[Laparoscopic right-side partial nephrectomy with fluorescence imaging in the near infrared spectrum using indocyanine green].

A clinical case of the use of fluorescence imaging in the near infrared spectrum with indocyanine green during laparoscopic right-side partial nephrectomy is presented in the article.

[The dynamics of demographic situation and state of reproductive health of population of circumpolar region of the Russian Federation].

The priority of state policy of the Russian Federation is to make conditions for sustainable social economic development of national regions, including the territories of the Arctic Zone. The successful solution of these tasks is possible only if there is sufficient amount of labor resources and at achieving positive dynamics of main demographic processes. The purpose of the study is to establish characteristics of both dynamics of main demographic processes and reproductive health of Northerners as exemplified by the Republic of Komi. MATERIALS AND METHODS: The retrospective ecological epidemiological study was carried out using reports of the Federal statistical observation. To evaluate demographic processes the values of main demographic parameters were calculated. To analyze dynamics of demographic processes time series of demographic coefficients were constructed and values of growth rate indicators were calculated. RESULTS: The number of male and female population of the Komi Republic in 1990-2023 decreased by 46.5% and 37.1%. The specific weight of people older than able-bodied age increased in males from 4.9% to 14.7% and in females from 15.7% to 31.6%. The number of females of fertile age (16-49 years) in the Komi Republic decreased by 152.602 people (-47.5%) and their general fertility rate decreased by 33.3%. The birth rate in the group of young women aged 15-19 years decreased in 1990-2021 by 80.1%; and of women aged 20-24 years decreased by 60.4%. The frequency of abortions tends to decrease, but significantly exceeds the national average values. CONCLUSION: The replacement-level fertility is not achieved in the Komi Republic. Taking into account the peculiarities of demographic, social economic processes, it is necessary to develop and to implement regional program of reproductive health improvement.

[The determinants of vaccination against the new coronavirus infection (COVID-19) of residents of the circumpolar region of Russia].

The maintenance of health of residents of the Northern Regions of Russia, including those living in the Arctic zone of the cbountry, is a condition of its advance development in XXI century. The percentage of Russian citizen vaccinated against the new coronavirus infection (COVID-19) does not exceed 50% after beginning of implementation of vaccination program. It can be conditioned by lower level of both of credence of citizen to health care system and health literacy.Purpose of the study is to establish determinants of vaccination of population against COVID-19 in circumpolar region of Russia as exemplified by the Arkhangelsk Oblast.The sociological survey was carried out using the interview technique of patients of medical organizations (n=433) and conditionally healthy residents of the Arkhangelsk Oblast (n=139). To evaluate the level of general health literacy the Russian version of questionnaire HLS19 - Q22-RU was applied. The most of conditionally healthy respondents and consumers of medical services looked for information about methods of prevention and treatment (80.4% and 58.2% correspondingly), had an experience of vaccination against COVID-19 (79% and 56.3% correspondingly). The relative chances of conditionally healthy respondents, women, and respondents having no children and no credence to national health care system to independently look for information related to COVID-19 is higher at 2.94, 2.08, 1.55 and 1.48-1.57 times correspondingly. The relative chances of conditionally healthy respondents having no children in family and assessing one's economic status as "higher than average" to be vaccinated against COVID-19 is higher at 4.02, 1.52, 1.53 times correspondingly. Availability of experience of vaccination against COVID-19 is conditioned by higher level of general health literacy.In the Arkhangelsk Oblast and other circumpolar regions of Russia the programs of increasing loyalty of citizen to measures of population prevention, including vaccine prevention, is to be implemented with consideration of established determinants of of vaccinations against COVID-19.

[Statistical modeling of the fact and requests frequency for emergency medical care by primary care different age groups patients.]

