Early diagnosis and verification of the pathogen is one of the successful components of the effectiveness of complex therapy of candidal stomatitis. The aim of the study was to evaluate the relationship between the clinical manifestations of candidal stomatitis and the verified pathogen. Materials and methods. 60 patients aged 45 to 74 years with a diagnosis of candidal stomatitis were examined. The clinical examination included the use of basic and additional methods: questioning, examination, palpation of the oral mucosa, determination of oral hygiene indices. In order to verify the pathogen, all patients were referred for a microbiological examination of the material taken from the pathological areas of the oral mucosa. After receiving the data from clinical and laboratory examinations, an assessment of the relationship between the clinical course of the pathology and the verified pathogen was carried out. Results. During the clinical examination, patients complained of burning sensation on the oral mucosa, halitosis, and xerostomia. 11.7 % of patients had a pronounced clinical picture in the form of extensive erosive foci on the oral mucosa, especially on the cheeks, along the line of teeth closure, and the lateral surfaces of the tongue. In the majority of patients (88.3 %), Candida albicans was the causative agent of candidal stomatitis, with their predominant prevalence and quantitative content of 104 CFU/mg. Candida non-albicans, which can be represented by various species: C. krusei (6.7 %), C. tropicalis (3.3 %) and C. glabrata (1.7 %), were detected in 11.7 % of patients. Conclusion. The severe course of candidal stomatitis with frequent recurrences indicates the presence of a resistant flora with a predominance of Candida non-albicans species.

An important indicator of healthcare development is the provision of high-tech medical care to the population, the need for which is dictated by the ever-increasing needs of the population. High-tech medical care significantly expands the possibilities for improving the efficiency of healthcare, which is why this area is receiving increasing attention. Taking into account regional characteristics is a necessary requirement for organizing the rational operation of the healthcare system in a particular territory. Objective. To analyze the volume and structure of high-tech medical care provided to the population of the Astrakhan region. Materials and Methods. The study was a retrospective, continuous-method study covering the observation period from 2014 to 2023. The data source was the Russian Ministry of Health's high-tech medical care monitoring system database. Results. The volume of high-tech medical care provided increased by 1.7 times over the entire study period, primarily due to compulsory health insurance funds. A significant portion of the high-tech medical care provided was provided to residents of Astrakhan, while residents of remote areas more often received it in the surrounding region. Almost one-third of patients receiving high-tech medical care were treated outside the region, and this proportion is growing. Despite the multidisciplinary nature of state-run medical institutions, not all specialties are covered. The leading profiles for the provision of high-tech medical care within the region are cardiovascular surgery (67.8 %), and outside of it, traumatology and orthopedics 28.1 %. Conclusion. To improve the efficiency and effectiveness of this type of medical care, continuous monitoring and analysis of the provision of high-tech medical care to the region's population is essential.

Today, surgical methods for treating degenerative spinal diseases are widely used and actively applied all over the world. Traditionally, more than 80 % of degenerative changes are localized in the lumbar region, and more than 60 % of them are associated with intervertebral disc damage. Aim. Is to show the effectiveness of rehabilitation measures by analyzing their relationship with surgical interventions such as microdiscectomy at the lumbar level. Methods. This study conducted a retrospective quantitative analysis of surgical interventions performed in the neurosurgery department of the State Budgetary Healthcare Institution of the Astrakhan Region, the Alexandro-Mariinskaya Regional Clinical Hospital in 2024. The rehabilitation treatment was analyzed based on the results of the rehabilitation center of the Tinaki Pension and Social Insurance Fund in Astrakhan. Results. In 171 cases (92 %), surgery was performed on a single lumbar motor segment. In 15 cases (8 %), indications for surgery at two levels were determined. In 45 cases (24.1 %), ongoing degeneration of the segment was identified. Of these, 32 (17.2 %) required repeated hospitalization in a hospital with a diagnosis of “Disc herniation relapse”. The results in the form of complete regression or a significant reduction in pain syndrome in the postoperative period were assessed as positive in 85 % of cases. The persistence of varying degrees of pain syndrome at this level and a subjective negative assessment were identified in 28 patients – in 15 %. Repeated revision intervention was performed in 29 (15. 5 %) cases. Of the 186 patients who underwent surgery, 120 (64.5 %) underwent rehabilitation measures at the medical rehabilitation department of the TINAKI Center for Rehabilitation and Social Services in Astrakhan. Conclusion. Active surgery for degenerative spinal diseases aimed at decompression of neural structures does not guarantee a positive result in terms of pain relief. Timely and important course of full-fledged rehabilitation contributes to the reduction of pain syndrome and improvement of the quality of life of patients.

