Using the example of metronidazole, modern scientific achievements in the field of discovering new mechanisms for the development of resistance of bacteria and protozoa to antibacterial drugs are systematized. At the molecular level, the epigenetic variability of the development of resistance to metronidazole, as well as its proteomic component in the series of ligand-enzyme-substrate-associated specificity of interaction, is considered. Experimental models with bacterial strains show the prospects of overcoming the mechanisms of antibiotic resistance using modern nanomaterials and organometallic framework polymers. The possibility of selecting conditions and a matrix of metalorganic framework polymers to achieve targeted drug delivery is noted. The use of nanomaterials makes it possible to potentiate the effect of an anti-bacterial drug.

The rat’s upper jaw of is a unique experimental object in biomedical research and is used to model various pathological conditions: fractures, postmenopausal osteoporosis, disorders of dentinogenesis and enamelogenesis. The rat’s upper jaw and humans differ in a number of morpho-functional aspects related to the peculiarities of nutrition and the structure of incisors in rodents. However, a comprehensive study of the processes of its development, growth and formation in rats in the experiment will contribute to further understanding of the features of its organization in humans. The purpose of the research: to analyze the existing domestic and foreign literature, to summarize and systematize the available information about the structure of the laboratory rat’s upper jaw at various stages of ontogenesis. The literature search on the subject of the presented article was conducted using the elibrary and PubMed databases, inclusive, until 09.10.2024. Literature sources were analyzed regardless of date, language and type (full text or abstract only). The presented work comprehensively examines issues related to the sources and periods of development, the macroscopic structure of the upper jaw, the structural features of the alveolar bone and its response to exogenous stimuli, the structural organization of the enamel organ, dentin, cement, pulp, periodontium, their blood supply and innervation during various periods of ontogenesis. Despite the differences in structural and functional organization of the upper jaw of humans and rats, the basic structure of their alveolar bone, dentin, enamel, periodontium and pulp has much in common.

Acute enteral insufficiency in children is a serious clinical condition that requires in-depth study in the context of modern medical research. The urgency of the problem is due to the high frequency of this condition, as well as its significant impact on the quality of life of patients and the prognosis of diseases of the gastrointestinal tract. Research in this area contributes to the development of effective methods of diagnosis, treatment and prevention, which is crucial for improving outcomes in children with acute enteral insufficiency.

Goal. To systematize existing research and identify the main trends, achievements and gaps in current knowledge about intestinal insufficiency in children. To analyze the literature sources covering the problem of intestinal insufficiency in children to a depth of about twenty years to identify available data on optimizing algorithms for the diagnosis and treatment of this pathological condition in children.

Materials and Methods. A comprehensive search was conducted to select relevant literature sources, including specialized databases such as PubMed and Scopus, various medical journals, and other resources. The search criteria included publications published between 2005 and 2024 written in English and Russian, focusing on key aspects of adult intestinal insufficiency. Peer-reviewed scientific articles, dissertations, monographs, and review articles were considered for inclusion.

Results. Modern medicine has achieved significant success in studying intestinal insufficiency. However, the key aspects of its pathogenesis in children remain incomplete, making it difficult to ensure 100 % effectiveness of applied therapeutic methods.

Conclusion: Although surgery in Russia has great opportunities, diagnosis of intestinal insuffiency remains a difficult and time-consuming task for pediatric surgeons. It is important to continue researching this area in order to better understand the causes and develop more effective treatments.

The combination of hepatitis C and metabolic syndrome is a predictor of a high rate of HCV infection progression. Metabolic syndrome is an unfavorable factor in the progression of the acute process in hepatitis C into chronic. Bioimpedance analysis reveals the imbalance of body composition components in patients with metabolic syndrome and chronic hepatitis C.

The purpose was to study the parameters of bioimpedance analysis in patients with acute and chronic hepatitis C and to evaluate the prognostic factors of chronization of the process in the liver.

Material and research methods. The study involved 216 patients. The device "Analyzer of assessment of the balance of water sectors of the body. Studied the nutritional status of patients and components of body composition.

Results. In patients with chronic hepatitis C, the proportion of fat mass and the ratio of waist circumference to hip circumference are significantly higher than normal (p < 0.05), as well as higher than in patients with acute hepatitis, which can be considered as a sign of the severity of the metabolic syndrome, since excess body weight obtained by increasing the volume of adipose tissue prevails.

Conclusion. Body mass index and indicators of visceral obesity (waist-to-hip ratio) are significantly increased in patients with chronic hepatitis C. The phase angle indicator can be considered as a marker of chronicity of the inflammatory process in the liver.