The frequency of seeking emergency medical care (EC) can be mediated by the characteristics of the patient's social status, his health literacy (HL) but not only by the clinical signs of the disease, health status. The goal of the cross-sectional survey was to identify factors determining the frequency of applying for EC by the young-aged, middle-aged (18-59 years) and elderly (60-74 years) patients of the primary health organizations in the Arkhangelsk Region and the Komi Republic (North-West Russia). Logistic regression (LR) was used to identify factors mediating the fact of applying for EC; zero-inflated negative binomial regression (ZINB) - to identify factors mediating the frequency of appeals. The majority of elderly respondents in the Arkhangelsk Region (72,5%) and the Komi Republic (74,1%) applied for EC at least once during the calendar year; among the young-aged and middle-aged respondents - 45,3% and 52,1% respectively. In the group of young-aged and middle-aged respondents, a higher frequency of appeals for EC is mediated by the age, low self-esteem of the well-being and health status, a chronic disease(s) affecting daily well-being in anamnesis, a low level of HL; in the group of the elderly respondents - by the fact of absence of a spouse, low self-esteem of the well-being, a chronic disease(s) affecting daily well-being in anamnesis, low levels of HL respectively. The obtained results obtained can be used to identify the «risk group¼ of patients of the primary health organizations who have a higher probability of applying for EC, and to organize additional preventive work with the min primary health organizations.

[The competence in health issues of population of circumpolar region of the Russian Federation].

The health literacy of citizen is determined by a set of demographic and social factors. The deficiency of health literacy of population in the Russian Arctic Zone conditions delay in indicators characterizing population health from their all-Russian values and menaces ability to achieve the targets of the National Strategy of Development of Russian Arctic Zone and Ensuring National Security up to 2035.The purpose of the study is to assess level of health literacy of patients and healthy population residing in circumpolar territories of Russia (Arkhangelsk Oblast).The level of general health literacy in the subgroups of respondents varied in narrow range of 26.9-36.3 points. The most significant difference was established between scores of interactive health literacy (Δ = 4.1 points) and critical health literacy (Δ = 3.4 points), which were higher in group of healthy respondents. The predictors of level of general health literacy are clinical status (value of dependent variables in healthy respondents was on average higher on 0.75-1.73 points), self-assessment of one's positioning in society (every additional point increases average level of general health literacy by 0.47-0.79 points) and age (every additional year of life reduces level of general health literacy by 0.08 - 0.09 points). The results of the study indicate on dependency between clinical status and the level of health literacy, determine social characteristics of risk group with low health literacy as object of additional preventive measures directed at citizen residing in in circumpolar terrotories of The Russian Federation.

[SATISFACTION OF THE RESIDENTS OF THE CIRCUMPOLAR REGION WITH THE STATE HEALTHCARE SYSTEM, DEPENDING ON THE LEVEL OF THEIR HEALTH LITERACY].

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

[Bilateral laparoscopic nephrectomy for polycystic kidney disease].

A clinical case of surgical treatment of a patient with autosomal dominant type of polycystic kidney disease, stage 5 of chronic kidney disease and secondary arterial hypertension is presented in the article. The technique of single-stage bilateral laparoscopic nephrectomy, patented by the authors, is described. The practicability and safety of a simultaneous bilateral procedures was demonstrated, as well as the advantage of laparoscopic access for this type of surgical interventions. The successful and prompt procedure allowed the patient to undergone to allotransplantation of a cadaveric kidney as soon as possible.

The medical demographic characteristic of group of citizen injured in road accidents on the Federal Highway.

The role of citizen of elderly age in road accidents on the Federal Highway was principally passive since passengers of vehicles predominated (p<0,0001). The most of victims of elderly age (66,7%) suffered of combined lesions. Considering gender of victim, presence of ethanol in blood at the moment of hospitalization, the role of victim of road accident and degree of severity of lesions in citizen of elderly age was in overall higher than in citizen of able-bodied age up to 2.3-2.9 points according ISS scale. The established medical demographic characteristics of victims of elderly age condition necessity of development of differentiated approaches to their medical care support, planning of measures of population prevention of medical sanitary aftermaths of road traumatism.

[The development of first medical care support to victims of road traffic accidents: The publications review].

The medical and demographic losses because of road traffic accidents continue to be significant in most of economically developed and developing countries. The national strategies of reducing medical and demographic losses include two groups of measures, depending on object of exposure: (1) targeted to decreasing risk of road traffic accidents and (2) targeted to timely and adequate medical care support of victims. Beyond this classification are activities targeted to developing and improving in participants of road traffic skills of first self-care and mutual assistance. The availability of mentioned skills is important for saving lives and preventing permanent disability of victims of road traffic accidents.

