin do not significantly impact canine cutaneous microbiota. BMC Vet Res. 2018; 14(1): 51. DOI: 10.1186/s12917-018-1370-y

16. Gómez-Chávez F, Cedillo-Peláez C, Zapi-Colín LA, et al. The Extracellular Vesicles from the Commensal Staphylococcus epidermidis ATCC12228 Strain Regulate Skin Inflammation in the Imiquimod-Induced Psoriasis Murine Model. Int J Mol Sci. 2021; 22 (23): 13029 p. DOI: 10.3390/ijms222313029

17. Nakatsuji T, Chen TH, Narala S, et al. Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis. Sci Transl Med. 2017; 9 (378): eaah4680. DOI: 10.1126/scitranslmed.aah4680

18. Chen H, Zhang J, He Y, et al. Exploring the Role of Staphylococcus aureus in Inflammatory Diseases. Toxins (Basel). 2022; 14 (7): 464 p. DOI: 10.3390/toxins14070464

19. Асоскова А.В., Сычев Д.А., Кубанов А.А. Вопросы безопасности применения метотрексата в терапии псориаза // Вестник Российской академии медицинских наук. – 2021. – Т. 76, Вып. 3. – С.254-267. Asoskova AV, Sychev DA, Kubanov AA. Voprosy` bezopasnosti primeneniya metotreksata v terapii psoriaza [Methotrexate Safety in Psoriasis: An Overview]. Vestnik Rossijskoj akademii medicinskix nauk [Annals of the Russian Academy of Medical Sciences]. 2021; 76 (3): 254–267. (In Russ.) DOI: 10.15690/vramn1527

20. Lv Y, Bian H, Jing Y, Zhou J. IL-17A inhibitors modulate skin microbiome in psoriasis: implications for microbial homeostasis. J Transl Med. 2025; 23 (1): 817 p. DOI: 10.1186/s12967-025-06723-9

21. Zhao H, Shang L, Zhang Y, et al. IL-17A inhibitors alleviate psoriasis with concomitant restoration of intestinal/skin microbiota homeostasis and altered microbiota function. Front Immunol. 2024; 15: 1344963 p. DOI: 10.3389/fimmu.2024.1344963

 

 

УДК: 616.2-002-053.2:616.12-008.331.1-074

DOI: 10.20969/VSKM.2026.19(4).30-37

 Predictors of myocarditis in children with acute respiratory infections across different age groups

Feruza M. Gafarova1, Sokhibdil A. Mannabov1, Orifjon A. Aripov1

1 Center for the Development of Professional Qualification of Medical Workers, 51 Parkent str., Mirzo Ulugbek District, 100007 Tashkent, Uzbekistan

Abstract. Introduction. Acute viral respiratory infections continue to lead in frequency among infectious diseases in adults and children in the modern world. Severity and speed of the development of clinical symptoms of these pathologies, as well as the frequency of complications, directly depend on the pathogenicity of the pathogen and the state of the body’s innate immune response. Aim. To improve early diagnosis and risk stratification of myocarditis in children with acute viral respiratory infections (AVRI) based on a comprehensive assessment of clinical, anamnestic, laboratory, and instrumental predictors across different age groups. Materials and Methods. Between 2023 and 2025, 195 patients aged 1-14 years with acute viral respiratory infections were studied. Of 195 patients,  112 children (57.44%) were diagnosed with laboratory- and instrumentally confirmed myocarditis and constituted the study group, while the comparator group consisted of 83 patients aged 1-14 years. Anamnestic, clinical, laboratory, and instrumental research methods were used. The findings were statistically processed using parametric and nonparametric criteria by methods of variational statistics. Results and Discussion. Echocardiography has the greatest diagnostic significance, recording a decrease in ejection fraction, chamber dilation, and regional contractility disorders, all being the markers of inflammation severity. ECG changes, such as repolarization disorders and tachycardia, were early functional indicators of myocardial damage. Elevated levels of troponin T and I demonstrated maximum sensitivity and specificity for inflammatory myocardial damage, while CK-MB and LDH complemented the picture of cytolysis and metabolic imbalance, and CRP enhanced the prognostic significance of other systemic inflammation biomarkers. The prognostic model has a high risk-stratification accuracy (AUC = 0.981) in early diagnosis and determination of the strategies for the management of such patients. Conclusions. The leading predictors of myocarditis in children are TnT > 34 pg/ml, CRP > 20 mg/l, decreased left ventricular ejection fraction, a combination of sinus tachycardia and ST-T changes, and a history of frequent acute viral respiratory infections.

Keywords: acute viral respiratory infections, children, myocarditis, early diagnosis.

For citation: Gafarova, F.M.; Mannabov, S.A.; Aripov, O.A. Predictors of myocarditis in children with acute respiratory infections across different age groups. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 30–37. DOI: 10.20969/VSKM.2026.19(4).30-37.

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2. DiGeorge NW, El - Ali AM, White AM. Pediatric Cardiac CT and MRI: Considerations for the General Radiologist. AJR Am J Roentgenol. 2020; 215(6): 1464-1473. DOI: 10.2214/AJR.19.22745

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4. Drazner MH, et al. 2024 ACC Expert Consensus Decision Pathway on Strategies and Criteria for the Diagnosis and Management of Myocarditis: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2024; 85 (5): 391-431. DOI: 10.1016/j.jacc.2024.10.080

5. Abdelkader S, Voladri DR, Kennedy JL. Beyond respiratory syncytial virus and rhinovirus: The other viral respiratory bandits. Ann Allergy Asthma Immunol. 2025; 135(3): 249-260. DOI:10.1016/j.anai.2025.05.015

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7. Javanian M, Barary M, Ghebrehewet S, Koppolu V. A brief review of influenza virus infection. J Med Virol. 2021; 93(8): 4638-4646. DOI: 10.1002/jmv.26990

8. Moriyama M, Hugentobler WJ, Iwasaki A. Seasonality of respiratory viral infections. Annu Rev Virol. 2020; 7: 83-101. DOI: 10.1146/annurev-virology-012420-022445

9. Atamna A, Babich T, Froimovici D, et al. Morbidity and mortality of respiratory syncytial virus infection in hospitalized adults: Comparison with seasonal influenza. Int J Infect Dis. 2021; 103: 489-493. DOI: 10.1016/j.ijid.2020.11.185

10. Schulz - Menger J, et al. 2025 ESC Guidelines for the management of myocarditis and pericarditis: Developed by the task force for the management of myocarditis and pericarditis of the European Society of Cardiology (ESC). Eur Heart J. 2025; 46 (32): 3191-3272. DOI: 10.1093/eurheartj/ehaf192

11. Williams JL, Jacobs HM, Lee S. Pediatric Myocarditis. Cardiol Ther. 2023; 12(2): 243-260. DOI: 10.1007/s40119-023-00309-6

12. Zhu P, Chen S, Zhang W, et al. Essential role of non-coding RNAs in enterovirus infection: From basic mechanisms to clinical prospects. Int J Mol Sci. 2021; 22(6): 1-17. DOI: 10.3390/ijms22062904

13. Sterne JAC, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019; 366 (l4898): 1-9. DOI: 10.1136/bmj.l4898

 

 

УДК: 616.314-002.4-085.33:615.33

DOI: 10.20969/VSKM.2026.19(4).38-43

 Photodynamic therapy and its impact on microbial load in periodontal pockets in aggressive periodontitis

Elbek A. Gaybullaev

EMU University, 7/1 Mukimi Street, Tashkent, 100104, Uzbekistan

Abstract. Introduction. Aggressive periodontitis is a rapidly progressive inflammatory and destructive disease of the periodontal tissues characterized by extensive alveolar bone resorption, a high microbial burden within periodontal pockets, and a rapidly evolving clinical course. Photodynamic therapy has emerged as a promising adjunctive approach owing to its potent local antimicrobial activity and its ability to reduce inflammatory responses. Aim. To evaluate changes in the microbial burden of periodontal pockets and assess the effectiveness of comprehensive treatment  incorporating photodynamic therapy in patients with aggressive periodontitis. Materials and Methods. A prospective, randomized study was conducted involving 180 patients aged 17-35 years diagnosed with aggressive periodontitis. All participants received comprehensive treatment, including local and systemic antimicrobial therapy, professional mechanical plaque removal, dental calculus removal, root surface debridement using the Vector system, and adjunctive photodynamic therapy. Photodynamic treatment was performed using a chlorin e6-based photosensitizer followed by activation with a light-emitting diode laser operating at a wavelength of 625–635 nanometers. Microbiological evaluation was performed before treatment and at one and three months after therapy using light microscopy with Pappenheim panoptic staining. The sample size was calculated using G*Power version 3.1 with a statistical power of 80%. Results and Discussion. marked reduction in  the microbial burden of periodontal pockets was observed as early as one month after treatment, with sustained improvement throughout the three-month follow-up period. The most pronounced therapeutic effect was demonstrated in patients aged 17–25 years with juvenile aggressive periodontitis, who exhibited a consistent reduction in microbial contamination at all follow-up assessments. Patients aged 26–35 years with rapidly progressive aggressive periodontitis also showed a decrease in microbial burden; however, the magnitude of improvement was less pronounced. These findings indicate that adjunctive photodynamic therapy significantly enhances the antimicrobial efficacy of comprehensive treatment for aggressive periodontitis. Conclusions. Photodynamic therapy significantly reduces the microbial burden of periodontal pockets for up to three months and demonstrates the greatest therapeutic benefit in younger patients with juvenile aggressive periodontitis.

