Basic information
| Title journal: | Issues of clinical and fundamental medicine |
|---|---|
| Number: | 3 |
| Year: | 2026 |
| Date of publication on the website: | 27.08.2026 |
| Full journal in PDF: | Download |
Content
POLYPRAGMASIA IN THE ELDERLY: AN UNAVOIDABLE EVIL, BUT MANAGEABLE. THE KEY TO SECURITY
UDC: УДК 615.06Section: The original article
Authors: Komandyshko Tatiana Aleksandrovna; Kamaltdinova Yasmina Danilovna; Khairulina Adela Azatovna; Morozova Valeria Andreevna
Annotation: Polypragmasia, the simultaneous administration of multiple medications, is a common and often unavoidable phenomenon in geriatric practice. The associated high frequency of adverse drug reactions (NLR) and drug interactions poses a serious threat to the safety of elderly and senile patients. An analysis of 120 medical records of patients over 65 years of age revealed a high prevalence of polypragmasia, which requires the introduction of an algorithm for regular review of therapy to reduce risks and improve the safety of treatment.
KEYWORDS: polypragmasia, elderly patients, drug safety, adverse drug reactions, retrospective analy-sis,
geriatric hospital.POSTOPERATIVE COMPLICATIONS OF BREAST ENDOPROSTHETICS
UDC: УДК 616-089.844+614.Section: The original article
Authors: Efremov Mikhail Igorevich; Efremova Angelina Olegovna; Lezhenina Svetlana Valerievna; Denisova Tamara Gennadievna; Zhamlikhanova Svetlana Safinovna; Denisov Melsik Spartakovich; Gruzinova Elena Nikolaevna
Annotation: Aesthetic and reconstructive surgery is an important field of medicine, allowing for the correction of congenital pathologies and imperfections in patients' appearance. Recently, there has been a growing demand for plastic surgery services. Augmentation mammoplasty is a leading surgical procedure. Thanks to improvements in breast implants and surgical techniques, the incidence of complications has decreased; however, a number of adverse effects remain, including implant rupture, fibrocapsular contracture (FCC), contouring, and changes in implant shape or position. A retrospective analysis of case histories, diagnostic images of patients at the Republican Clinical Oncology Dispensary of the Chuvash Republic Ministry of Health (RCOD) and a literature review examined the most common complications following mammoplasty using implants, their incidence statistics, primary causes, and diagnosis. The complication rate was found to be 36.05 %. The most common complication was grade 1 FCC without implant shape change (15.45 %). Early postoperative complications included seromas and hematomas (~7–10 %), and the most severe was implant deformation resulting from traumatic impact (5.15 %). Rarer complications, such as paresis, sensory disturbances, and granuloma, are also possible. Timely diagnosis and standardization of medical service protocols will help avoid the most severe and common complications of mammoplasty.
KEYWORDS: mammoplasty, endoprosthetics, plastic surgery, diagnosis of complications.NATURAL FOCI OF INFECTION IN CHUVASHIA: CURRENT STATE OF THE PROBLEM
UDC: УДК 614.3Section: The original article
Authors: Akimova Venera Petrovna; Efimova Darina Yuryevna; Ivanova Diana Nikolaevna; Vasilyeva Tatyana Vladimirovna
Annotation: THE PROBLEM OF NUTRITION AND MALNUTRITION IN ELDERLY PATIENTS: CLINICAL CASE ANALYSIS
UDC: УДК 616-008Section: A clinical case
Authors: Komandyshko Tatiana Aleksandrovna; Khusnullina Alsu Azatovna; Kirlasheva Veronika Borisovna
Annotation: The problem of malnutrition (malnourishment) in elderly patients is widespread and is associated with
a high risk of complications. Based on the example of a clinical case of a 78-year-old patient, the article discusses approaches to diagnosis using screening scales (MNA-SF, MUST) and complex treatment. The importance of early detection of nutritional deficiencies and timely initiation of multidisciplinary nutritional support as an integral part of therapy to improve outcomes and prognosis in geriatric patients is emphasized.
KEYWORDS: malnutrition, malnourishment, elderly patients, geriatrics, nutritional support, screening, MNA, MUST, sarcopenia, senile asthenia.A CLINICAL CASE OF LEGIONELLA PNEUMONIA IN A WORKING-AGE PATIENT
UDC: УДК 616-002Section: A clinical case
Authors: Solenova Elena Aleksandrovna; Barsukova Elena Vladimirovna; Babaeva Elvira Gennadievna; Vedernikova Alexandra Dmitrievna; Sazieva Dilyara Fanisovna; Minyatullov Alfat Ildusovich
Annotation: Study objective: To raise awareness among practicing physicians about the timely diagnosis of Legionella pneumonia using a clinical case of a working-age patient.