[The means of optimization of medical care support of victims of road traffic accidents at the hospital stage: The publications review].

The road traffic traumatism remains among the most actual medical social problems in Russia. The injured because of road traffic accidents suffer of predominant severe multiple and combined injuries (polytrauma) very often resulting in permanent disablement and lethal outcomes. The existing three-level system of traumatologic centers to supply specialized medical care of the injured in road traffic accidents demonstrates efficiency only on condition of observation of routing of patients. The new organizational approaches to specialized medical care to the injured at the hospital stage is needed for further decreasing of lethality and disability in group of victims of road traffic accidents.

Laser-induced fluorescent visualization and photodynamic therapy in surgical treatment of glial brain tumors.

High-grade gliomas have a diffuse and infiltrative nature of the growth of tumor cells, due to which the achievement of radical resection is difficult. Surgical resection completeness of brain tumors is an important factor in prolonging the life of patients. An accurate definition of tumor boundaries and residual fluorescent regions is impossible due to imperfections of the equipment used for fluorescent imaging. 5-aminolevulinic acid (5-ALA) is a precursor of protoporphyrin IX (PpIX) in humans and is clinically used to detect and treat tumors. Currently, fluorescence-guided surgery with PpIX used a surgical microscope with an excitation wavelength in the blue spectrum range. Because of its low ability to penetrate into biological tissue, blue light is ineffective for providing high-quality fluorescent navigation. Also, when performing an operation using radiation in the blue spectrum range, the photosensitizer's surface layer (PS) often bleaches out, which leads to frequent errors. The use of red light emission makes it possible to slow down the PS bleaches out due to the absorption properties of PpIX, but this task is technically more complicated and requires highly sensitive cameras and specialized optical filters. The new two-channel video system for fluorescent navigation has a radiation source in the red range of the spectrum, the penetration depth of which is greater than the blue light, which makes it possible to increase the depth of probing into biological tissues. The study's clinical part involved 5 patients with high grade glioma and 1 patient with low grade glioma: grade III oligodendrogliomas (2), grade IV glioblastomas (3), and grade II diffusion astrocytoma (1).

[The combined use of kinesio- and laser therapy in the regional hemodynamic disorders correction in dilated cardiomyopathy]. / Sochetannoe primenenie kinezo- i lazeroterapii v korrektsii narushenii regionarnoi gemodinamiki pri dilatatsionnoi kardiomiopatii.

The search for new methods of symptomatic therapy of dilated cardiomyopathy (DCM) remains a relevant objective of modern cardiology. This is due to the low and short-term existing methods effectiveness of conservative and surgical treatment, including drug therapy. PURPOSE OF THE STUDY: Efficacy evaluation of the combined use of kinesio- and laser therapy for the correction of regional hemodynamics in patients with DCM against the background of maintenance drug therapy. MATERIAL AND METHODS: 100 patients with DCM were examined. All patients received differential maintenance drug therapy (beta-blockers, ACE inhibitors, with intolerance to the latter - angiotensin II receptor blockers, aldosterone receptor antagonists, diuretics, cardiac glycosides, antiarrhythmic drugs). Patients were divided into 2 groups at least 3 months after the selection of drug therapy. Intravenous laser blood irradiation (ILBI) and the selection of unloading therapeutic exercises were performed for patients of the main group during therapy. Patients in the control group received only drug therapy. The main research method was venous occlusion plethysmography. It was used to assess regional hemodynamics with the determination of recirculating blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) against a functional stress test. RESULTS: Data obtained in the dynamic observation process (after 1, 3, 6, 9 and 12 months) in the main group indicate a significant increase in Qr and QH, a decrease in Rr and RH, Vt. Significant positive dynamics in the control group was not observed. The regional hemodynamics indices after 9 and 12 months of observation significantly worsened. CONCLUSION: Thus, according to venous-occlusal plethysmography, the use of unloading therapeutic exercises in combination with ILBI against the background of rationally selected differentiated drug therapy in patients with DCM significantly improves the regional hemodynamics. The developed symptomatic therapy methods can be applied in the practice of cardiologists, general practitioners, therapeutists, rehabilitation physicians to optimize the treatment of patients with DCM.