Keywords: aggressive periodontitis, photodynamic therapy, microbial burden, periodontal pocket, chlorin, comprehensive treatment

For citation: Gaybullaev, E.A. Photodynamic therapy and its impact on microbial load in periodontal pockets in aggressive periodontitis. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 38–43. DOI: 10.20969/VSKM.2026.19(4).38-43.

REFERENCES

1. Yudina NA, Yakovleva-Malykh MO. Cytokine profile of gingival fluid in patients with various forms of periodontal diseases. Modern Dentistry. 2021;(2):58-62.

2. Romanov AE, Tsarev VN, Rudneva EV. Antibacterial therapy in the comprehensive treatment of periodontitis. Dentistry. 2000;(1):23-25.

3. Chawla K, Lamba AK, Verma M. Antimicrobial photodynamic therapy and erbium, chromium: yttrium-scandium-gallium-garnet laser-assisted periodontal pocket therapy for the treatment of  aggressive periodontitis: a randomized controlled clinical trial. World J Dent. 2022;13(5):473-478. DOI:10.5005/jp-journals-10015-2081

4. Schär D, Ramseier CA, Eick S, et al. Transgingival photodynamic therapy adjunctive to subgingival mechanical instrumentation in supportive periodontal therapy: a randomized controlled clinical study. Photodiagnosis Photodyn Ther. 2020; 32: 101971. DOI: 10.1016/j.pdpdt.2020.101971

5. Derikvand N, Ghasemi SS, Safiaghdam H, et al. Antimicrobial photodynamic therapy with diode laser and methylene blue as an adjunct to scaling and root planing: a clinical trial. Photodiagnosis Photodyn Ther. 2020;31:101818. DOI:10.1016/j.pdpdt.2020.101818

6. Nie X, Jiang C, Wu S, et al. Photodynamic therapy in periodontitis: a narrative review. Photodiagnosis Photodyn Ther. 2024;41:103257. DOI:10.1111/phpp.12946

7. Fekrazad R, Khoei F, Bahador A, et al. Comparison of different modes of photo-activated disinfection against Porphyromonas gingivalis: an in vitro study. Photodiagnosis Photodyn Ther. 2020;31:101818. DOI:10.1016/j.pdpdt.2020.101818

8. Pinheiro SL, Santos PH, Silva TL, et al. The efficiency of photodynamic therapy in the bacterial reduction of periodontal pockets: a clinical study. Diagnostics (Basel). 2022;12(12):3026. DOI:10.3390/diagnostics12123026

9. Sgolastra F, Petrucci A, Gatto R, et al. Photodynamic therapy in the treatment of chronic periodontitis: a systematic review and meta-analysis. Lasers Med Sci. 2013;28(2):669-682. DOI:10.1007/s10103-012-1127-4

10. AlAhmari F, Ahmed HB, Al-Kheraif AA, et al. Effectiveness of scaling and root planing with and without adjunctive antimicrobial photodynamic therapy in the treatment of chronic periodontitis among cigarette smokers and never-smokers: a randomized controlled clinical trial. Photodiagnosis Photodyn Ther. 2019;25:247-252. DOI:10.1016/j.pdpdt.2019.01.006

11. Gholami L, Shahabi S, Jazaeri M, et al. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol. 2023;13:1020995. DOI:10.3389/fmicb.2022.1020995

12. Gaybullaev EA. Etiotropic therapy of aggressive periodontitis: contemporary antibiotic regimens and their effectiveness. The Bulletin of Contemporary Clinical Medicine. 2026; 19 (1): 118-122. DOI: 10.20969/VSKM.2026.19(1).118-122

13. Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. J Periodontology. 2016; 20(1): 36–47. DOI: 10.1111/prd.12135

14. Mombelli A, Cionca N, Almaghlouth A. Does adjunctive systemic antibiotic therapy reduce the recurrence of periodontitis in patients treated by mechanical debridement? A systematic review and meta-analysis. J Clin Periodontol. 2015; 42(Suppl 16): S104–S118. DOI: 10.1111/jcpe.12336 26

15. Koluboğlu S, Akalin FA. Antibiotics in the Treatment of Periodontitis: A Systematic Review of the Literature. J Basel. 2021; 10(11): 1312. DOI: 10.3390/antibiotics10111312

 

 

УДК: 6616.36-056.52:612.352.2

DOI: 10.20969/VSKM.2026.19(4).44-54

 Comprehensive assessment of association between abdominal fat depot, hepatic steatosis, and inflammatory serum biomarkers in patients with non-alcoholic fatty liver disease

Nigora M. Djuraeva1, Ravshan A. Ibadov1, Sardor Kh. Ibragimov1, Bekhruz I. Urinov2, Khanum V. Abdukhalimova1, Omar R. Muchiashvili3

1 Republican Specialized Scientific and Practical Center of Surgery named after Academician V. Vakhidov, 10 Kichik Xalqa Yo’li str., 100115 Tashkent, Uzbekistan

2 Central Consultative and Diagnostic Polyclinic No. 1 of the Main Medical Department under the Administration of the President of the Republic of Uzbekistan, 65 S. Azimov str., Yashnabad District, 100000 Tashkent, Uzbekistan

3Tashkent State Medical University, 2 Farobiy Street, Admazar District, 100109 Tashkent, Uzbekistan

Abstract. Introduction. Non-alcoholic fatty liver disease, being a hepatic manifestation of metabolic syndrome, develops due to the overload of hepatocytes with lipids and metabolic-inflammatory disturbances. These alterations can be quantitatively assessed using unenhanced computed tomography with semi-automatic segmentation of abdominal fat depots and evaluation of hepatic steatosis. Aim. This study was to evaluate the association of quantitative computed tomography parameters of abdominal fat and hepatic steatosis with biochemical markers, inflammatory markers, and the adipokine profile in patients with non-alcoholic fatty liver disease and in healthy individuals. Materials and Methods. The study included 175 patients divided into two groups: The study group with non-alcoholic fatty liver disease (n=95) and the control group without any signs of hepatic steatosis according to computed tomography and laboratory tests (n=80). Unenhanced abdominal computed tomography was performed with the semi-automatic calculation of visceral adipose tissue volume and single-slice scanning, and hepatic steatosis was assessed using liver density and the liver-to-spleen density ratio index. Laboratory testing included measuring the levels of aspartate aminotransferase, alanine aminotransferase, bilirubin, cholesterol, and bile acids in a subset of patients (n=25 per group), with additional analysis of C-reactive protein, tumor necrosis factor alpha, interleukins 1, 6, and 10, leptin, adiponectin, and the leptin/adiponectin ratio. Results and Discussion. Obesity was significantly more prevalent in patients with non-alcoholic fatty liver disease than in the control group (61% vs. 29%). The mean volume and area of visceral adipose tissue were significantly higher in the study group, i.e., 4,217±134 ml and 175±14 cm² versus 2,803±251 ml and 115±11 cm², respectively (p<0.001). Patients in the study group also demonstrated elevated levels of aspartate aminotransferase, alanine aminotransferase, bilirubin, and cholesterol, as well as the decreased liver density (42.3±2.7 vs. 63.7±3.8 Hounsfield units; p<0.001). In the subset of patients, there were the increased leptin, leptin/adiponectin ratio, and C-reactive protein levels reflecting metabolic and inflammatory imbalance associated with visceral obesity. Conclusions. The integration of computed tomography metrics and serum biomarkers provides a non-invasive, informative assessment of the non-alcoholic fatty liver disease phenotype. This approach can be used for stratifying clinical risk, monitoring disease progression, and optimizing individualized therapeutic strategies.

Keywords: non-alcoholic fatty liver disease, hepatic steatosis, computed tomography, visceral adipose tissue, abdominal obesity, serum biomarkers.

