IntroductionHepatocellular carcinoma (HCC) is one of the most common cancers worldwide. The prevalence of hepatitis B (HBV) and C (HCV) in Russia was 7.6 and 5.4 per 100,000, respectively. The aim of this study was to assess the proportion of HCV and HBV infection among HCC patients, to evaluate associations between HCV, HBV and stage of HCC and to compare survival of HCC patients by their HBV/HCV status in the Arkhangelsk region of northwest Russia.Materials and methodsA retrospective cohort study was conducted using data on all histologically confirmed HCC cases. Proportions of infected and non-infected HCC cases were calculated by Wilson's method. The associations between HBV, HCV and severity of HCC were assessed by Pearson's Chi-squared test. Survival data were presented using Kaplan–Meier curves and median survival. Survival time between the groups was compared using log-rank tests. Adjustment for potential confounders (sex, age groups, stage of HCC and cirrhosis stage by Child-Paquet scale) was performed using Cox regression.ResultsThere were 583 histologically confirmed HCC cases. The viral status was registered in 311 of patients with pre-mortem diagnosis, where 124 or 39.9% (95% confidence interval (CI), 34.4–45.4) had HBV, 54 or 17.4% (95% CI, 13.5–21.9) had HCV and 16 or 5.1% (95% CI, 3.2–8.2) were infected with both HBV and HCV. The median survival rates of patients were 3 months (95% CI, 2.3–3.8), 3 months (95% CI, 2.0–3.9) and 1 month (95% CI, 0.0–0.6) for patients with HBV, HCV and HBV and HCV, respectively. For virus-free patients, it was 5 months (95% CI, 3.5–6.5), log-rank test=10.74, df=3, p=0.013. Crude Cox regression showed increased risk of death for HBV and HBV and HCV groups in comparison with virus-free patients, and not reaching the level of statistical significance for HCV. After adjustment, the hazard ratios (HRs) decreased to non-significant levels or even reversed, with only exception for the group of patients infected with both hepatitis viruses.ConclusionsWe found that more than half of HCC patients were infected with HBV or HCV. The study did not reveal an association between viral status of HCC patients and stage of HCC. The viral hepatitis may have an impact on survival of HCC patients.

Objective — To compare the mental component of the quality of life (QOL) in patients with stages 0-2 of knee osteoarthritis (OA) sensu Kellgren-Lawrence after treatment either with symptomatic slow-acting drugs for osteoarthritis (SYSADOA) and non-steroidal anti-inflammatory drugs (NSAIDs), or with SYSADOA, NSAIDs and orthovoltage radiotherapy (OVRT), in an open randomized study, using the SF-36 questionnaire. Material and Methods — The patients were randomly assigned to two groups: SYSADOA and SYSADOA+OVRT. Patients were asked to fill out the SF-36 questionnaire. The results were presented in the form of a mean of scores on each of four QOL survey sections for both groups at five time points: before and immediately after the treatment, at 6 months, 12 months and 36 months. Results — The groups were similar in their baselines characteristics (age, gender, body mass index [BMI], pain syndrome duration). Being initially equal, QOL improved by the end of treatment in both groups with statistically significantly greater improvement after OVRT. Further on, the QOL indicators in the OVRT group kept increasing, peaking at 12 months for social role functioning (SRF), emotional role functioning (ERF) and vitality (V), and at 36 months for mental health (MH). In contrast, the patients of SYSADOA/NSAIDs group were experiencing a decrease in their mental component over the analyzed period of time, and the levels of three out of four indicators at 36 months were even lower than their initial values. Conclusion — Adding OVRT to the standard SYSADOA/NSAIDs treatment for knee OA of stages 0-2 ensured improved mental well-being of patients for at least three years.

During the treatment of superficial burn injuries pa6ents are o7en confronted with painful dressing changes. Therefor we o7en treat these wounds with very expensive materials like nylon mesh combined with animal collagen that can stay on the wound and slowly peel off during re--epithelializa6on. Due to our good experiences with the treatment of small burn injuries with pure natural silk as cost--efficient material, we now also started trea6ng large burn injuries for the first 6me with silk.

The aim of the research. To carry out a comparative analysis of registration of primary and overall incidence of gonarthritis (GA) and the factors affecting these indices in clinics of Arkhangelsk. Material and methods. Th e population of Arkhangelsk is attached to fi ve main polyclinics: No. 1, 2, 4 (AGKP1, AGKP2, AGKP4), the first city clinical hospital named aft er E. E. Volosevich (PGKB1) and the Primorsky Central district hospital (PPRCRB) together serving 74.7 % of the population. We formed a continuous sample based on the medical service utilisation rate in the attached population for gonarthritis patients within the period from 2016 to 2019. Th e analysed parameters were: gender, age, acute or chronic form of the disease, diagnosis according to ICD-10 and the specialist visited by the patient. The features in registration of GA at the level of primary healthcare institutions and their effect on primary and overall incidence were analysed. Results. In four years, a total of 3,282 of primary GA patients were registered in the fi ve clinics, the mean age was 55.9 years, female patients accounted to 1,952 (59 %), male patients – to 1,329 (41 %). The average annual levels of primary GA incidence per 1000 population ranged from 0.98 to 1.38, with the maximum of 3.05 registered in PGCB1. The overall incidence of GA per 1000 population in polyclinics 1, 2 and 4 was 26.2-27.4, with the values of 15.6 and 4.5 for PGKB 1 and PPRCRB, respectively. Patients over 60 years of age predominated in PGKB1 (48 %), amounting to 41 % in AGKP1, 27 % in AGKP2, 33 % in AGKP4, 32 % in PPRCRB. Maximal prevalence was 105 cases per 1000 population (1 % of the attached population) by 45 years in AGCP1, in other polyclinics the indicator was lower. More oft en, GA was diagnosed by general practitioners – 2296 (71 %), traumatologists and surgeons – 647 (20 %), rheumatologists – 302 (9 %). Th e most common diagnoses were M17.9-966 (30 %), M17.0 10 939 (29 %), less oft en: M17.2 – 66 (2 %) and M17.4 – 75 (2 %). Conclusion. Th ere is no unifi ed system of primary and general morbidity registration at the level of primary healthcare institutions within the same region. To objectify GA registration, it is necessary to introduce a single registry of patients.