Computer-Assisted Semen Analysis (CASA) systems are currently widely used to evaluate human spermatozoa as an alternative method to traditional manual semen examination, which has several limitations. The introduction of digital microscopy with subsequent automatic artificial intelligence-based object recognition is considered as a promising direction in optimizing semen analysis. During this research study, 100 semen samples were examined with a consistent evaluation of sperm motility and morphology, DNA fragmentation, and the presence of leukocytes in each sample. Each sample was examined sequentially: first using the Vision Assist automatic scanning system and Vision Sperm software, then by manual microscopy. As a result of the study, data was obtained that using the Vision system allows for a faster and more standardized semen analysis: the average time spent on automated evaluation of semen was two times less compared to manual microscopy of semen. Thus, the use of Vision systems reduces the time for conducting semen analyses, standardizes them, increasing the efficiency of laboratories.
Higher medical education, despite some specificity of its organization, has always followed promising trends. Modern challenges inevitably transform the practice of educational interaction. The changes are related to the digital vector of transformations, the expansion of the technological component of the educational process, and the increased subjectivity of interaction actors. Rapidly changing circumstances place increasingly high demands on the teaching staff of universities, stimulating interest in the psychosomatic well-being of medical educators as a condition for effective adaptation to difficult-to-predict communication situations. The purpose of the study is to assess the state and prospects of personalizing the educational process at a medical university based on an integrative assessment of the teaching community. The results of the study made it possible to assess the significance of a personalized approach in training personnel in higher medical education, as well as to specify its risks. In conclusion, the statement is formulated about the significance of the psychosomatic well-being of medical educators in organizing personalized interactions, the indicators of which correlate with general, emotional, and volitional control.
Introduction. This article presents the results of a retrospective analysis of preferential drug provision for outpatient patients in the Republic of Uzbekistan (RUz) over the period from 2021 to 2025. Based on reports from the Dori-Darmon pharmacy network, the dynamics of prescription dispensing and funding volumes were examined. The monitoring results revealed a decrease in the quantitative indicators of dispensed prescriptions alongside an increase in overall expenditures. This trend demonstrates a shift from an extensive to an intensive model of pharmaceutical provision. A significant increase in the average cost of a single preferential prescription was identified. The main financial burden within the system is associated with oncology, endocrinology, and hemodialysis services. Materials and methods. This paper describes the findings of the retrospective analysis conducted on the preferential provision of pharmaceuticals (referred to as ‘LO’) based on existing objective structural and statistical parameters for the years 2021 through 2025 in the Republic of Uzbekistan. The analysis examined the dynamics of issuing prescriptions; the volume of financial funding received from the state (in both material as well as monetary form); and the average total cost of prescriptions by region and type of disease (nosology). All data were obtained primarily from the Dori-Darmon JSC pharmacy chain's 2021 summary reports (the last available report at the time of conducting this research). Results. The report showed a significant decline in the number of prescriptions written over the five-year period – a decrease of 89,104 prescriptions in total during that same time frame. While this decrease occurred despite an increase in total costs from approximately $2,15 million in 2023 to $2,51 million in 2025, it is also notable that as there is now a shift from an extensive model of LO to an intensive model of LO. The average cost of 1 preferential prescription was dramatically increased from about $4,28 in 2021 to about $5,71 in 2025. The main factors driving these increases were the number of patients requiring hemodialysis; additionally, as more dollars have been made available for oncology treatment, those patients are now using prescription medications rather than hospital-based services. Conclusion. Currently, oncology, endocrinology and psychiatry account for the majority of the financial strain within the system. Nosologically and regional divergence creates the need for the introduction of new budget planning tools and to allocate expenditures appropriately.