For citation: Djuraeva, N.M.; Ibadov, R.A.; Ibragimov, S.Kh.; et al. Comprehensive assessment of association between abdominal fat depot, hepatic steatosis, and inflammatory serum biomarkers in patients with non-alcoholic fatty liver

REFERENCES

1. Yu J, et al. Visceral adipose tissue has moderate correlation with hepatic steatosis and can predict liver fat content in patients with suspected non‑alcoholic fatty liver disease. J Clin Imaging Sci.2021;10: e2565. DOI: 10.3390/livers3030033

2. Targher G, Byrne CD. Visceral fat and non‑alcoholic fatty liver disease: mechanisms and clinical implications. Nat Rev Endocrinol. 2025;2: 5–15. DOI: 10.1038/ncpendmet0059

3. Miyazaki M, et al. Visceral adiposity and hepatic steatosis: role of adipose tissue dysfunction and inflammation in NAFLD development. Obes Rev. 2023; 24(2): 456–468. DOI: 10.1111/obr.13605

4. Kim JH, et al. Visceral and subcutaneous fat quality and cardiometabolic risk: associations with liver fat content and NAFLD severity. JACC Cardiovasc Imaging. 2013; 6(7): 762–771. DOI: 10.1016/j.jcmg.2012.11.021

5. Nishimura Y, et al. Visceral adipose tissue quantity and quality are independentlyassociated with the prevalence of non‑alcoholic fatty liver disease in middle‑aged adults. Int J Obes. 2020; 44: 123–131. DOI: 10.1038/s41366-020-00787-0

6. Penner KL, et al. Adipose tissue dysfunction increases hepatic lipid accumulation and NAFLD risk: evidence from metabolic, inflammatory and imaging studies. Hepatology. 2024; 79(3): 1024–1036. DOI: 10.1002/hep.31876

7. Limanond P, Raman SS, Lassman C, et al. Macrovesicular hepatic steatosis in living related liver donors: correlation between CT and histologic findings. Radiology. 2004; 230(1): 276–280.

8. Lee JH, Park K, Lee HS, et al. Usefulness of visceral fat area and controlled attenuation parameter in assessing hepatic steatosis severity. J Gastroenterol Hepatol. 2023; 38(5): 870–877. DOI: 10.1111/jgh.16050

9. Ciardullo S, et al. Visceral adiposity predicts hepatic steatosis and fibrosis in individuals with metabolic dysfunction – associated steatotic liver disease. Metabolism. 2024; 128: 155195. DOI: 10.1016/j.metabol.2022.155195

10. Smith SR, et al. Anthropometric indexes for prediction of visceral adipose tissue and non‑alcoholic fatty liver disease: results from a multicenter cohort. Eur J Clin Nutr. 2024; 78(4): 543–552. DOI: 10.1038/s41430-024-01135-8

11. Dorairaj V, Sulaiman SA, Abu N, Abdul M. Non‑alcoholic fatty liver disease: pathogenesis and non‑invasive diagnosis including visceral fat roles. Biomedicines. 2022; 10(1): 15. DOI: 10.3390/biomedicines10010015

12. Rhee EJ, Kwon H, Lee MS. Metabolic scores including visceral fat indices as predictors Of NAFLD and hepatic steatosis severity. Clin Endocrinol (Oxf). 2023; 99(3): 370–377. DOI: 10.1111/cen.14760

13. Zhang LY, et al. Non‑linear relationship between body fat composition and non‑alcoholic fatty liver disease mediated by metabolic score for insulin resistance. J Sci Rep. 2025; 15: 24917. DOI: 10.1038/s41598-025-10765-w

14. Miyake T, Sato K, et al. Visceral adiposity and its relation to hepatic fat fraction measured by MRI in adults with NAFLD: association and clinical correlates. J Magn Reson Imaging. 2024; 59(2): 523–531. DOI: 10.1002/jmri.28018

15. Wildman‑Tobriner B, et al. Hepatic proton density fat fraction correlates with visceral adiposity and histologic steatosis severity in NAFLD. Radiology. 2024; 293(1): 111–119. DOI: 10.1148/radiol.2021204288

16. Cusi K, et al. Visceral‑to‑subcutaneous abdominal fat ratio is associated with non‑alcoholic fatty liver disease and liver fibrosis across ethnic groups. Endocrinol Metab (Seoul). 2020; 35(1): 165–176. DOI: 10.3803/EnM.2020.35.1.165

 

 

УДК: 16.127-005.8

DOI: 10.20969/VSKM.2026.19(4).55-62

 Effect of specialized inpatient motivational counseling on long‑term outcomes in cardiology patients: Results of a 2‑year follow‑up

Khava R. Dovlatukaeva1, Anastasia Yu. Lebedeva1, Rashad A. Faradzhov1, Yulia M. Yufereva1, Alexey O. Shevchenko1

1 N. I. Pirogov Russian National Research Medical University, 1 Ostrovityanov str., Bldg. 6, 117513 Moscow, Russia

Abstract. Introduction. Acute coronary syndrome remains the leading cause of hospitalization and mortality worldwide, while post-discharge prognosis is determined not so much by the quality of the initial intervention as by the patient’s long-term adherence to secondary prevention. Standard patient education in hospital settings often fails to produce sustained behavioral changes. In recent years, the role of motivational counseling has been actively discussed, which is a patient-centered approach aimed at resolving internal ambivalence and enhancing readiness for change. However, evidence of its efficacy specifically during the in-hospital period for acute coronary syndrome remains insufficient, and  domestic data are scarce. Aim. To assess how a specialized motivational counseling program implemented during hospitalization affects the time to the onset of any adverse clinical events, such as calls to a doctor at home, calls to emergency medical services, or rehospitalization, among cardiology patients over a two-year follow-up period. Materials and Methods. This prospective study included 212 patients (78 women and 134 men) with acute coronary syndrome. The intervention group (n=58) got the in-hospital motivational counseling, while the control group (n=154) received standard therapy. The groups were comparable in baseline demographic, clinical, and anatomical characteristics (p>0.05). The primary outcomes included analysis of event-free survival (free from home physician visits, emergency medical service calls, or rehospitalizations) over 2 years. Results and Discussion. At baseline, patients in the intervention group showed poor treatment adherence (with the median Morisky-Green score of 2) and lacked knowledge of risk factors. Motivational counseling demonstrated a statistically significant increase in the duration of no-symptom period across all parameters considered. In the intervention group, the median time before the first request for a home visit was 250 days, which was significantly longer than in the control group (100 days; p = 0.009). The time taken to call an ambulance also increased significantly, from 113 days in the control group to 232 days in the intervention group (p = 0.001). The most significant improvement was seen in terms of time to readmission: 230 days versus 104 days in the control group (p = 0.001). Conclusions. In-hospital motivational counseling is an effective secondary prevention strategy that significantly prolongs the “no-symptom” period, reduces the need for emergency medical care, and improves long-term disease control in post-acute coronary syndrome patients.

Keywords: acute coronary syndrome, myocardial infarction, motivational interviewing, secondary prevention, treatment adherence, quality of life.

For citation: Dovlatukaeva, Kh.R.; Lebedeva, A.Yu.; Faradzhov, R.A.; et al. Effect of specialized inpatient motivational counseling on long‑term outcomes in cardiology patients: Results of a 2‑year follow‑up. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 55-62. DOI: 10.20969/VSKM.2026.19(4).55-62.

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УДК: 616-089.844:616-073.756.8

DOI: 10.20969/VSKM.2026.19(4).63-68

 Clinical significance of preoperative vascular mapping in reduction mammaplasty

Yana V. Kiziun1, Madamin M. Madazimov1, Feruz F. Turaev2, Maria G. Pustovetova3, Nozima A. Akramova4

1Andijan State Medical Institute, 1 Yusuf Otabekov str., 170127 Andijan, Andijan Region, Uzbekistan

2Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov, 10 Kichik Khalk Yuli str., 100115 Tashkent, Uzbekistan

3EMU University, 7/1 Mukimi Street, 100104 Tashkent, Uzbekistan

4Expert Consulting Group, 53 Zavkiy Street, Chilanzar District, 100100 Tashkent, Uzbekistan

