JOURNAL OF EDUCATION AND SCIENTIFIC MEDICINE

CYTOKINEMIA IN ADHESIONS OF THE ABDOMINAL CAVITY AND ITS COMPLICATIONS IN ELDERLY AND SENILE PATIENTS

A.O. Okhunov — 2026-01-26

The high incidence of acute commissural small bowel obstruction and its complications in elderly patients is accompanied by an increase in postoperative mortality, which is based on immune system disorders. We set ourselves the goal of determining the degree of cytokinemia development in patients with various forms of abdominal adhesions. At the same time, among the analyzed cohorts of patients, we also identified patients with acute adhesions, small intestinal obstruction and a form complicated by peritonitis. In the blood of patients, we study the concentration of interleukins, which belong to the group of pro-inflammatory. We found that changes in the concentration of interleukins in the blood depend on the pathology being analyzed, related to intestinal obstruction or the development of peritonitis.

ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WHO HAVE HAD COVID-19

F.M. Abdurakhmanov — 2026-01-26

From the very first report of mass mortality among diabetic patients infected with COVID-19 infection, emphasis was placed on the severity of damage to the respiratory system in the form of acute respiratory distress syndrome in adults. The unifying factor in the pathogenesis of such a fatal change was the development of dysfunction of the endothelial system (DES), which leads not only to systemic inflammatory damage to the vascular endothelium but also to its consequences in the form of increased blood clotting and a decrease in fibrinolysis processes. The changes that occur in the body of patients after COVID-19 do not disappear completely. First of all, this should be noted about patients with chronic morbid backgrounds, such as, for example, type 2 diabetes mellitus (T2DM). In our study, endothelial function conditions were evaluated in 92 patients who have T2DM. Three cohorts of patients were organized. Indicators characterizing the state of DES were examined in blood obtained by puncture from a peripheral vein.

SURGICAL MANAGEMENT OF COMBINED RECTOCELE AND CYSTOURETHROCELE AND DETERMINANTS OF RECURRENCE

B.S. Navruzov — 2026-01-31

Combined rectocele and cystourethrocele represent a frequent and therapeutically challenging form of pelvic floor dysfunction. Although numerous surgical techniques have been developed to address anterior and posterior compartment defects, long-term stability remains variable, and recurrence continues to be reported across different operative approaches. The coexistence of these conditions raises important questions regarding optimal surgical strategy, selection of access route, choice of reinforcement material, and adequacy of multilevel reconstruction. This narrative review analyzes contemporary evidence on native tissue repair, levatorplasty, mesh-augmented techniques, laparoscopic and robotic procedures, and combined reconstructive strategies in the management of rectocele associated with cystourethrocele. Particular attention is given to anatomical restoration versus functional outcome, predictors of surgical success, and factors associated with recurrence. Available data indicate that recurrence is influenced not only by technical execution but also by baseline pelvic floor integrity, multilevel involvement, connective tissue quality, and biomechanical load redistribution after repair. Comparative studies demonstrate that isolated compartment correction may lead to symptom persistence or progression in adjacent structures, while more extensive reconstructions do not uniformly translate into superior long-term outcomes. The evidence suggests that durability depends on balanced load distribution, appropriate patient selection, and integration of functional assessment into surgical decision-making. Understanding determinants of recurrence in combined rectocele and cystourethrocele is essential for refining operative strategy and improving long-term pelvic floor stability.