Introduction. Post-COVID syndrome (PCS) is associated with persistent dysfunction of the coagulation system, which is often latent and cannot be verified by standard coagulation tests. Therefore, adequate risk stratification requires a transition to integrated methods for assessing thrombin potential in combination with standard tests, which will allow personalization of antithrombotic prophylaxis strategies during the rehabilitation period in patients who have recovered from COVID-19. Aim. To evaluate the parameters of the thrombin generation test (TGT) and D-dimer level in patients with a history of COVID-19. Materials and methods. The study included 80 patients with a history of COVID-19, examined 6 months after recovery. At the time of the study, all patients were receiving clinically selected therapy according to their comorbidities. The control group consisted of 68 healthy individuals without cardiovascular diseases, thromboembolic complications, or a history of COVID-19 at the time of inclusion. In patients who had recovered from COVID-19 (6 months after recovery) and in control subjects, the thrombin generation test (TGT) was performed using an automatic Ceveron-alpha coagulometer, and D-dimer levels were measured using an ERBA ECL 412 coagulometer. Additionally, D-dimer levels were analyzed in patients during the acute phase of COVID-19. Results. Six months after COVID-19, patients showed a statistically significant decrease in thrombin generation test (TGT) values compared to the control group, primarily due to the use of direct oral anticoagulants (DOACs). No significant differences in any TGT parameters were found between patients who had severe and moderate forms of the disease. D-dimer levels six months after recovery were significantly higher than during the acute phase. Conclusion. The study confirms that post-COVID syndrome is associated with prolonged activation of the hemostatic system, characterized by an increase in D-dimer concentrations by the sixth month of observation compared to the acute phase of the disease. The absence of a statistically significant correlation between baseline and current values of this marker indicates the independent nature of delayed fibrinolytic impairments, likely due to persistent endothelial dysfunction rather than the severity of primary coagulopathy. At the same time, an integrated assessment of the hemostatic system using a thrombin generation test allows for the evaluation of the effectiveness of anticoagulant therapy.
Aim. To analyze the relationship between semiological diagnosis and SSC (sperm sediment cytology)-bacteriospermia (SSC-mB “+”) in infertile male. Results. 162 men (162; 30.62 %) with various combinations of semiological diagnoses were presented by SSC-mB “+”. According to investigation, SSC-mB “+” has a relationship with pathospermia. Mostly, the combinations of semiological diagnoses like agglutination, dyskinesia, asthenozoospermia, necrozoospermia, oligostenozoteratozoospermia and viscosipathy are attended SSC-mB “+”. The combinations of semiological diagnoses like pyospermia, oligoastenozoospermia, hemospermia less often are atttended SSC-mB “+”. Semiological diagnoses of oligospermia, azooospermia, cryptozoospermia and normozoospermia most are not attended SSC-mB “+”. If oligoastenotheratozoospermia, oligoastenozoospermia, viscosipathy, pyospermia, and agglutination are presented there is a high probability of SSC-mB “+”. If necrozoospermia is presented there is a low probability of SSC-mB “+”. If asthenozoospermia, dyskinesia, cryptozoospermia, azoospermia, hemospermia, and oligospermia are presented the assumption of SSC-mB “+” is unlikely. Conclusion. The data can provide the attending physician with evidence-based information about the relationship between SSC-mB “+” and semiological diagnoses that will support a correct interpretation the outcomes of easy-to-perform microscopic methods “Basic semen examination+SSC”-ROSE which can claim to be screening for detection of bacteriospermia.
Cytologic screening is only effective with adequate material. The Bethesda System (TBS), an international system for standardizing the results of cervical cytology, establishes criteria for adequacy. According to the TBS, a sample prepared by liquid-based cytology (LBC) can be classified as adequate if it contains not less than 5,000 squamous epithelial cells. There are methods of manual assessment of the cellularity of cytological samples. However, the uniformity of cellular material distribution of LBC samples makes possible the application of automatic tools for assessing the adequacy of the material based on the cellularity criterion. This paper compares the results of digital LBC samples adequacy assessment using the automated artificial neural network method Vision Cyto Pap and the manual assessment method. Analysis of the results of counting squamous epithelial cells in 506 LBC samples showed a significant correlation (r = 0.93) between the automated and manual method. The high diagnostic parameters (sensitivity = 93.8 % and specificity = 99.2 %) of the automated Vision Cyto Pap method allow to conclude that the algorithms of such a tool can be used to determine the adequacy of the cytological material by the number of squamous epithelium cells with sufficient reliability.