Abstract. Introduction. Breast hypertrophy is a pathological condition characterized by excessive breast enlargement that negatively affects the patients’ quality of life, while severe forms, such as gigantomastia, require accurate preoperative vascular assessment to optimize planning the reduction mammaplasty and minimize the risk of nipple-areola complex ischemic complications. Aim. To evaluate the clinical significance of preoperative vascular mapping using color Doppler ultrasound imaging in planning and performing reduction mammaplasty in patients with severe breast hypertrophy. Materials and Methods. A prospective study was conducted involving 50 female patients with severe gigantomastia aged 23-55 years (mean age 35.0±8.2 years). Preoperative ultrasound examination of breast was performed using high-frequency linear transducers (12-18 MHz) with color Doppler ultrasound imaging. The study protocol included assessment of the localization, diameter, and distribution patterns of perforating vessels feeding the nipple–areola complex. The obtained vascular mapping data were used for the individualized selection of the vascular pedicle during reduction mammaplasty. Postoperative outcomes were evaluated based on the nipple-areola complex viability, incidence of complications, and patient satisfaction. Results and Discussion. Preoperative color Doppler ultrasound imaging successfully identified the vascular sources feeding the nipple-areola complex in all patients. The internal thoracic artery perforators were identified as the dominant blood supply source in 29 patients (58%), lateral thoracic artery branches in 13 patients (26%), while a combined vascular pattern was observed in 8 patients (16%). The mean diameter of internal thoracic artery perforators was 1.6±0.4 mm, whereas lateral thoracic artery perforators measured 1.3±0.3 mm. Individualized surgical planning based on preoperative vascular mapping allowed preservation of adequate tissue perfusion. During postoperative follow-up, complete nipple-areola complex viability was achieved in 98% of patients, with partial necrosis observed in 2% of cases. Overall patient satisfaction with surgical outcomes was 96%. Conclusions. Preoperative color Doppler ultrasound vascular mapping is an effective and safe method for assessing breast vascular anatomy in reduction mammaplasty. Identification of dominant and secondary vascular sources enables the individualized selection of the vascular pedicle, preservation of nipple-areola complex perfusion, and reduction of ischemic complications. This approach improves surgical safety and contributes to better functional and aesthetic outcomes in patients undergoing reduction mammaplasty.

Keywords: breast hypertrophy, reduction mammaplasty, color Doppler ultrasound, breast vascular anatomy

For citation: Kiziun, Y.V.; Madazimov, M.M.; Turaev, F. F.; et al. Clinical significance of preoperative vascular mapping in reduction mammaplasty. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 63-68. DOI: 10.20969/VSKM.2026.19(4).63-68.

REFERENCES

1. Pérez Panzano E., Güemes-Sánchez A., Gascón-Catalán A. Quality of Life Following Symptomatic Macromastia Surgery: Short- and Long-term Evaluation. Breast J. 2016;22:397–406. DOI: 10.1111/tbj.12589

2. Longo B, Campanale A, Santanelli di Pompeo F. Nipple–areola complex cutaneous sensitivity: a systematic approach to classification and breast volume. J Plast Reconstr Aesthet Surg. 2014; 67: 1630–1636.

3. Мадазимов М.М., Тураев Ф.Ф., Кизюн Я.В., [и др.]. Персонализированный подход к редукционной маммопластике на основе допплеровского ультразвукового определения  кровоснабжения сосково-ареолярного комплекса // JHNS. – 2025. – Т. 30, № 1. – С. 169–176. Madazimov MM, Turaev FF, Kizyun YaV, et al. Personalizirovannyy podkhod k reduktsionnoy mammoplastike na osnove dopplerovskogo ul’trazvukovogo opredeleniya krovsnabzheniya soskovo-areolyarnogo kompleksa [Personalized approach to reduction mammoplasty based on Doppler ultrasound assessment of blood supply of the nipple–areola complex]. JHNS. 2025; 30 (1): 169–176. (In Russ.)

4. Salas-López A, Morgado-Águila C, López-de-Celis C, et al. Breast Vascularization and Its Implication in Breast Reduction and Mastopexy Surgery: Anatomical Study. Journal of Personalized Medicine. 2024; 14(5):536. DOI: 10.3390/jpm14050536

5. Li X, Geng J, Jin D, et al. Preoperative visualization of mammary artery for breast reduction surgery based on computed tomography angiography. Egypt J Radiol Nucl Med. 2024; 55: 1. DOI: 10.1186/s43055-023-01170-2

6. Schmidt G, Mayo T, von Falkenhausen A, et al. Mapping internal and lateral anterior intercostal artery perforator flaps with colour Doppler ultrasound: correlation between preoperative imaging and intraoperative findings in oncoplastic breast surgery. Arch Gynecol Obstet. 2026; 313: 160. DOI: 10.1007/s00404-026-08417-z

7. Wang D, Wang Y, Zhang Q, Wu Y. Hypertrophic breasts versus normal-sized breasts: comparison of blood supply to the nipple–areola complex based on DCE-MRI. J Plast Reconstr Aesthet Surg. 2023; 76: 191–197.

8. Elmelegy N, Shokr T, Osama M. Nipple–areola complex ischemia or necrosis in freestyle perforator flap reduction mammoplasty operations. Aesthet Plast Surg. 2019; 43: 1506–1514.

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10. Eleiba RA, Elfeki B, Ismail KA, Hegazy SA. A clinical score for predicting complications following breast reduction. J Pak Med Assoc. 2023; 73: S82–S86.

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12. egas MR, Martina L, Segovia-Gonzalez M, Garcia-Garcia JF, et al. Vascular anatomy of the breast and its implications in the breast-sharing reconstruction technique. J Plast Reconstr Aesthet Surg. 2023; 76: 180–188.

13. Berberoğlu Ö, Temel M, Türkmen A. Effects of Reduction Mammaplasty Operations on the Spinal Column: Clinical and Radiological Response. Aesth Plast Surg. 2015; 39:514-522. DOI: 10.1007/s00266-015-0516-6

14. Egorov YuS, Dzottsoev AK. The blood supply to the nipple-areolar complex (a literature review). Tumors of Female Reproductive System. 2017;13:42-46. DOI: 10.17650/1994-4098-2017-13-2-42-46

15. Wuringer E. Secondary reduction mammaplasty. Plast Reconsr Surg. 2002;109(2):812-814.

 

УДК: 616.5-089.87:577.1

DOI: 10.20969/VSKM.2026.19(4).69-74

 Enhancing the efficacy of facial lipofilling in aesthetic and post‑traumatic deformities using cell‑based technologies

Madamin M. Madazimov1, Feruz F. Turaev2, Khava Y. Mohamed1, Maria G. Pustovetova3, Nozima A. Akramova4

1Andijan State Medical Institute, 1 Yusuf Otabekov str., 170127 Andijan, Andijan Region, Uzbekistan

2 Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov,

10 Kichik Khalk Yuli str., 100115 Tashkent, Uzbekistan

3EMU University, 7/1 Mukimi str., 100104 Tashkent, Uzbekistan

4Expert Consulting Group, 53 Zavki str., Chilanzar District, 100100 Tashkent, Uzbekistan

Abstract. Introduction. Modern aesthetic and reconstructive facial surgery is rapidly evolving toward cellular and regenerative technologies that enhance fat graft survival and improve soft tissue quality. Enriching lipofilling with the stromal-vascular fraction has become a trending approach, providing long-lasting results and reducing repeated procedures. Aim. To evaluate the efficacy and safety of facial lipofilling enhanced with cellular technologies, specifically, autologous adipose tissue enriched with the stromal-vascular fraction for the correction of aesthetic and post-traumatic facial deformities. Materials and Methods. The study included 50 patients aged 25–65 years (45.2±10.5) with aesthetic defects or post-traumatic changes of the facial soft tissues. Patients were assigned to two groups: Study group (n=25) receiving lipofilling with fat enriched with the stromal-vascular fraction, and the control group (n=25) receiving standard lipofilling without any enrichment. Fat tissue was harvested under infiltration anesthesia, and it was processed and injected using a microinjection technique. Fat was harvested under infiltration anesthesia and microinjected; outcomes were assessed after 6 and 12 months using 3D photogrammetry, patient satisfaction, and surgeon evaluation. Safety was evaluated based on the incidence of early postoperative complications. Results and Discussion. Six months after the procedure, post-lipofilling patients with fat tissue enriched with the stromal-vascular fraction demonstrated significantly higher graft survival compared to the control group. The mean fat tissue volume retention in the study group was 78.2±5.4%, whereas it was 56.1±6.8% (p<0.001) in the control group. Patients in the study group also showed a significant improvement in the quality of the skin and facial soft tissues: Skin elasticity index increased by 17.5±3.2%, compared to 6.8±2.7% in the control group (p<0.01). The aesthetic score on the Global Aesthetic Improvement Scale was higher in the study group (4.5±0.3 points) than in the control group (3.2±0.4 points, p<0.001). Conclusions. Facial lipofilling with autologous adipose tissue enriched with the stromal-vascular fraction significantly improves graft survival compared to traditional methods and leads to a statistically significant enhancement of aesthetic outcomes, as measured by the Global Aesthetic Improvement Scale.

Keywords: facial lipofilling, stromal-vascular fraction, autologous adipose tissue, cosmetic surgery, post-traumatic reconstruction.