A retrospective study was conducted on the treatment of 151 (100 %) patients with transsphincteric and extrasphincteric anal fistulas operated on in 2020-23. In the main group (n=70), two-stage treatment was performed: ligature-frame (patent for invention No. 2835127), followed by sphincteroplasty (36.4 %) or plastic surgery with a displaced flap (9.9 %). In the control group (n = 81), a single-stage treatment was performed: sphincteroplasty (41.7 %) or plastic surgery with a mixed flap (11.9 %). The groups were comparable by sex (p = 0.736), age (p = 0.703), disease duration (p = 0.394), comorbidity (p = 0.075), and body mass index (p = 0.851). The distribution of the internal fistula openings (anterior, posterior, and lateral) did not differ (p = 0.517–0.799). The average surgery time in the main group was 28 minutes, in the control group – 30 minutes (p = 0.082). A binary logistic regression study (n = 151) showed that the anterior localization of the internal fistula opening is the only significant predictor of disease recurrence (p = 0.045). Gender, age, body mass index, and other factors studied showed no significant association with disease recurrence (p > 0.05). It was also found that the method of surgical treatment significantly affects the outcome of treatment: single-stage surgery (sphincteroplasty) increases the risk of disease recurrence by 4.95 times (p = 0.016); plastic surgery with a divided flap – by 17.33 times (p < 0.001). Binary logistic regression analysis demonstrated moderate predictive ability (pseudo-R2 = 17.8 %), with a sensitivity of 89.7 % and a specificity of 42.6 %. It has been established that the anatomy of the fistula and the choice of the surgical method are critical for the prognosis of disease recurrence.

Low birth weight is a leading predictor of neonatal morbidity and mortality, as well as a factor associated with an increased risk of metabolic and cardiovascular disorders later in life. According to the Ministry of Health of the Russian Federation, the birth rate of children with hypotrophy in the Volga region over the past five years has remained consistently high (4–6 %), which underscores the need for accurate identification of regional risk factors associated with maternal diseases during pregnancy.

The aim of the study was to study the effect of maternal diseases suffered during pregnancy on the weight of the newborn, as well as to identify regional features of the prevalence of these diseases and their impact on the risk of fetal hypotrophy.

Materials and methods. The study included data on 5,477 newborns, of which 5,161 children had a normal birth weight, and 316 children were diagnosed with fetal hypotrophy. The following maternal diseases were selected for analysis: hypertension, preeclampsia, type 1 and type 2 diabetes mellitus (including gestational), urinary tract diseases, anemia, thyroid diseases, SARS-CoV-2 infection, and fetoplacental insufficiency. Statistical methods were used to assess the incidence of diseases and their effect on newborn weight, including univariate analysis of variance and logistic regression.

Results of the study. The analysis showed that the presence of hypertension, preeclampsia, diabetes mellitus, SARS-CoV-2 infection and fetoplacental insufficiency in the mother is significantly associated with a lower body weight of the newborn (p < 0.05). Logistic regression revealed the most significant risk factors for fetal hypotrophy, among which fetoplacental insufficiency and SARS-CoV-2 infection have the greatest impact (OR 8.50 and 6.00, respectively).

Conclusion. Maternal diseases suffered during pregnancy are significant risk factors affecting the weight of the newborn. The revealed data emphasize the importance of monitoring and timely treatment of hypertensive and diabetic conditions, infections and other pathologies during pregnancy to improve perinatal outcomes.

The article is devoted to the influence of substrates with high prebiotic potential on the functional activity of representatives of the normobiota of the large intestine Bifidobacterium bifidum.

Purpose of the study. Comparative assessment of the prebiotic potential of substrates in relation to Bifidobacterium bifidum under in vitro conditions.

Materials and methods. For the study, we took prebiotic objects that have bifidogenic activity and are available for use among the population for preventive and therapeutic purposes. The lyophilizate of the Bifidobacterium bifidum 791 strain reduced on Kitta-Tarozzi medium was used as a test culture; lactulose, pumpkin fiber, psyllium, apple pectin and inulin were used as prebiotic objects. Sowing of a daily culture of test strains of Bifidobacterium bifidum (n = 9) in 1 ml from pre-prepared dilutions 10^–7, 10^–8, 10^–9, 10^–10 was carried out in a regenerated Blaurocca nutrient medium. The results were taken into account visually by the presence of typical colonies in the form of strands characteristic of bifidobacteria (CFU/ml).

Results. Taking into account the prebiotic potential of lactulose revealed stimulation of the growth of bifidobacteria in dilutions 10-⁷ by 5.7 (p=0.009), in dilutions 10^-8 and 10^-9 – by 6.6 (p = 0.022 and 0.041, respectively), in 10^–10 – by 8.0 times (p = 0.0039) (comparison with culture control). Colonies of Bifidobacterium bifidum, when growing in test tubes with lactulose, looked like dense thick volumetric strands.

Conclusion. The study showed the predominance of the prebiotic potential of lactulose and pumpkin fiber in relation to Bifidobacterium bifidum in vitro. These substrates can be recommended for use in the prevention and treatment of dysbiotic disorders provoked by risk factors.

Uncomplicated recurrent lower urinary tract infection is a pressing problem not only for urologists, but also for clinical microbiologists. Currently, there are no quantitative indicators of diagnostically significant bacteriuria levels, which complicates the interpretation of bacteriological test results. The chronic and recurrent nature of the disease may be associated not only with quantitative, but also with qualitative (pathogenic, persistent) characteristics of uropathogens.