Aim of the study. Assess the diagnostic capabilities of detecting microorganisms in the wild ejaculate and sediment ejaculate. Materials and methods. 42 male volunteers were examined, aged 28 to 69, who were married and had children. Men applied for a preventive examination and to exclude asymptomatic male accessory gland infections. All patients had no active complaints characteristic of inflammatory diseases of the genitourinary tract. The study of the wild ejaculate and sediment ejaculate was performed by PCR real-time on DT-96 amplifiers (NPO DNA-Technology LLC, Russia) using the Androflor? test. Results. The value of the total bacterial mass in the sediment of the ejaculate is not statistically significantly higher compared to the wild ejaculate (p > 0.05). Candida spp. was statistically significantly more common in semen sediment (p < 0.05). In the sediment of the ejaculate were more often identified Enterobacteriaceae spp. / Enterococcus spp., Haemophilus spp., Staphylococcus spp., Streptococcus spp., Bacteroides spp. / Porphyromonas spp. / Prevotella spp. and Anaerococcus spp. (p > 0.05). In 11.9 % of observations, in the absence of bacteria in the wild ejaculate, microorganisms in low titers were identified in sediment ejaculate. Conclusion. According to the data obtained, the performance of the biological sample of the ejaculate sediment is higher compared to the sample of the wild ejaculate. The proposed modification of the preanalytical laboratory stage of the PCR technique, namely the diagnosis of ejaculate sediment using PCR real-time with the Androflor? test, makes it possible to more accurately determine pathogens, including those persisting in the form of biofilms in male accessory gland, even at low concentrations.
In this article, the purpose of the study was a comparative analysis of the parameters of the functional state of the body of students under the systematic influence of moderate physical exertion of northern (Scandinavian) walking. The study included 85 second-year students of the Volga Research Medical University. To visualize the indicators of the state of the body, the system of sports testing “MedicalSoft” was used. The functional status of the students' organism was studied before the start of Nordic (Scandinavian) walking classes, and after the completion of a two-month course of exposure to metered physical exertion. The analysis of the data obtained was carried out in accordance with the age standards that were formed by the developers of the equipment. It is established that systematic health-improving and training loads favorably affect the state of the body of the subjects, increasing its adaptive capabilities, which is confirmed by dynamic changes in the values of integral indicators.
Rehabilitation, as a system of medical, psychological, socio-economic measures aimed at eliminating or possibly fully compensating for disabilities, is of great importance in the social protection of disabled people and the prevention of disability. In the article, based on the analysis of the cur-rent legislative and regulatory acts, scientific articles on the topic of rehabilitation and our own research, it is shown that there is no proper correspondence between the theory of rehabilitation, regulations and the organization of the rehabilitation process in medical institutions. The authors have proposed a number of ideas and activities that, in their opinion, should help in resolving existing inconsistencies and contradictions.
Background. Chimeric Antigen Receptor T-cell (CAR-T) therapy demonstrates significant potential in oncology; however, its application in solid tumors, particularly ovarian cancer, is subject to several limitations. The development of novel T-lymphocyte vectors specific to tumor antigens necessitates a comprehensive preclinical assessment, including the study of the pharmacokinetic profile. Objective. To establish the key pharmacokinetic parameters of the developed CAR-T cell product (GM-TLP) designed for the therapy of CA125-expressing tumors. Materials and methods. The study was conducted on outbred mice and Chinchilla rabbits. The animals received a single intravenous injection of genetically modified T-lymphocytes, transfected with the CA125-specific plasmid, at a dose of $10^6$ cells per injection. Pharmacokinetic parameters were assessed by the quantitative determination of plasmid DNA in the mononuclear cell fraction of the blood and homogenates of internal organs using real-time PCR (qPCR) over a period of 30 days post-administration. Results. It was found that the maximum concentration of plasmid DNA in the blood of animals is reached 30 minutes after injection. A rapid decrease in concentration was shown during the first day, followed by reaching a plateau (11.2 – 13 % of cmax in the period from 3 to 12 days. By the 30th day, the concentration was approaching the background values. Rapid distribution of GM-TLP into parenchymal organs was noted: maximum concentrations in the spleen (44.8 ± 8.98 pg/ml), liver (25.4 ± 4.56 pg/ml), lungs (18.9 ± 3.87 pg/ml) and thymus (12.3 ± 2.54 pg/ml) were also recorded after 30 minutes. The modified lymphocytes and plasmid DNA persisted in the studied tissues during the entire follow-up period (30 days). Conclusion. The obtained pharmacokinetic data confirm the ability of the developed CAR-T cell product for rapid distribution and sustained persistence in the body of experimental animals. This prolonged persistence is a critically important factor for ensuring a sustained antitumor effect. The established pharmacokinetic parameters provide a solid basis for the further development and optimization of the therapeutic strategy.