For citation: Madazimov, M.M.; Turaev, F. F.; Mohamed, Kh.Y; et al. Enhancing the efficacy of facial lipofilling in aesthetic and post‑traumatic deformities using cell‑based technologies. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 69-74. DOI: 10.20969/VSKM.2026.19(4).69-74.

REFERENCES

1. Roshdy OH, Abdallah WI, Farid CI, et al. Stromal vascular fraction improves the durability of autologous fat temple augmentation – a split-face randomized study using ultrasound biomicroscopy. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2022;75(6):1870–1877. DOI: 10.1016/j.bjps.2021.12.005

2. Gontijo-de-Amorim NF, Charles-de-Sá L, Rigotti G. Mechanical Supplementation With the Stromal Vascular Fraction Yields Improved Volume Retention in Facial Lipotransfer: A 1-Year Comparative Study. Aesthet Surg J. 2017 Oct 1;37(9):975-985. DOI: 10.1093/asj/sjx115

3. Cai W, Yu LD, Tang X, Shen G. The Stromal Vascular Fraction Improves Maintenance of the Fat Graft Volume: A Systematic Review. Ann Plast Surg. 2018 Sep;81(3):367-371. DOI: 10.1097/SAP.0000000000001589

4. Bonta M., Daina L., Muţiu G. The process of ageing reflected by histological changes in the skin. Romanian Journal of Morphology and Embryology. 2013;54(3 Suppl):797–804.

5. Nasim S, Nasim H, Kauke M, Safi AF.Autologous fat grafting for cosmetic temporal augmentation: a systematic review. Front Surg. 2024;11:1410162. DOI:10.3389/fsurg.2024.1410162

6. Vania R, Sanjaya IG, Hamid AR, et al. Early activation of macrophage-2 with IL-4 in stromal vascular fraction increases VEGF levels and adipocyte count and maintains volume of fat graft in Wistar rats (Rattus norvegicus). Narra J. 2024;4(3):e1080. DOI: 10.52225/narra.v4i3.1080

7. Yin Y, et al. Autologous fat graft assisted by stromal vascular fraction improves facial skin quality: A randomized controlled trial. J Plast Reconstr Aesthet Surg. 2020;73(6):1166-1173. DOI: 10.1016/j.bjps.2019.11.010

8. Wufuer M, et al. Improving Facial Fat Graft Survival Using Stromal Vascular Fraction-Enriched Lipotransfer: A Multicenter Rando­ mized Controlled Study. Plast Reconstr Surg. 2024;153(4):690e-700e. DOI: 10.1097/PRS.0000000000010625

9. Gentile P, et al. Mechanical Supplementation With the Stromal Vascular Fraction Yields Improved Volume Retention in Facial Lipotransfer: A 1-Year Comparative Study. Aesthet Surg J. 2017. DOI: 10.1093/asj/sjx148

10. Zhou Y, et al. The Stromal Vascular Fraction Improves Maintenance of the Fat Graft Volume: A Systematic Re­ view. Aesthetic Plast Surg. 2018; 81(3):367–371. DOI: 10.1007/s00266-018-1191-0

11. Yin Y, Li J, Li Q, et al. Autologous fat graft assisted by stromal vascular fraction improves facial skin quality: A randomized controlled trial. J Plast Reconstr Aesthet Surg. 2020 Jun;73(6):1166-1173. DOI: 10.1016/j.bjps.2019.11.010

12. Vinci V, Bucci F, Caimi E, et al. Elliptical Lipoaspirate Activation Versus Coleman Technique: A Randomized Double-Blinded Clinical Trial on Adipose Tissue Grafting for Scar Treatment. Aesthetic Plast Surg. 2025;49(10):2783-2798. DOI: 10.1007/s00266-025-04804-0

13. Fang J, Chen F, Liu D, et al. Adipose tissue-derived stem cells in breast reconstruction: a brief review on biology and translation. Stem Cell Res Ther. 2021;12(1):8. DOI: 10.1186/s13287-020-01955-6

14. Мадазимов М.М., Мохамед Х.Ю., Тураев Ф.Ф., [и др.]. Оценка эффективности клеточно-обогащенного липофилинга в коррекции возрастных изменений мягких тканей лица // Медицинский журнал молодых ученых. – 2025. – Т. 1, № 16(12). – С. 53–56. Madazimov MM, Mohamed HY, Turaev FF, et al. Otsenka effektivnosti kletochno-obogashchennogo lipofilinga v korrektsii vozrastnykh izmeneniy myagkikh tkaney litsa [Evaluation of the effectiveness of cell-enriched lipofilling in the correction of age-related changes in facial soft tissues]. Meditsinskiy zhurnal molodykh uchenykh. 2025;1(16(12)):53–56. (In Russ.)

 

УДК: 611:57.087

DOI: 10.20969/VSKM.2026.19(4).75-85

 Experimental quantitative morphometric assessment of morpho-functional changes in the liver following long-term dipsacoside administration

Avazbek R. Mamataliev1, Yuriy D. Azizov1, Dilfuza T. Isanova1, Gulsara D. Reymnazarova2, Sodiqjon S. Saydaliev1, Andrey N. Don2

1 Andijan State Medical Institute, 1 Yusuf Otabekov str., 170127 Andijan, Andijan Region, Uzbekistan

2Tashkent State Medical University, 2 Farobiy str., Admazar District, 100109 Tashkent, Uzbekistan

Abstract. Introduction. Modern morphology relies on quantitative methods to accurately assess structural and morphofunctional changes. Dipsacoside, a triterpene saponin with hypolipidemic effects, is a promising compound for liver-related research. Aim. To identify the morphological and morphometric changes in the liver under the influence of dipsacoside. Materials and Methods. The study was conducted on 45 sexually mature outbred male rabbits maintained under standard vivarium conditions. Liver morphology was examined using histological specimens stained with hematoxylin and eosin. Morphometric analysis included the point-counting method, as well as cytometric and karyometric measurements. Statistical analysis involved the evaluation of morphometric parameters, correlation analysis, and ROC analysis to assess predictive performance. Results and Discussion. Administration of dipsacoside resulted in sequential morphofunctional changes in the liver. After 30 days, a tendency toward increased hepatocyte volume was observed alongside a statistically significant increase in nuclear volume (p < 0.001), indicating enhanced synthetic activity. At 60 days, both hepatocyte and nuclear volumes increased significantly (p = 0.002), reflecting stable functional reorganization of liver cells. By day 90, nuclear volume remained significantly elevated (p < 0.001), while changes in hepatocyte volume were not statistically significant. ROC analysis demonstrated high predictive value of morphometric parameters (AUC up to 1.000), while correlation analysis revealed a moderate positive relationship between hepatocyte and nuclear volumes (ρ up to 0.664), confirming the systemic nature of the observed changes. These findings suggest activation of centrilobular hepatocytes with increased metabolic and synthetic activity. Given the liver’s central role in lipid metabolism, such changes may represent a morphological correlate of the hypolipidemic effect of dipsacoside. Conclusions. Dipsacoside induces significant morphofunctional changes in the liver, particularly characterized by increased nuclear volume and activation of hepatocyte function at 30 and 60 days. Morphometric methods combined with advanced statistical analysis proved highly informative for assessing these changes. The findings support the potential of dipsacoside as a promising agent for the correction of lipid metabolism disorders and prevention of atherosclerosis.

Keywords: morphometry, liver, hepatocytes, dipsacoside, triterpene saponins, hypolipidemic effect, correlation analysis.

For citation: Mamataliev, A.R.; Azizov, Y.D.; Isanova, D.T.; et al. Experimental quantitative morphometric assessment of morpho-functional changes in the liver following long-term dipsacoside administration. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 75-85. DOI: 10.20969/VSKM.2026.19(4).75-85.

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3. Don AN, Nagay SG, Sadikova DZ. Assesment of morphological changes in the thyroid gland by test-point method with the introduction of dipsacoside. Astana meditsinalyk zhurnaly [Astana Medical Journal]. 2022;(S1):181–186. (In Russ.). статья на анг языке DOI: 10.54500/2790-1203.S1.2022.181-186

4. Чумаченко П.А. О совокупном морфофункцио­ наль­ном показателе активности щитовидной железы // Архив патологии. – 1980. – № 4. – С. 84–85. Chumachenko PA. O sovokupnom morfofunktsional’nom pokazatele aktivnosti shchitovidnoy zhelezy [On the integrated morphofunctional indicator of thyroid gland activity]. Arkhiv patologii [Archives of Pathology]. 1980;(4):84–85. (In Russ.)