Objective: to study the relationship between hemolytic, antilysozyme activities, extended-spectrum βlactamase production with virulence genes in gram-negative uropathogens in uncomplicated recurrent lower urinary tract infection in women. Proven pathogens, representatives of gram-negative microbiota with a predominance of E. coli (74.2 %), were isolated from the urine of 62 patients with uncomplicated recurrent lower urinary tract infection. In all strains isolated from urine the virulence genes were determined: papA, papE/F, papGII, afa, bmaE, fyuA, iutA, feoB, kpsMII, usp. These virulence genes were responsible for adhesion, iron absorption system, capsule synthesis and uropathogenic specific protein. In parallel, hemolytic activity, antilysozyme activity, as well as production of extendedspectrum β-lactamases were determined in the isolated strains. The study showed that strains of gram-negative bacteria isolated from the urine of patients in most cases had hemolytic activity (61.3 %), production of extended-spectrum βlactamases (56.5 %). All strains had antilysozyme activity and in all of them the studied virulence genes were presented. The presence of hemolytic activity was reliably associated with such virulence genes as feoB, fyuA, usp, papA, kpsMII; the presence of antilysozyme activity was associated with papA, afa and fyuA; production of extended-spectrum βlactamases – with papA and fyuA. Common virulence genes for which a relationship with the presence of hemolytic activity, antilysozyme activity, production of extended-spectrum β-lactamases were papA and fyuA. The detected reliable correlation relationships between the studied features with certain virulence genes more likely can lead to a chronic and recurrent course of the disease and maintenance of the infectious and inflammatory process in the urinary tract.

The aim of this study was to identify the key problems and prospects for the development of biologically active suture materials. Modern domestic and foreign literature sources on this topic were analyzed. One of the main difficulties remains the creation of a universal suture material that would combine the advantages of existing solutions without their disadvantages. Current developments, such as “Tveran” (“Volot”, Russia) or combination of polypropylene and polyglycolic acid with fluoroquinolones, show high efficiency, but their use is associated with the risk of antibiotic resistance development. This problem is becoming increasingly important due to the emergence of resistant strains of microorganisms. Additional limitations include the hydrophobicity of filaments, as well as the lack of functional groups for immobilization of active compounds on the surface of the suture material. Addressing these issues can significantly improve the efficiency and safety of suture materials.

Food-borne botulism is a severe and often deadly food-borne bacterial poisoning. 300-500 cases of the disease are registered annually in Russia, and in 2024 an outbreak was recorded with 417 people infected in 11 regions of the country. Botulism in pregnant women is particularly dangerous. The study of such cases is of scientific interest, as it allows us to assess the effect of the disease not only on the pregnant woman's body, but also on her fetus, to determine the features of the course of the disease in this category of patients, the effectiveness, timeliness, safety and adequacy of medical care and treatment. The article describes a case of severe food-borne botulism in a woman at the 28th week of pregnancy with the release of botulinum toxin type A + E, and a successful temporary resolution of pregnancy. There was no adverse effect of botulism on the course of pregnancy, fetal development and delivery. The paper provides an analysis of the clinical picture of food-borne botulism.

Posterocapsular cataract due to the use of glucocorticoids is a clinically significant adverse reaction that is accompanied by a decrease in the patients’ ability to work and their quality of life. The use of these drugs as a preventive anti-inflammatory therapy during the new coronavirus infection pandemic, the increase in the overall incidence of cataracts in the Chuvash Republic in recent years, and the lack of scientific literature describing such adverse reactions make it relevant to demonstrate a clinical case of steroid cataract in a patient after a new coronavirus infection.

The purpose of the study was to draw the attention of practitioners to the problem of the safety of dexamethasone pharmacotherapy using the example of a case of posterior capsular cataract in both eyes after a new coronavirus infection.

Materials and research methods. On the basis of the Budgetary institution “Republican Clinical Ophthalmological Hospital” of the Ministry of Health of the Chuvash Republic (Cheboksary), a retrospective analysis of the case of posterocapsular cataract of both eyes in a patient was performed after 1.5 years of hospital treatment for a new coronavirus infection using therapeutic doses of dexamethasone.

Research results. Patient E., 68 years old with posterior capsular cataract of both eyes, applied to the Budgetary institution “Republican Clinical Ophthalmological Hospital” of the Ministry of Health of the Chuvash Republic for surgical treatment. It became known from her medical history that 1.5 years ago she received hospital treatment for a new coronavirus infection complicated by pneumonia using dexamethasone. After that, she began to notice a gradual decrease in vision in both eyes, about which she contacted the Republican Clinical Ophthalmological Hospital. Upon examination by an ophthalmologist, posterocapsular cataract of both eyes was diagnosed, and therefore the patient was hospitalized for surgical treatment.

Conclusions. This clinical case demonstrates that the use of therapeutic doses of dexamethasone against the background of a new coronavirus infection may precede the development of posterocapsular cataract as a clinically significant adverse reaction that necessitates hospitalization and surgical treatment.