Materials and methods: Retrospective analysis of primary medical records of a patient with verified Legionella disease treated at a Level 3 clinical facility. Data processing was performed in compliance with the requirements of the Federal Law on Personal Data Protection using a software package and artificial intelligence tools.
Results: A patient with a complicated premorbid background (chronic bronchitis, 25-year smoking history, arterial hypertension) and behavioral risk factors (daily alcohol consumption, intermittent use of nonsteroidal anti-inflammatory drugs, use of air conditioning in a tractor cab) developed bilateral polysegmental pneumonia with a right-sided lesion affecting up to 85 %. The disease was characterized by a hyperacute fever (up to 41 °C), pulmonary (hemoptysis, respiratory failure), and extrapulmonary manifestations (diarrhea, abdominal syndrome). Initial empirical therapy (ceftriaxone + levofloxacin) was ineffective. Rapid verification of the diagnosis with a rapid urine test allowed for de-escalation to levofloxacin monotherapy (1000 mg/day, subsequently tapered to 500 mg/day), resulting in clinical and radiographic improvement.
Conclusion. This case demonstrates that a combination of factors such as air conditioning, alcohol abuse, and nonsteroidal anti-inflammatory drug use may be risk factors for the development of Legionella pneumonia. Early use of urinary antigen immunochromatographic testing and timely antibacterial therapy with fluoroquinolones are key factors in a favorable outcome.
KEYWORDS: Legionella pneumonia, Legionella pneumophila, clinical case, risk factors, immunochromatographic analysis, community-acquired pneumonia, alcohol, non-steroidal anti-inflammatory drugs, air conditioning.MEDICAL CONFIDENTIALITY IN THE AGE OF DIGITAL HEALTHCARE: CHALLENGES OF LEGAL REGULATION AND PERSONAL DATA PROTECTION
UDC: УДК 614.2Section: Literature review
Authors: Lezhenina Svetlana Valerievna; Markedantova Angelina Ivanovna; Denisov Melsik Spartakovich; Sidorova Tatyana Nikolaevna; Shuvalova Nadezhda Vyacheslavovna ; Denisova Elena Alekseevna
Annotation: The rapid introduction of digital technologies in healthcare—telemedicine and electronic medical records—is transforming traditional approaches to protecting patient privacy.
Objective: To analyze recommendations for modernizing legal mechanisms for protecting medical confidentiality in the digital healthcare environment based on a comparative analysis of international standards and national regulatory practices.
Materials and Methods: This paper presents an analytical review. The study examined international personal data protection standards (primarily the EU General Data Protection Regulation, GDPR), Russian legislation (Federal Laws No. 323-FZ and No. 152-FZ, departmental regulations of the Russian Ministry of Health and Roskomnadzor), and scientific publications on information security, telemedicine, electronic medical records, and the use of big data. An assessment of the technological risks of the digital environment was conducted, and Russian and international approaches were compared. Particular attention was paid to the delineation of responsibilities between medical organizations and cloud service operators, informed consent, and cross-border data transfer.
Results: It was established that the classical concept of medical confidentiality, focused on the doctor-patient relationship, is inconsistent with the realities of distributed data processing involving IT developers and cloud service operators. Systemic gaps were identified: uncertainty in the distribution of responsibility between medical organizations and third-party services, insufficient security of information systems, the formal nature of informed consent, and conflicts during cross-border data transfer. A comparison with the GDPR revealed that Russian regulation lags behind in terms of data subject rights. It is shown that the expansion of the circle of data processing subjects to include IT developers and cloud platform operators erodes traditional privacy guarantees and complicates the identification of data controllers. Cyberattacks (phishing, ransomware, zero-day exploits) are recognized as the most significant practical threats.
Conclusion. An adaptive regulation model is proposed that combines mandatory certification of medical information systems, end-to-end encryption requirements, a unified incident registry, and multi-level compliance control with a clear distribution of responsibility. This approach allows for the synchronization of legal norms with technological developments and ensures a balance between privacy protection and the effectiveness of digital healthcare.