5. Дон, А. Н. Морфология щитовидной железы в фокусе тиреодологии: экспериментальное исследование трансформации. – Ташкент, 2025. – С. 30. Don AN. Morfologiya shchitovidnoy zhelezy v fokuse tireoidologii: eksperimental’noe issledovanie transformatsii [Thyroid gland morphology in the focus of thyroidology: experimental study of transformation]. 2025;30 p. (In Russ.)

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УДК: 616.248-036.22:616.211-002-036.22:613.84

DOI: 10.20969/VSKM.2026.19(4).86-92

 Allergic respiratory diseases in children aged 6-7 and 13-14 years: Five-year trends and behavioral risk factors

Olga S. Medvedeva1

1Tyumen State Medical University, 54 Odesskaya str., 625023 Tyumen, Russia

Abstract. Introduction. Allergic respiratory diseases in children and adolescents are still highly prevalent, while symptom-based indicators often exceed the rate of official diagnoses. Assessment of temporal trends using standardized international instruments allows an objective evaluation of epidemiological patterns and the completeness of disease detection. Aim. To assess the five-year dynamics of the prevalence of bronchial asthma and allergic rhinitis symptoms in children aged 6-7 years and adolescents aged 13-14 years in Tyumen, to evaluate the relationship between symptom prevalence and physician-diagnosed bronchial asthma, and to analyze changes in behavioral risk factors in 2019-2025. Materials and Methods. A repeated population-based cohort epidemiological study was conducted using the standardized Global Asthma Network questionnaire. A total of 5,978 valid questionnaires dated 2019 and 5,947 dated 2025 were analyzed. Calculated values included absolute and relative measures (n, %), relative risk, and 95% confidence intervals. Proportions were compared using the chi-square test. Statistical significance was set at p<0.05. Results and Discussion. The prevalence of bronchial asthma symptoms remained stable over the five-year period and accounted to approximately 20% in children aged 6-7 years and 17% in adolescents aged 13-14 years. The prevalence of physician-diagnosed bronchial asthma remained substantially lower, indicating a persistent discrepancy between symptom prevalence and official disease registration. Among children aged 6-7 years, a trend toward increasing allergic rhinitis symptoms was observed, while a decrease in rhinitis symptoms was accompanied by an increase in diagnosed pollinosis in adolescence. Discernible unfavorable changes were identified in behavioral risk factors, namely: Cigarette smoking increased more than fourfold, and the use of electronic nicotine delivery systems increased more than fourteenfold among adolescents (p<0.001). Conclusions. Bronchial asthma symptoms in children and adolescents in Tyumen are still highly prevalent without a corresponding increase in confirmed diagnoses. The substantial rise in nicotine exposure among adolescents highlights the need to strengthen preventive and early diagnostic strategies.

Keywords: bronchial asthma; allergic rhinitis; children and adolescents; under-diagnosis; vaping; population-based study

For citation: Medvdeva, O.S. Allergic respiratory diseases in children aged 6-7 and 13-14 years: Five-year trends and behavioral risk factors. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 86-92. DOI: 10.20969/VSKM.2026.19(4).86-92.

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10. Tiotiu A, Novakova P, Nedeva D, et al. Impact of tobacco smoke on asthma and COPD. Front Med. 2021; 8: 620160. DOI: 10.3389/fmed.2021.620160

11. Wang MP, Ho SY, Leung LT, Lam TH. Electronic cigarette use and respiratory symptoms in adolescents. Thorax. 2022; 77 (3): 257–264. DOI: 10.1136/thoraxjnl-2021-217041

12. Xie Z, Ossip DJ, Rahman I, Li D. Electronic cigarette use and respiratory symptoms among youth. Am J Respir Crit Care Med. 2023; 207 (2): 201–210. DOI: 10.1164/rccm.202203-0560OC

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УДК: 616.314-089.843-053.6-073.75

DOI: 10.20969/VSKM.2026.19(4).93-99

 Dental implantation in adolescents with congenital agenesis of the maxillary lateral incisors: A 10‑13‑year follow‑up of marginal bone stability and success factors

Luiza I. Nikitina1, Sharora F. Dzhuraeva1

1 Chuvash State University named after I.N. Ulyanov, 15 Moskovsky Ave., 428015 Cheboksary, Russia

Abstract. Introduction. Congenital agenesis of upper lateral incisors is a significant clinical and aesthetic problem in adolescent dentistry. Dental implantation is the treatment of choice for rehabilitation, but its long-term success is determined by the preservation of marginal bone stability. Aim. To analyze the long-term outcomes (10–13 years) of peri-implant tissue condition and identify factors contributing to the prevention of marginal bone resorption in adolescents with congenital agenesis of upper lateral incisors. Materials and Methods. A retrospective cohort study was conducted with 14 patients (8 girls, 6 boys) aged 14–17 years at the time of implantation. A total of 28 implants (Nobel Biocare, Straumann, MIS) were placed in the maxillary lateral incisor region (2011–2024). All patients underwent preliminary orthodontic treatment. Evaluation included clinical parameters, such as peri-implant pocket depth (PPD), bleeding on probing (BOP), and stability, and radiographic analysis, such as cone beam computed tomography and periapical radiographs). Results and Discussion. Implant survival rate was 100% over the follow-up period. Median PPD was 2.7 mm. Signs of inflammation (BOP) were noted in 7.1% of implants, pocket depth >5 mm – in 3.6%. Progressive bone resorption according to cone beam computed tomography was absent in all patients. The absence of peri-implant complications was recorded in 90% of cases. High results are associated with an integrated approach: digital planning based on cone beam computed tomography, the use of minimally invasive surgical protocols (including the On1 concept), biologically oriented prosthetics, and strict hygiene control. Conclusions. Long-term success of dental implantation in adolescents with agenesis is achievable with an interdisciplinary approach, the key elements of which are precise planning, atraumatic surgery, and effective prevention. Marginal bone stability (median bone loss 1.1–1.2 mm) over more than 10 years of follow-up demonstrates the effectiveness of the applied strategy.

Keywords: congenital agenesis, dental implants, bone resorption, peri-implantitis, long-term outcomes.

For citation: Nikitina, L.I.; Dzhuraeva, Sh.F. Dental implantation in adolescents with congenital agenesis of the maxillary lateral incisors: A 10 13 year follow up of marginal bone stability and success factors. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 93-99. DOI: 10.20969/VSKM.2026.19(4).93-99.

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13. Никитина Л.И., Мухамеджанова Л.Р., Громова А.С. Использование цифровых технологий при реабилитации пациентов с первичной адентией // Вестник современной клинической медицины. – 2024. – Т. 17, вып. 3. – С.101–107. Nikitina LI, Mukhamedzhanova LR, Gromova AS. Ispol’zovanie tsifrovykh tekhnologii pri reabilitatsii patsientov s pervichnoi adentiei [The use of digital technologies in the rehabilitation of patients with primary adentia]. Vestnik sovremennoi klinicheskoi meditsiny [Bulletin of Modern Clinical Medicine]. 2024; 17(3): 101-107. (In Russ.) DOI: 10.20969/VSKM.2024.17(3).101-107

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УДК: 616.006.6-073.756

DOI: 10.20969/VSKM.2026.19(4).100-104

 Magnetic resonance imaging and machine learning in the differential diagnostics of ovarian cancer grades and stages

Mukhayo R. Khayitboeva1, Madina I. Tairova1, Kubat Sh. Ibraimov2, Temirlan B. Beksultanov2, Alexey A. Oginsky2, Yulduz A. Karimova3, Zilola D. Mirtadzhieva4

1Tashkent State Medical University, 2 Farabi str., 100109, Tashkent, Republic of Uzbekistan

2I. K. Akhunbaev Kyrgyz State Medical Academy, 92 I. Akhunbaev str., 720020, Bishkek, Kyrgyz Republic

3Tashkent State Medical University, 103 Makhtumkuli str., Tashkent, Republic of Uzbekistan

4Medical and Preventive Center under the Council of the Federation of Trade Unions of the Republic of Uzbekistan,

159A Shortepa str., Mirzo-Ulugbek district, Tashkent, Republic of Uzbekistan

Abstract. Introduction. Treatment strategy and prognosis in ovarian cancer largely depend on tumor grade and disease stage. Accurate preoperative differentiation between low-grade and high-grade tumors and assessment of the disease extent are essential for optimal treatment planning. Aim. To evaluate the diagnostic performance of magnetic resonance imaging combined with machine learning techniques in differentiating low-grade and high-grade ovarian cancer and in distinguishing limited and advanced stages of the disease. Materials and Methods. The study included 69 patients with histologically verifi ed ovarian cancer for malignancy grade assessment and 97 patients for disease staging analysis. Thirteen magnetic resonance imaging features and two clinical parameters — menopausal status and serum cancer antigen CA-125 level — were used as input variables. Machine learning–based predictive models were developed using logistic regression with stepwise feature selection. Statistical analysis included correlation analysis and ROC analysis. Results and Discussion. Conventional visual assessment of magnetic resonance imaging features showed limited ability to differentiate ovarian cancer malignancy grades. Application of machine learning enabled development of a predictive model for malignancy grade differentiation with an area under the ROC curve of 0.799±0.063, sensitivity of 96.0%, and accuracy of 84.1%. The machine learning–based model for disease stage differentiation demonstrated an area under the ROC curve of 0.743±0.048. Conclusions. Machine learning–based analysis of magnetic resonance imaging and clinical data signifi cantly enhances the diagnostic performance of MRI in preoperative assessment of ovarian cancer malignancy grade and stage and represents a promising tool for personalized treatment planning.

