Annals of the Russian academy of medical sciences

Background: iduction of labor (IL) is a technology of early delivery for diseases and complications in pregnant women. At the same time, the frequency of IR in obstetric hospitals at various levels has not been sufficiently studied.

Аims: analyze the frequency of IL using the example of the Sverdlovsk region (SR) and of Yekaterinburg in 2014–2022.

Materials and methods: a cross-sectional simultaneous study of the frequency of IL in medical organizations of the Sverdlovsk region and the Yekaterinburg in 2014-2022 was conducted. The Federal Statistical Observation Form No. 32 «Information on medical care for pregnant women, women in labor and women in labor» was analyzed. The frequency of IL was calculated as the ratio of the number of IL to the total number of births and expressed in ppm (‰). The effectiveness of IL was determined using the coefficient of IL.

Results: the number of births in the SR decreased 1.6 times, in Yekaterinburg — 1.4 times in 2014-2022. The frequency of IL in the region was 102.3%, in the city — 177.0% in 2022. The average growth rate of the IL index was 4.3% and 4.9%, respectively, in 2015–2022. IL has not been used in obstetric hospitals of the 1st group since 2018. In obstetric hospitals of groups 2 and 3, the frequency of IL has increased in the Sverdlovsk region since 2016 (p<0.001), in the city — in 2017 (p<0.001) compared with 2014. The average growth rate of IR in obstetric hospitals of the 3 group in the Sverdlovsk region was 21%, in Yekaterinburg — 37% and was characterized by a pronounced growth trend in 2015–2022.

Conclusions: induction of labor was used only in obstetric hospitals of the 2 and 3 groups. An indicator of the frequency of induced labor is recommended for monitoring the stage of medical care for pregnant women.

Background. More and more data confirm the need for personalized pharmacotherapeutic treatment based on the genetic characteristics of the patient, which will become the main method of future antihypertensive treatment, especially in patients with refractory hypertension, in order to rationally prescribe pharmacotherapy.

Aims — to study the pharmacodynamic parameters of the effectiveness of therapy with angiotensin II receptor blockers in the form of monotherapy and as part of combined drugs in patients with hypertension, depending on the genetic characteristics of patients – the genetic polymorphism A1166C of the angiotensin II type 1 receptor gene (AGTR1). Methods. The study included 179 patients from the Moscow region with newly diagnosed arterial hypertension (AH) of 1–2 degrees, among whom 141 (78.8%) women and 38 (21.2%) men aged 32 to 69 years, who were randomly assigned to irbesartan and valsartan groups in the form of mono- or combination therapy with hydrochlorothiazide by a simple randomization method. After 3 weeks of pharmacotherapy, the presence of the rs5186 (A1166C) genetic polymorphism of the type 1 angiotensin II receptor gene (AGTR1) was determined.

Results. After 3 months of valsartan therapy, among heterozygotes, the change in office DBP was statistically significantly less pronounced compared to the A/A genotype by an average of 5.4 mmHg (p = 0.009), and there was also a less pronounced decrease by an average of 5.6 mmHg, however, not statistically significant, in heterozygotes compared to the C/C genotype (p = 0.192). There was a tendency in patients with genotype A/C compared with genotype A/A after 3 weeks of using irbesartan in the form of a less pronounced decrease in office SAD by an average of 4.3 mmHg. The decrease in office DBP was less pronounced by an average of 5.2 mmHg (p = 0.019); patients with CC genotype also showed a less pronounced decrease in DBP (by an average of 4.2 mmHg), compared with the A/A genotype, however, this difference was not statistically significant (p = 0.48).

Conclusions. The A1166C polymorphism of the AGTR1 gene significantly affects the antihypertensive effect of valsartan in patients with grade 1–2 hypertension, leading to a decrease in DBP and an increase in HR in A/C heterozygotes compared to A/A homozygotes. No association between the polymorphism and the antihypertensive effect of irbesartan was identified; however, patients with A/C and C/C genotypes showed a less pronounced reduction in SBP and DBP. No relationship was found between genotype and the achievement of target BP levels or the need for therapy intensification. Further prospective studies with a larger sample size are required to clarify the genetic factors influencing the antihypertensive efficacy of ARBs.

The scientific, technical, ethical, and legal aspects of applying artificial intelligence (AI) in modern medicine, as well as its impact on medical professionals and patients, are examined. The research methodology is based on the analysis of scientific publications dedicated to the use of AI in medicine. Systematization of the available data allows identifying key limitations faced by developers of medical AI systems and their users. These issues are related to the quality and completeness of the data on which machine learning models are built, the limited clinical context, challenges in knowledge generalization, and system interoperability. Ethical challenges include concerns about privacy, algorithmic bias, and the distribution of responsibility. Additionally, there are issues regarding the regulatory framework for AI in healthcare and the training of medical professionals in computer technologies. Overcoming these limitations requires improving data quality, developing multimodal systems, increasing algorithm transparency, and refining the regulatory framework.