A wide range of drugs with metabolic action have been developed for the prevention and treatment of liver damage of various etiopathogenesis. However, the efficacy of these drugs in clinical settings remains unsatisfactory, necessitating the development of new approaches to hepatoprotective therapy. Aim. The study aims at analyzing the efficacy of combination therapy for toxic liver damage in an experiment using agents with antihypoxic and antioxidant effects. Materials and Methods. Ten groups of rats were formed, with 10 individuals in each: Group 1 was a control group, the rest were subjected to acetaminophen-induced hepatitis and were administered for 10 days with the following: saline solution (comparison group), remaxol (Group 3), ascorbic acid (Group 4), α-lipoic acid (Group 5), α-tocopherol acetate (Group 6) and combinations of remaxol with antioxidants (Groups 7–10). Following the experiment protocol, blood was collected from the caudal vena cava and liver for laboratory testing. Cytolytic syndrome markers and prooxidant-antioxidant balance indicators were determined. Results. Remaxol demonstrated the ability to reduce the manifestations of cytolytic syndrome in acute toxic liver injury, which was characterized by reduced aminotransferase and lactate dehydrogenase activity by 12–25 % relative to the comparison group. Analysis of the combined effect of antioxidant drugs revealed a potentiating effect with the combined use of remaxol and antioxidants. The group of animals receiving remaxol and all 3 antioxidants was characterized by the lowest aminotransferase and lactate dehydrogenase activity values that was reduced by 2.0, 1.7, and 2.6 times, respectively, relative to the indicators in Group 2. Conclusion. The effectiveness of metabolic therapy for acute liver injury can be increased by administering succinic acid preparations together with direct-acting antioxidants, such as vitamin E and ascorbic and lipoic acids.

Subepithelial corneal opacities are a common consequence of adenoviral and mixed-infection keratoconjunctivitis, occurring in 10 % of cases. They rarely undergo spontaneous resorption, persisting for life in most  cases and often causing decreased vision and quality of life in patients. This paper examines clinical cases of treating subepithelial corneal opacities developed in the context of adenoviral ocular surface damage – keratoconjunctivitis, with corneal opacities resorption using a byopolymer hydrogel (SPHERO®oko, BIOMIR service JSC, Russia).

Demographic, anamnestic and clinical data are of particular diagnostic and prognostic importance in patients with cardiovascular diseases, and have not previously been studied in patients with infective endocarditis and coronavirus infection. The aim. To study demographic, anamnestic and clinical data of patients with infective endocarditis and coronavirus infection upon admission to the hospital. Materials and methods. A retrospective analysis of the data of 69 patients with infective endocarditis who were treated at the Federal State Budgetary Institution Federal Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation (Astrakhan) from 2019 to 2023 was carried out. To study the significance of demographic, anamnestic and clinical data of patients with infective endocarditis, depending on the presence or absence of Covid-19, they were divided into 2 groups: group 1 consisted of 24 patients with infective endocarditis and laboratory-confirmed Covid-19; group 2 – 45 patients with infectious endocarditis without Covid-19. Results. The study of demographic, anamnestic and clinical data of patients with infective endocarditis and coronavirus infection allowed us to identify a group of patients with coronavirus infection with a high risk of developing infective endocarditis: males aged 44 to 64 years, with primary infective endocarditis with aortic valve damage.