Keywords: magnetic resonance imaging; ovarian cancer; machine learning; malignancy grade; staging.

For citation: Khayitboeva, M.R.; Tairova, M.I.; Ibraimov, K.Sh.; et al. Magnetic resonance imaging and machine learning in the differential diagnostics of ovarian cancer grades and stages. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 100-104. DOI: 10.20969/VSKM.2026.19(4).100-104.

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УДК: 616.314-089.843-036.1

DOI: 10.20969/VSKM.2026.19(4 ).105-111

 Comprehensive rehabilitation of patients following tooth extraction

Igor V. Chumakov1, Alexander V. Moskovsky1

1 I.N. Ulyanov Chuvash State University, 15 Moskovsky Ave., 428015 Cheboksary, Chuvash Republic, Russia.

Abstract. Introduction. Tooth extraction is a common surgical procedure often followed by postoperative complications, such as pain, swelling, or prolonged healing. Physiotherapeutic methods, including cryotherapy, electrophoresis, and ultrasound therapy, are proposed as effective means to improve recovery. Aim. To evaluate the impact of these methods on relieving pain, reducing swelling, and accelerating tissue regeneration. Materials and Method. A randomized controlled trial was conducted with 60 patients divided into two groups: Control (standard treatment) and experimental (standard treatment + physiotherapy). Assessment criteria included pain intensity (Visual Analog Scale, VAS), degree of swelling, and healing time. Cryotherapy, Novocain electrophoresis, and  ultrasound therapy were used. Statistical analysis was performed using the t-test in SPSS 25.0. Results and Discussion: The experimental group showed a significant reduction in pain by 32% (day 3) and 55% (day 7), a decrease in swelling by 25% and 40%, respectively, and a 1.5-day shorter healing time compared to the control group (p < 0.01). Side effects were minimal. Physiotherapeutic methods demonstrate high effi cacy in postoperative recovery after tooth extraction, reducing pain, swelling, and accelerating healing. The results support the feasibility of integrating these methods into clinical practice. Further research is needed to optimize protocols and assess long-term effects. Conclusions. The use of a complex of physiotherapeutic methods, such cryotherapy, electrophoresis with Novocain, and ultrasound therapy, in the postoperative period after tooth extraction significantly reduces pain syndrome, reduces swelling, and shortens the time required for tissue healing. The results obtained confi rm the effectiveness and safety of this approach, which allows us to recommend implementing it in clinical practice to improve the quality of the patients’ postoperative rehabilitation.

Keywords: rehabilitation, too th extraction, cryotherapy, electrophoresis, ultrasound therapy.

For citation: Chumakov, I.V.; Moskovsky, A.V. Comprehensive rehabilitation of patients following tooth extraction. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 105-111. DOI: 10.20969/VSKM.2026.19(4).105-111.

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УДК: 616.12-008.331-053.9:616.98:578.834.1

DOI: 10.20969/VSKM.202 6.19(4).112-121

 Assessment of changes in clinical and laboratory findings in older post-COVID-19 patients with hypertension

Asya A. Shadieva1, Elena N. Chernysheva1, Elena A. Lyalyukova2

1 Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia

2Omsk State Medical University, 12 Lenin str., 644099 Omsk, Russia

Abstract. Introduction. Some post-COVID-19 patients may develop signs of cardiovascular damage. Those at highest risk for developing cardiovascular complications include patients aged over 65 years, those with chronic obstructive pulmonary disease, diabetes, obesity, malignancies, and immunodefi ciency conditions. Arterial hypertension is one of the most common conditions in older patients who have recovered from COVID-19. In post-COVID-19 patients, hypertension may worsen due to activation of the renin-angiotensin-aldosterone system, chronic infl ammation, hypoxia, and other mechanisms. Aim. To assess key clinical and functional indicators in post-COVID-19 individuals aged over 60 years with hypertension. Materials and Methods. The study included 98 patients aged over 60 years, who were divided into 3 groups: Group 1 – post-COVID-19 patients with arterial hypertension, Group 2 – patients with arterial hypertension without COVID-19 history, Group 3 was a control group. A prospective cohort study was conducted, assessing anamnestic data and using physical and laboratory research methods. Patients were examined at inclusion in the study and after 6 months. Results and Discussion. Patients in Group 1 presented complaints and required intensification of antihypertensive therapy signifi cantly more often than patients in Group 2. Patients in Group 1 also had higher levels of ESR, leukocytes, platelets, creatinine, uric acid, total cholesterol, and low-density lipoproteins. In participants with COVID-19, complications occurred in 54% of cases, compared to 7% in the group without the history of this disease. Complications included stroke, myocardial infarction, deep vein thrombosis, pulmonary embolism, and the development of refractory hypertension. Conclusions. Older hypertensive patients who recovered from COVID-19  (Group 1) had signifi cant changes in clinical and laboratory test results compared to patients with hypertension without COVID-19 history (Group 2), as well as a higher risk of developing cardiovascular complications.

Keywords: post-COVID-19, patients aged over 60 years, arterial hypertension, post-COVID cardiovascular complications.

For citation: Shadieva, A.I.; Chernysheva, E.N.; Lyalyukova, E.A. Assessment of changes in clinical and laboratory findings in older post-COVID-19 patients with hypertension // The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 112-121. DOI: 10.20969/VSKM.2026.19(4).112-121.

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REVIEWS

УДК: 614.2

DOI: 10. 2096 9/VSKM.2026.19(4).122-130

 Controlled adaptability index: A cybernetic model for assessing the national anti-drug system (Part II)

Azis V. Akhokhova 1, Amina T. Mishkhozheva1, Milana M. Khamzhueva1, Izabella R. Atabaeva1

1 Kabardino-Balkarian State University named after Kh.M. Berbekov, 173 Chernyshevsky str., 360004 Nalchik, Kabardino-Balkarian Republic, Russia

Abstract. Introduction. Modern anti-drug policy faces nonlinear dynamics of the drug market, multiple heterogeneous actors, and delays in management response, which requires the development of formalized cybernetic models to assess the adaptability of the state system. Aim. The objective of the study is to develop a formalized cybernetic architecture AURA (Adaptive Unifi ed Regional Antidrug Architecture) to assess the meso-level adaptability of the regional anti-drug system. Materials and methods. The study applies a systems-cybernetic approach based on the Viable System Model and Ashby’s law of requisite diversity, with an analysis of aggregated interdepartmental structural, temporal, network, and medical indicators of the regional anti-drug system. The indicators are normalized using the min-max method, the contour weighting coeffi cients are determined by the Delphi method, the three-loop AURA architecture (L1–L3) is formalized as a recursive model taking into account the inertia parameter λ. Results and discussion. A recursive three-loop architecture, AURA (L1–L3), has been developed, combining the data, coordination, and strategic regulation loops and aligned with the Viable System Model levels. The index of controlled adaptability, At, has been formalized, aggregating the normalized parameters of structural (C/F*), temporal (1–T_gap*), network (ρ*), and medical (M_d*) adaptability. For the fi rst time within the Viable System Model approaches, the medical loop has been included as an independent component of system viability, ensuring a direct link between management decisions and clinical outcomes (remission, treatment coverage, mortality). The At index is calculated using a recursive formula with inertia λ and weighting coeffi cients w1–w4 determined using the Delphi method and statistical validation. Conclusions. The AURA architecture enables a transition from reactive to feed-forward management, the integration of disparate data into a single digital system, and the generation of predictive indicators for the viability of regional anti-drug policies. Practical limitations are related to the completeness of interdepartmental data, the variability of network connections, and the standardization of medical indicators. The obtained results form a computable basis for constructing digital public health management frameworks and assessing the viability of anti-drug policies in the constituent entities of the Russian Federation.

Keywords: AURA, controlled adaptivity, Viable System Model, cybernetics, dynamic thresholds.

