Vol 5, No 3 (2025)
Literature reviews
Biomarkers of vascular cognitive dysfunction in patients with chronic obstructive pulmonary disease (review). Part 1.
Abstract
Cognitive dysfunction (CD) is a common and serious extra-pulmonary manifestation of Chronic Obstructive Pulmonary Disease (COPD), occurring in 77% of patients with the hypoxemic form of the disease and associated with high mortality and disability. The main pathogenic factors of CD in COPD are considered to be hypoxia, hypercapnia, impaired cerebral blood flow, systemic inflammation, and neurodegenerative processes. However, a unified understanding of risk factors, methods for early diagnosis, and correction of CD still does not exist. Currently, the diagnosis of CD relies mainly on subjective methods, such as patient interviews and neuropsychological testing, the results of which can be distorted by low educational level, anxiety, and other factors. In this regard, the search for objective biomarkers of CD is relevant. Promising plasma markers under consideration include ghrelin, neurofilament light chain (NF-L), S100B protein, microRNA, glial fibrillary acidic protein (GFAP), and myelin basic protein (MBP). The study pays special attention to the hormone ghrelin. It has been proven that ghrelin has neuroprotective properties: it increases neuronal survival, reduces apoptosis, inflammation and oxidative stress, and improves mitochondrial function. It is suggested that it can cross the blood-brain barrier and have a positive effect on neurogenesis and synaptic activity. In COPD, ghrelin also demonstrates positive systemic effects, reducing hypoxia-induced pulmonary hypertension and counteracting muscle atrophy. Despite encouraging data on the association of ghrelin with improved cognitive function in neurodegenerative diseases such as Alzheimer's and Parkinson's, no direct studies have been conducted on the role of ghrelin as a biomarker for CD specifically in COPD patients. An analysis of available scientific publications (both domestic and foreign) showed that existing studies examined ghrelin levels in such patients primarily in connection with nutritional status, obesity, or systemic inflammation, but not with cognitive function. Thus, although the neuroprotective and anti-inflammatory properties of ghrelin make it a promising candidate for further research, its role as a biomarker for cognitive dysfunction in COPD is currently unproven and requires targeted study. The development of objective methods for the early diagnosis of CD remains an urgent task for improving the quality of life and prognosis of COPD patients.
2-10
Methods of extracorporeal hemocorrection in the therapy of sepsis and septic shock
Abstract
Sepsis and septic shock remain a significant problem in critical care medicine, as they are among the most frequent causes of death in the intensive care unit. Currently, such methods of extracorporeal hemocorrection (EHC) as hemodiafiltration and high-volume hemofiltration occupy a certain place among the possibilities for treating severe systemic diseases and pathological processes, in particular, sepsis and septic shock. This review demonstrates the capabilities and prospects of using various methods of extracorporeal hemocorrection, both currently used and under development, taking into account the pathophysiological features of sepsis.
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Original Articles
About the organization of training camps: "Young medical instructor" with students of schools in Omsk on the basis of BUZOO "TCMK"
Abstract
Annotation. The purpose of the study is the formation of patriotic orientation and motivation for military service among students during training camps, as well as practical skills to provide first aid (self– and mutual assistance) to the wounded (affected) and suddenly ill.
Material and methods: formalization, generalization, comparison and system analysis, story, display, training. The object of the study was the results (preparedness) of students for first aid to the wounded during the training camp on the course "Tactical medicine and general military training".
The results and their discussion. The study identified a direct relationship between the training system of students, their motivation, and the formation of practical skills in first aid during training camps: "Young sanitary instructor" with citizens of the Russian Federation, students of schools in the city of Omsk within the framework of the project "Ready for sanitary defense".
Conclusion. The passage of the "Young Medical Instructor" training camps by students of the graduating classes of Omsk schools during the academic year will allow them to form general military and medical competencies that contribute to the comprehensive development of the younger generation of Russians, increase the level of safety, professional orientation, medical literacy and patriotism.
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Assessment of professional burnout of medical staff of the central district hospital
Abstract
Goal. To assess the level of professional burnout among doctors of Tarskaya Central District Hospital.
Material and methods. The study involved 65 doctors of Tarskaya Central District Hospital of various specialties, who provided medical care to patients both in outpatient and inpatient settings. Of these, 63.1% are women and 36.9% are men; the median age is 53 (38; 61) years. The method of diagnosing emotional burnout was used – an abbreviated version of the MBI questionnaire adapted in Russian by N.E. Vodopyanova and E.S. Starchenkova for medical professionals. Burnout syndrome was assessed on 3 scales: "Psychoemotional exhaustion", "Depersonalization", "Reduction of professional achievements". The interpretation of the results was based on a comparison of the estimates obtained for each of the scales with the standard values for each scale. The questionnaire was supplemented with questions that, according to literary sources, contribute to the development of professional burnout syndrome (gender, age, marital status, having children, work experience, part-time work, specialty).