[The regional characteristics of road traumatism in the Arkhangelsk oblast].

The article considers the results of continuous retrospective documentary study of regional characteristics of road traffic injuries with medical consequences on the Federal highway M-8 "Kholmogory" in the Arkhangelsk oblast in 2012 - 2018. The analysis was applied to 906 medical records of patients older than 18years hospitalized with urgent indications after road traffic accident and received in-patient treatment in medical organizations of the Arkhangelsk Oblast located in area of the Federal highway M-8 "Kholmogory". The significant decreasing of number of accidents with medical consequences recorded in the covered area as well as significant decreasing number of victims and perished with minimal rate ​​in 2018 was established. It is revealed that the largest number of victims of road traffic accidents was recorded in summer - 300 (31.1%) and autumn - 270 (29.8%) of this year. The Saturday and Sunday occurred to be the most dangerous days of the week in this respect. In day periodicity, maximal number of victims was recorded in the evening time (18-24 PM, 35.1%) and the smallest number in the night time (1-6 AM, 14.6%). Among injured individuals, significantly dominated males (p<0,001) and in total sampling young people under the age of 40.

[The Evaluation of Quality of Medical Care Support of Victims of Road Traffic Accidents at Pre-Admission Stage in Conditions of the Russian Arctic].

The retrospective continuous documented study of volume and quality of emergency medical care of victims of road traffic accidents occurred in the Arctic zone of the Russian Federation in 2012-2016. It is determined that on the examined territory there are enough of forces and means for timely and qualitative emergency medical care support of victims of road traffic accidents. It is established that more than 80% of all victims received medical care at the very site of accident during 20 minutes and no longer from the moment of calling ambulance and more than 90% of all victims were transported to admitting office of duty hospitals during first 40 minutes from the moment of being injured. The medical care, including application of pain killers (77.2%), intra-venous infusion of anti-shock remedies (35.1%), application of transport immobilization (74.9%) and implementation of medical evacuation to multi-field hospitals of Severodvinsk, was provided by specialists of emergency medical care teams to significant majority of victims of road traffic accidents (p < 0.001). It is established that a significant number of victims of road traffic accidents with combined and multiple injuries did not received at the pre-admission stage the anti-shock infusion therapy appropriate to their health condition. The mistakes of diagnostic of injuries due to road traffic accidents were established. The most significant of them in 10.4% was under diagnostic of shock condition in victims that conditioned inadequate infusion therapy and inadequate volume of rendered medical care of victims at the pre-admission stage of medical evacuation.

[The role of CO2-laser in scarring management]. / Otsenka vozmozhnostei uglekislotnogo lazera v lechenii rubtsovykh deformatsii.

AIM: To assess the role of CO2-laser in treatment of various scars and to determine the indications for its application. PATIENTS AND METHODS: It has been carried out a prospective analysis of treatment of 218 patients with scars of different duration, locations and anatomic areas with the use of CO2-laser for the period 2011-2017. POSAS scale and sonography were used for analysis. RESULTS: 1. Laser therapy is not effective for scarring-related functional defects (contractures, ectropion, microstomia), when surgery is indicated. 2. The outcomes of treatment (both surgical and laser) depend on the time of existence of the scars rather their cause and anatomical region. 3. Laser therapy is not effective enough for formed scars existing over 12 months. 4. Laser therapy is effective for immature scars, especially indicated for cicatricial deformation when the aesthetics cannot be repaired with traditional surgery. CONCLUSION: Application of CO2-laser in scars treatment with regard to its real efficiency determines the effectiveness of therapy.

Enantioselective cytotoxicity of ZnS:Mn quantum dots in A549 cells.