For citation: Akhokhova, A.V.; Mishkhozheva, A.T.; Khamzhueva, M.M.; Atabaeva, I.R. Controlled adaptability index: A cybernetic model for assessing the national anti-drug system (Part II). The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 122–130. DOI: 10.20969/VSKM.2026.19(4).122-130.

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УДК 616-08-039.71

DOI: 10.2096 9/VSKM.2026.19(4).131-139

 Modern approaches to the prevention of hemostatic disorders to improve pregnancy outcomes

Irina A. Karpova1, Victor A. Platitsyn1, Anastasia S. Pavlenko1,2, Elena A. Mateykovich1, Valentina A. Polyakova1, Maria R. Nekrasova 1,3, Aleksey I. Sozonov1

1 Tyumen State Medical University, 54 Odesskaya str., 625023 Tyumen, Russia

2 Ural State Medical University, 3 Repin str., 620028 Yekaterinburg, Russia

3 Tyumen State Regional Hospital, 55 Kotovsky str., 625027 Tyumen, Russia

Abstract. Introduction. Pregnancy loss, including spontaneous miscarriages and late reproductive losses, represents a complex medical and social issue. One of the key underlying pathogenic links is the hemostatic system disorders. In pregnancy, physiological hypercoagulation can take a pathological form leading to microtromboses in placental vessels, to placental insuffi ciency, and eventually to pregnancy interruption or to severe obstetric complications, such as preeclampsia or fetal growth retardation. Aim. To systematize and analyze modern approaches to the prevention hemostatic disorders in patients with history of threatened miscarriage or actual loss of pregnancy at different gestational ages. Materials and Methods. Bibliometric analysis was conducted. Literature was searched for and selected in databases, such as PubMed, eLIBRARY, Сyberleninka, and DOAJ, for the period of 1999-2025. Eligibility criteria were met by 53 full-text articles published in peer-reviewed journals, both in Russian and in English, dealing with the pharmacological correction of hemostatic disorders in miscarriage. Resultsand Discussion. Preventive strategies vary depending on the trimester and the leading pathogenetic factor. In case of confi rmed antiphospholipid syndrome, the standard treatment includes combined therapy with low doses of the acetylsalicylic acid and the preventive doses of low molecular weight heparin throughout the pregnancy with possible addition of hydroxychloroquine if the risk is high. For patients with hereditary thrombophilia and bad obstetric history, the drug of choice is low molecular weight heparin, often combined with acetylsalicylic acid. To correct hyperhomocysteinemia associated with polymorphism of folate cycle genes, pregravid therapy is prescribed with the elevated doses of active folates. High efficacy the daily use of 150 mg of the acetylsalicylic acid, starting from the 1st trimester of pregnancy is proven to prevent preeclampsia and fetal growth retardation associated with it, while in case of very high risk, it is recommended to combine it with low molecular weight heparin. In therapy control, the integral coagulologic monitoring methods, such as thrombodynamics, play a key role. Conclusions. Modern approach to the prevention of reproductive losses associated with hemostatic disorders is based on the principals of individual risk stratifi cation, early diagnosis of pathological conditions, and timely initiation of personalized antithrombotic and pathogenetic therapy. Treatment optimization is possible using the modern techniques of hemostasis laboratory control.

Keywords: hemostatic disorders, prevention, low molecular weight heparin, aspirin, pregnancy outcome.

For citation: Karpova, I.A.; Platitsyn, V.A.; Pavlenko, A.S.; et al. Modern approaches to the prevention of hemostatic disorders to improve pregnancy outcomes. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 131-139. DOI: 10.20969/VSKM.2026.19(4).131-139.

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УДК: 615.015.8

DOI: 10.2096 9/VSKM.2026.19(4).140-148

 International strategies for combating the spread of antibiotic resistance in microorganisms: A review of scientific literature

Viktoria V. Cherkasova1, Olga I. Knysh1

1 Tyumen State Medical University, 54 Odesskaya str., 635023 Tyumen, Russia

Abstract. Introduction. Antimicrobial resistance (AR) of microorganisms is one of the most serious global threats to human health, leading to millions of deaths yearly. The problem is particularly relevant due to the uncontrolled use of antibiotics in veterinary medicine and animal husbandry, which creates the main evolutionary pressure on the formation and spread of resistant bacterial strains. Given the global nature of the threat that does not recognize state borders, it is critically important to study and compare international regulatory experience to identify the most effective strategies and adapt successful practices. Aim. To summarize research data on the problem of global antibiotic resistance and effective international strategies to combat it. Materials and Methods. Modern international scientifi c research on the AR issues, data from global monitoring systems, such as GLASS or ESVAC, and the World Health Organization (WHO) reports and national regulatory documents were analyzed. Results and Discussion. It has been found that the veterinary sector is the key consumer of antibiotics: In som e countries, the volume of their use in animals is twice as high as medical use. The main risks of uncontrolled turnover of antibiotics in veterinary medicine have been identified: Direct spread of resistant zoonoses, such as salmonellosis, brucellosis, etc., the ingress of drug residues into the food chain, and environmental pollution followed by developing antibiotic-resistant microorganisms. Empirical evidence (the experience of Denmark, Spain, and Italy) proves that strict legislative constraints, such as prohibition of preventive use and growth stimulants, lead to a signifi cant reduction in consumption without compromising productivity. It has been determined that comprehensive measures to combat the AR bacteria spread are the most effective. It was proven that it is necessary to introduce an integrated “One Health” approach and coordinate the actions of the human, animal and environmental health sectors. Conclusions. Fighting against AR requires priority and strict control over the use of antibiotics in animal husbandry. The most effective strategy includes combining balanced legislative regulation, raising the AR awareness, implementing training programs for veterinarians and farmers, developing alternative treatment and prevention techniques, and internationally integrating within the framework of the “One Health” concept.

Keywords: antibiotic resistance, resistant strains, uncontrolled turnover of antibiotics

For citation: Cherkasova, V.V.; Knysh, O.I. Internati onal strategies for combating the spread of antibiotic resistance in microorganisms: A review of scientifi c literature. The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 140-148. DOI: 10.20969/VSKM.2026.19(4).140-148.

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51. Небогина А.М. Антибиотикорезистентность: причины и последствия // Бюллетень медицинских интернет-конференций. – 2025. – Т . 15. – № 2. – С. 38-38 Nebogina AM. Antibiotikorezistentnost’: prichiny i posled stviya [Antibiotic resistance: causes and consequences]. Byulleten’ medicinskih internet-konferencij [Bulletin of medical Internet conferences]. 2025; 15(2): 38-38. (In Russ.)

 

CLINICAL CASE

УДК: 616.127-005.4-073.756.8

DOI: 10.20969/VSKM.202 6.19 (4).149-154

 Long-term follow-up and management of a patient with multiple coronary artery aneurysms (a case report)

Albert S. Galyavich1, Larisa V. Baleeva1, Zulfiya M. Galeeva1, Alexandra A. Sabirzyanova1, Rustem N.Khairullin2, Elvira G. Safina2, Alexey Yu. Rafikov2

1 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia

2 Interregional Clinical and Diagnostic Center, 12а Karbyshev str., 420101 Kazan, Russia

Abstract. Introduction. Coronary artery aneurysm is a rare condition characterized by localized dilatation of the coronary artery lumen. Aim. To accumulate and systematize data on coronary artery aneurisms and guide clinical practice, since reports on clinical cases involving this condition remain limited in the national literature. Materials and Methods. This paper presents analysis of a clinical case of a 46-year-old male with multiple coronary artery aneurysms, detailing the diagnostic fi ndings and management. Results and Discussion. Clinical course in this patient with multiple coronary artery aneurysms was complicated by myocardial infarction and recurrent episodes of unstable angina. Instrumental evaluation revealed mural thrombi within the coronary arteries, areas of post-infarction fi brosis, and minimal myocardial ischemia. These fi ndings justifi ed the selection of a conservative anticoagulation strategy without repeated revascularization. Despite ongoing medical therapy, the patient exhibits a progressive decline in myocardial contractile function, potentially requiring heart transplantation in the future. Conclusions. Over a four-year follow-up period, multiple coronary artery aneurysms were complicated by thrombosis, unstable angina, and myocardial infarction, ultimately resulting in the development of chronic heart failure.

Keywords: coronary artery aneurysm, myocardial infarction, unstable angina, coronary artery thrombosis, case report.

For citation: Galyavich, A.S.; Baleeva, L.V.; Galeeva, Z.M.; et al. Long-term follow-up and management of a patient with multiple coronary artery aneurysms (a case report). The Bulletin of Contemporary Clinical Medicine. 2026, 19 (4), 149-154. DOI: 10.20969/VSKM.2026.19(4).149-154.

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