Background. To date, the lack of modern algorithms for the diagnosis and treatment of various forms of otosclerosis (OS) leads to progressive bilateral hearing loss, failures and complication during the operation and disability of the socially active part of the population. The development of a modern therapeutic and diagnostic algorithm for various forms of OS is an urgent topic, the development of which became possible due to the advent of modern medical technologies: high-resolution computed tomographs, microscopes, endoscopes, surgical lasers and motor systems.

Aims — to develop an innovative treatment and diagnostic algorithm for various forms of otosclerosis.

Methods. In a non-randomized controlled prospective study, the results of the examination, treatment and follow-up of 2,421 patients with OS in the period from 2009 to 2022 were analyzed. Conservative inactivating therapy was performed in 288 patients with active and 28 with cochlear forms of OS. Stapedoplasty was performed in 2,393 patients. A partial stapedectomy was performed in group 1, a piston stapedoplasty technique was performed in group 2, and a wide stapedotomy was performed in group 2. In all cases, the operation was performed with CO₂ laser assistance (Acuspot 30C, Lumenis, USA). In the obliterating form of OS, various stapedoplasty techniques were performed, depending on the stage, with various means of assistance (the Skeeter Otologic Drill System motor System (Medtronic Xomed, USA) and a CO₂ laser. When the active form was detected, piston stapedoplasty with CO₂ laser assay was performed. The evaluation of the functional results of the developed methods of stapeplasty (stapedoplasty) was carried out according to the tonal data. Results. For the first time, based on the results of examination, treatment and treatment of a significant number of patients (2421), a modern therapeutic and diagnostic algorithm and a new clinical and radiological classification for OS have been developed. In a comparative assessment of the functional effectiveness of the developed stapedoplasty techniques, the best results were obtained after performing partial stapedectomy and wide stapedotomy (groups 1 and 3) — “excellent” results were achieved after 3 months in 96% of patients, and with piston (group 2) — after 6 months in 78% with a closure of less than 10 dB (p ≤ 0.05). Cochlear complications in the early postoperative period were detected in 0.8% of patients and recurrence of hearing loss in the long-term period in 1%.

Conclusions. The accumulated many years of experience in examining and surgical treatment of patients with OS allowed us to develop an algorithm for diagnosis, treatment and a new clinical and radiological classification, which led to an increase in the frequency of diagnosis of OS and the effectiveness of treatment of hearing loss in patients with various forms of OS.

Background. Minimally invasive surgery (MIS) has been increasingly utilized as an alternative to open surgery (OPEN) for lumbo-sacral spondylolisthesis treatment. However, comparative analyses of outcomes remain limited.

Aims — to compare perioperative and functional outcomes between MIS and OPEN in patients with lumbar spondylolisthesis.

Methods. A retrospective cohort study of 224 patients (2018–2024) was conducted. Patients were divided into MIS (n = 120) and OPEN (n = 104) groups. Outcomes analyzed included surgical duration, blood loss, hospital stay, functional recovery (Oswestry Disability Index, ODI), pain reduction (Visual Analog Scale, VAS), and complications. Statistical analysis was performed using the Wilcoxon rank-sum test (p < 0.05 considered significant).

Results. MIS demonstrated shorter operative time (145 min vs. 200 min, p < 0.001), reduced blood loss (140 mL vs. 400 mL, p < 0.001), and shorter hospital stay (4 vs. 9 days, p < 0.001). Functional recovery and pain relief were also superior in MIS, with fewer complications.

Conclusions. MIS is associated with faster recovery, lower complication rates, and improved functional outcomes compared to OPEN. These findings support the increased adoption of MIS in lumbar spondylolisthesis treatment.

April 27, 1955 marked the 70th anniversary of the prominent scientist, specialist in the field of oncology, radiology and healthcare organization, to the laureate of the Government of the Russian Federation Award in science and technology, Honored Doctor of the Russian Federation, Academician of the Russian Academy of Sciences Vladimir Alekseevich Solodkiy.

On June 1, 2025, the 75th anniversary was celebrated by the largest Russian scientist, embryologist, outstanding specialist in the field of development biology, ethnic features of health and diseases, well-known organizer in the field of science and education, political and public figure, winner of the Lenin Komsomol Prize in Science and Technology, winner of the Prize of the Government of the Russian Federation in Science and Technology, Honored Scientist of the Russian Federation, Academician of the Russian Academy of Sciences Sergey Ivanovich Kolesnikov.