Victor V. Romantsov

The reform of the postgraduate medical education system in the Russian Federation has significantly impacted the quality of professional knowledge acquired by specialists and has also revealed several problems in medical education. The transition from the traditional system of advanced training, coupled with the introduction of periodic accreditation, has created additional challenges for specialists in gaining access to professional practice. The Department of Psychiatry No. 2 of the Kuban State Medical University of the Russian Ministry of Health (Kuban State Medical University) conducted an anonymous survey of 212 psychiatric specialists and clinical psychologists at specialized institutions in the Krasnodar Territory, representing 30.0% of the total. Respondents expressed a number of preferences for optimizing existing postgraduate training. The transition to periodic accreditation and its practical significance in line with current requirements dominated the negative responses, accounting for 24.1% of cases, which is a worrying signal.

Background: the problem of studying certain aspects of the quality of life of patients with mental disorders, including the neurotic spectrum, remains insufficiently disclosed. The level of quality of life is influenced by various factors, one of which is the nature of intra-family relationships, which largely depends on the indicators of social functioning. The aim was to identify and analyze indicators of social functioning that undergo changes against the background of the development of neurotic spectrum disorders and have an impact on intra-family relationships. Patients and Methods : a simultaneous prospective comparative study of individual aspects of social functioning affecting family relationships of patients with neurotic spectrum disorders before and after the development of neurotic pathology was conducted. The research material was data from an anonymous voluntary survey of 500 patients with diagnoses according to the International Classification of Diseases 10th revision (ICD-10) — F40–F48; F32; F06. A specially designed questionnaire was used, which included blocks for assessing family status, work, financial situation, fear of stigmatization, and the specifics of seeking specialized help. Results : against the background of the development of a neurotic mental disorder, the divorce rate increased 3-fold, and the level of conflict in families increased significantly. The deterioration of the financial situation due to the forced transition to a job with a lower salary was subjectively associated with an increase in the number of family conflicts in 69.4% of cases. A pronounced fear of intra-family stigmatization was noted by 31.2% of patients, while external stigmatization was noted by 39.6%. More than a third of patients (36%) first sought specialized psychiatric help only 2 years or more after the onset of the disease. One of the main reasons of late referral was the fear of stigmatization due to their disorder. Conclusion : indicators of social functioning such as marital status, financial status, and fear of stigmatization of an existing neurotic disorder show significant dynamics and are closely related to the nature of intra-family relationships in patients with neurotic spectrum disorders. Studying the specific effects of neurotic spectrum disorders is important for developing an integrated approach to therapy and rehabilitation.

Today, a relevant aspect of developing a competent understanding of medicine as a complex science interconnected with a number of humanities disciplines is to consider its history through the prism of the most outstanding research teams of scientific medical schools. The presented article is devoted to consideration of the historical path of formation and development of the scientific medical school of anesthesiology and resuscitation in Kuban. The authors provide data on the prerequisites (conditions for improving knowledge about anesthesiology and resuscitation in the region) and the main stage of this process. The materials of the historiographic research were data from archival funds, in particular the state archive of the Krasnodar Territory and the Museum of History of the Kuban State Medical University, personal collections of members of the scientific school, as well as specialized literature within the scope of the work. The research methodology involved the use of chronological, biographical, analytical and narrative methods.

Today, a relevant aspect of developing a competent understanding of medicine as a complex science interconnected with a number of humanities disciplines is to consider its history through the prism of the most outstanding research teams of scientific medical schools. The presented article is devoted to consideration of the historical path of formation and development of the scientific medical school of anesthesiology and resuscitation in Kuban. The authors provide data on the prerequisites (conditions for improving knowledge about anesthesiology and resuscitation in the region) and the main stage of this process. The materials of the historiographic research were data from archival funds, in particular the state archive of the Krasnodar Territory and the Museum of History of the Kuban State Medical University, personal collections of members of the scientific school, as well as specialized literature within the scope of the work. The research methodology involved the use of chronological, biographical, analytical and narrative methods.