Chirality strongly influences many biological properties of materials, such as cell accumulation, enzymatic activity, and toxicity. In the past decade, it has been shown that quantum dots (QDs), fluorescent semiconductor nanoparticles with unique optical properties, can demonstrate optical activity due to chiral ligands bound on their surface. Optically active QDs could find potential applications in biomedical research, therapy, and diagnostics. Consequently, it is very important to investigate the interaction of QDs capped with chiral ligands with living cells. The aim of our study was to investigate the influence of the induced chirality of Mn-doped ZnS QDs on the viability of A549 cells. These QDs were stabilized with D- and L-cysteine using a ligand exchange technique. The optical properties of QDs were studied using UV-Vis, photoluminescence (PL), and circular dichroism (CD) spectroscopy. The cytotoxicity of QDs was investigated by high content screening analysis. It was found that QDs stabilized by opposite ligand enantiomers, had identical PL and UV-Vis spectra and mirror-imaged CD spectra, but displayed different cytotoxicity: QDs capped with D-cysteine had greater cytotoxicity than L-cysteine capped QDs.

Application of semiconductor quantum dots in bioimaging and biosensing.

In this review we present new concepts and recent progress in the application of semiconductor quantum dots (QD) as labels in two important areas of biology, bioimaging and biosensing. We analyze the biologically relevant properties of QDs focusing on the following topics: QD surface treatment and stability, labeling of cellular structures and receptors with QDs, incorporation of QDs in living cells, cytotoxicity of QDs and influence of the biological environment on the biological and optical properties of QDs. Initially, we consider utilization of QDs as agents in high-resolution bioimaging techniques that can provide information at the molecular levels. The diverse range of modern live-cell QD-based imaging techniques with resolution far beyond the diffraction limit of light is examined. In each technique, we discuss the pros and cons of QD use and deliberate how QDs can be further engineered to facilitate their application in the respective imaging techniques and to produce significant improvements in resolution. Then we review QD-based point-of-care bioassays, bioprobes, and biosensors designed in different formats ranging from analytic biochemistry assays and ELISA, to novel point-of-care smartphone integrated QD-based biotests. Here, a wide range of QD-based fluorescence bioassays with optical transduction, elecrochemiluminescence and photoelectrochemical assays are discussed. Finally, this review provides an analysis of the prospects of application of QDs in selected important areas of biology.

Enantioselective cellular uptake of chiral semiconductor nanocrystals.

The influence of the chirality of semiconductor nanocrystals, CdSe/ZnS quantum dots (QDs) capped with L- and D-cysteine, on the efficiency of their uptake by living Ehrlich Ascite carcinoma cells is studied by spectral- and time-resolved fluorescence microspectroscopy. We report an evident enantioselective process where cellular uptake of the L-Cys QDs is almost twice as effective as that of the D-Cys QDs. This finding paves the way for the creation of novel approaches to control the biological properties and behavior of nanomaterials in living cells.

Chlorin e6-ZnSe/ZnS quantum dots based system as reagent for photodynamic therapy.

Stable water-soluble complexes of Cd-free ZnSe/ZnS quantum dots (QDs) and chlorin e6 complexes have been prepared. These complexes have shown approximately 50% intracomplex fluorescence resonance energy transfer from QDs to chlorin e6. The photodynamic therapy (PDT) test of the complexes against the Erlich acsite carcinoma cell culture demonstrated a two-fold enhancement of the cancer cell photodynamic destruction as compared to that of free chlorin e6 molecules. It was shown that the PDT effect was significantly increased due to two factors: the efficient QD-chlorin e6 photoexcitation energy transfer and the improvement of cellular uptake of the photosensitizer in the presence of ZnSe/ZnS QDs.

Note: Near infrared spectral and transient measurements of PbS quantum dots luminescence.

We describe an experimental setup for the characterization of luminescence from nanostructures. The setup is intended for steady-state and time-resolved luminescence measurements in the near-infrared region. The setup allows us to study spectral luminescence properties in the spectral range of 0.8-2.0 µm with high spectral resolution and kinetic luminescence properties between 0.8 and 1.7 µm with a time resolution of 3 ns. The capabilities of the system are illustrated by taking luminescence measurements from PbS quantum dots. We established the size dependencies of the optical properties of the PbS quantum dots over a wide spectral range. Finally, the energy transfer process was studied with a high temporal and spectral resolution.