Results. Among doctors, the median level of professional burnout according to the results of the survey was 43 (35;27) points, which corresponded to a low value of professional burnout. Significant correlations were identified between the indicators of professional burnout and the following factors: respondents who were satisfied with the variety of work performed, the prestige of work, and relationships with management had less severe professional burnout than those who were dissatisfied; the highest values of professional burnout were determined for groups with less work experience; specialists who had a part-time job had a higher level of depersonalization than the respondents who did not have a part-time job. Trends towards the presence of correlations between indicators of professional burnout and the following factors were identified: married/married people had a higher level of depersonalization than unmarried/unmarried, widows/widowers; respondents with children had a reduction in personal achievements and professional burnout were less pronounced than respondents without children; those who were satisfied with their chosen profession had a reduction in personal relationships were expressed to a lesser extent than those who were dissatisfied; those who were satisfied with wages had less emotional exhaustion than those who were dissatisfied.
Conclusion. The results indicate the influence on the development of professional burnout among doctors of the central district hospital of such factors as team relationships, relationships with management, a sense of the usefulness of their profession, and the variety of work performed. The risk groups of doctors who were slightly more likely to develop professional burnout than other groups were identified: young professionals; family doctors; doctors without children; specialists with part–time jobs.
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Point of view
Classification of approaches to the problem of consciousness: dualistic theories
Abstract
The "consciousness and brain" problem has been at the forefront of philosophical and scientific inquiry for over half a century. The level of complexity and inexhaustibility of the problem field itself has led to a multitude of positions and concepts that have emerged during this time. Obviously, it is not possible to cover all existing theories of consciousness. In this case, a productive solution seems to lie in constructing a "classification tree," which allows, firstly, to clarify the conceptual differences between the created theories. Secondly, to conduct preliminary generalizations of a number of sufficiently similar ideas expressed from different fields of knowledge. In this regard, the article presents an analysis of possible approaches to classifying theories of consciousness, with a brief overview of the theories themselves. It is also shown that, despite the elegance of the proposed solutions to the "consciousness-brain" problem, none of them leads us out of the conceptual dead ends.
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Materials of Conferences, Symposia and Seminars
Analysis of the composition and antibiotic sensitivity of the main pathogens of purulent diseases of the paranasals in the West Siberian region
Abstract
Rational antibiotic therapy is a pressing issue in the treatment of ENT diseases. Knowledge of the species composition of pathogens causing purulent sinusitis and their sensitivity to antibiotics in each region can serve as a means of monitoring the development of chronic infection and its complications, as well as microbial resistance to antibacterial drugs, as well as improving treatment effectiveness and reducing the incidence of complications. Objective: To analyze the species composition and sensitivity of the main pathogens causing rhinosinusitis to antibiotics in the Omsk Region. Materials and Methods: A review of 1,500 patient records was conducted for patients treated in the adult ENT inpatient department of the Regional Clinical Hospital during the calendar year, including 198 (13.2%) with a diagnosis of acute sinusitis. A third of these patients (n=66) underwent culture testing of paranasal sinus secretions for sensitivity to antibiotics and antifungals. The predominant flora were staphylococci (71%), streptococci (7%), and enterobacteria (19%). The antibiotic susceptibility spectrum of the isolated flora was analyzed, and empirical selection of antibiotic therapy in patients with purulent rhinosinusitis was substantiated. Knowledge of the species composition of acute sinusitis pathogens allows for dynamic assessment of changes in antibiotic resistance and facilitates rational antibiotic therapy.
59-64
Teacher. Teachers.
Abstract
The article by Galina Evgenievna Rudykh, Honored Doctor of the Russian Federation, presents personal recollections of her journey in medicine and of two key teachers who shaped her as an otorhinolaryngologist. The first was Nikolai Vasilyevich Mishyenkin, professor and head of the department at the Omsk Medical Institute, who laid the foundations of the scientific approach to the specialty and is remembered as a modest, talented scientist and educator. The second was Anatoly Grigorievich Shanturov, head of the department at the Irkutsk Medical Institute, under whose guidance the author completed her residency and mastered practical surgical work. The article describes the author's challenging yet rewarding path: from working in the remote settlement of Tofalaria to many years of heading the pediatric ENT department at the Ivan-Matryona Hospital in Irkutsk. This narrative is a tribute to the teachers whose knowledge, principles, and human qualities became a guiding light in the author's professional and personal life, as well as a reflection on the importance of continuity, mentorship, and vocation in medicine.
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