The article examines in detail the historical process of organization and subsequent development of the first psychiatric hospital in Kuban - the State Budgetary Healthcare Institution "Specialized Clinical Psychiatric Hospital No. 1" of the Ministry of Health of the Krasnodar Territory, covering a period of 120 years. The authors conducted a historiographical study based on materials from departmental, private and state archives, memories of hospital employees, as well as specialized literature. The results of the work done are presented in detail in chronological order. For the first time, data has been established and systematized, reflecting the sequence of transformations of the psychiatric department, opened by the Cossack military administration of the Kuban region, into an independent institution, acting as the flagship of the system of providing psychiatric care to the population of the Krasnodar region. Data are provided on changes in the hospital's bed capacity, the composition of inpatient and outpatient departments, chief physicians, as well as features that influenced its development in various years.

СОВРЕМЕННОЕ ПРЕДСТАВЛЕНИЕ О НАУЧНЫХ МЕДИЦИНСКИХ ШКОЛАХ В РАМКАХ НАУЧНОГО ОБРАЗОВАНИЯ ЧЕРЕЗ ПРИЗМУ СТУДЕНЧЕСКОГО ВОСПРИЯТИЯ

Introduction: The article discusses formation and development of the Kuban school of thought in thoracic surgery. We reviewed the main aspects of the accumulation of knowledge and experience in thoracic surgery and formation of a scientific association of thoracic surgeons that further developed into a school of thought first regionally, then internationally.Objective: To analyze the main stages of the development of the Kuban school of thought in thoracic surgery through the prism of scholars who made major contributions to the formation of the school’s research concept, as well as through succession (transfer of scientific and medical experience).Materials and methods: Our methodology involved a comparative historical analysis of the most important stages of the development of the school of thought in thoracic surgery, a retrospective evaluation of the contributions made by the surgeons who transformed the surgical community, and a comprehensive analysis of research materials on this subject. We used retrospective, biographical, analytical, and comparative research methods.Results: We identified the fundamental trends in the development of the Kuban school of thought in thoracic surgery, key directions for improving the methods of chest pathology diagnosis and surgical treatment that have been forming in the Kuban over the past 100 years.The education and training of staff, as well as formation of a scientific medical community and its international integration clearly demonstrated the transformation dynamics of the Krasnodar Krai’s research potential in thoracic surgery.

Background. Central nervous system tuberculosis is one of the most severe forms of extrapulmonary tuberculosis, which is due to an unfavorable clinical course, a high incidence of neurological complications and deaths. Despite this, the problem of early diagnosis is still not solved. Aim. To study the clinical and laboratory-instrumental features of the early diagnosis of tuberculous meningitis in HIV-infected patients. Materials and methods. A retrospective analysis of 31 case histories of patients with tuberculous lesions of the meninges and central nervous system in the late stages of HIV infection who were treated at the Clinical Tuberculosis Dispensary of Krasnodar Territory in 20202022 was carried out. The data of clinical manifestations of the disease, the results of laboratory and instrumental methods of examination were analyzed. Statistical data processing was performed by Microsoft Office Excel 2021 with the calculation of averages, standard deviation. Results. Tuberculous lesions of the meninges and the central nervous system among HIV-infected people were more common in men of working age who were not previously registered in a tuberculosis dispensary. All HIV-infected patients had late stages of HIV infection with severe immunodeficiency: the content of CD4+ lymphocytes less than 100 cells was detected in 45.46%; from 100 to 200 cells/l of CD4+ lymphocytes were recorded in 36.36%, more than 200 cells/l in 18.18%. Also, in all the studied patients, the primary focus was established in the form of tuberculosis of the respiratory organs, represented in 56.52% of cases by disseminated pulmonary tuberculosis. More than 70% had generalized tuberculosis with damage to the kidneys, spleen, and peripheral lymph nodes. A feature of the manifestation of tuberculous meningitis in HIV-infected people can be considered a high frequency of acute increase in neurological symptoms. Of the cerebral manifestations, the most common were: headache, dizziness, photophobia. 13.04% of HIV-infected patients complained of nausea and vomiting. 91.30% showed signs of damage to the substance of the brain, represented by mono-, hemiparesis and damage to the cranial nerves, mainly IIIIV, VI, VII pairs. The composition of CSF in HIV-positive patients revealed the presence of mild pleocytosis (up to 100 cells/l) in 56.52% of cases. The nature of the change in the concentration of proteins, chlorides and glucose is nonspecific. Conclusions. The study revealed the features of medical and social characteristics, clinical and laboratory and instrumental picture of tuberculous meningitis in HIV-infected patients and without HIV infection.