KEYWORDS: medical confidentiality; medical confidentiality; Personal data protection; digital health; telemedicine; GDPR; information security; electronic health records; big data.DELTA-SLEEP-INDUCING PEPTIDE: BIOLOGICAL EFFECTS AND PHARMACOLOGICAL POTENTIAL
UDC: УДК 616.092:543.645.Section: Literature review
Authors: Azovskaya Yesenia Artemovna; Iskusnykh Anna Yuryevna
Annotation: Purpose of the study. The purpose of this review article is to systematically analyze and summarize current scientific data on the biological effects and pharmacological potential of delta-sleep-inducing peptide (DSIP). The study aims to assess the potential for its use in the treatment of a wide range of pathological conditions, including metabolic, neurological, stress-induced, and age-associated diseases.
Materials and Methods. This article analyzes the scientific literature on delta sleep-inducing peptides. It also summarizes and systematizes data from experimental and clinical studies published in the scientific article databases Cyberleninka, Google Scholar, and Elibrary.
Results. It was established that DSIP, a nonapeptide with amphiphilic properties, exhibits a broad spectrum of biological activity. The peptide exhibits pronounced antioxidant properties, activating key defense enzymes (su-peroxide dismutase, catalase, and glutathione peroxidase), and has a membrane-stabilizing effect. Its ability to modulate neurotransmitter systems (GABA, glutamate, and catecholamines), regulate endocrine functions through the hypothalamic-pituitary-adrenal axis and circadian rhythms, and exhibit immunomodulatory effects was demonstrated. In pathological conditions, Delta-SIP exerts a complex protective effect: radioprotective (modification of post-radiation changes in the liver, spleen, and blood), hepatoprotective (reduction of AST and ALT activity), geroprotective (correction of age-related metabolic disorders, hypoglycemic and lipid-lowering ef-fects), and stress-limiting. Clinical studies confirm the
efficacy of a Delta-SIP-based drug (Deltaran) in the treatment of childhood epilepsy and stress-induced psoriasis, accompanied by positive dynamics of immunological parameters.
KEYWORDS: Delta-sleep-inducing peptide, regulatory peptides, metabolic disorders.BCG OSTETIS AS A COMPLICATION OF ANTI TUBERCULOSIS IMMUNIZATION WITH BCG VACCINE: A LITERATURE REVIEW
UDC: УДК 616-036.22Section: Literature review
Authors: Wekker Maria Aleksandrovna; Gilazutdinova Elvina Ilshatovna; Amirova Tanzilya Khafizovna; Zubrinkin Aleksey Vladimirovich
Annotation: DRUGS AFFECTING THE OUTCOMES AND PROGNOSIS OF DENTAL TREATMENT. FOCUS: SELECTIVE SEROTONIN REUPLOAD INHIBITORS AND IMPLANTOLOGY PROBLEMS
UDC: УДК 615.2Section: Literature review
Authors: Trukhan Dmitry Ivanovich; Sulimov Anatoly Filippovich; Epifanova Yulia Vladimirovna; Trukhan Larisa Yurievna; Chusov Innokenty Sergeevich; Stepanov Igor Nikolaevich
Annotation: ABSTRACT. Problems arising in the interaction between internists and dentists include a lack of understanding of the relationship between somatic and dental diseases and an underestimation of the need for an interdisciplinary approach when treating patients with comorbid/multimorbid pathology. Drug therapy for somatic diseases can impact a patient's dental status, treatment outcomes, and prognosis. Neuropsychiatric disorders complicate oral hygiene and routine dental clinical monitoring, and the medications used can compromise the health of the oral cavity and peri-implant tissues. Selective serotonin reuptake inhibitors are the cornerstone of treatment for depression, anxiety disorders, obsessive-compulsive disorder, and panic disorder in people of all age groups. Serotonin significantly inhibits bone mineralization and osteoblast differentiation.
We searched PubMed and Scopus for publications up to January 10, 2026, on the effects of selective serotonin reuptake inhibitors on the outcomes and prognosis of dental treatment. Experimental and clinical studies, reviews, and meta-analyses demonstrate a potential association between the use of selective serotonin reuptake inhibitors and implant failure and increased failure rates. To improve the effectiveness of dental treatment outcomes and prognosis, dentists need to be aware of the patient's concomitant/comorbid medical conditions and the potential side effects of medications that may negatively impact oral organs and tissue.
KEYWORDS: medications, selective serotonin reuptake inhibitors, bone tissue, implantology, implant, implant fail-ure, implant rejection.