Relevance. Changes in the oral cavity have a close relationship with pathological processes in the liver. In the scientific articles is practically no information on the description of oral cavity in non-alcoholic fatty liver disease (NAFLD) patients.

Goal — to determine the dental status of patients with NAFLD and to identify the leading mechanisms of development of oral pathology to formulate directions of dental care.

Materials and methods. Аn assessment of the dental status of patients with NAFLD in the Clinical Hospital “RZD-Medicine” (Kirov, Russia) included an objective examination, hygienic and periodontal indices, biochemical parameters of oral fluid and microbiological examination.

Results. It was revealed high prevalence of dental caries and tooth loss: the number of extracted teeth is 2 times higher than in individuals without NAFLD; 100 % patients had lesions of the oral mucosa and inflammatory periodontal diseases. A decrease in the antioxidant activity of saliva and a predominance of periodontogenic microorganisms in the oral microbiota were noted.

Discussion. Possible linking mechanisms between dentistry pathology and NAFLD include dietary patterns, changes in the gastrointestinal microbiome, and the predominance of proinflammatory reactions in the immune response.

Conclusion. Patients with NAFLD are characterized by multiple combined lesions of hard tissues of teeth, oral mucosa, and periodontium. Unfavorable changes in the biochemical composition of oral fluid and oral microflora contribute to the development and progression of pathological processes. All patients with NAFLD need complex treatment of oral cavity pathology, including oral hygiene, treatment of dental and oral mucosa lesions, periodontal diseases, prosthetics.

The psychoemotional status of pregnant women is influenced by factors such as age, income, marital status, and employment status. Pregnant women with high levels of anxiety have a more complicated course of pregnancy and childbirth. The definition of the features of a woman’s psychoemotional state during pregnancy remains relevant.

The aim of the study is to determine the features of the medical and social profile, the course of pregnancy and obstetric outcomes in patients with high levels of anxiety.

Materials and methods. Psychological testing was conducted to determine the personal level of anxiety in 100 pregnant women for the period 2013–2016 and in 100 patients for 2018–2021. The medical and social portrait, the course of pregnancy and its outcomes were studied in 16 patients with high levels of anxiety for the period 2013–2016 (group 1) and in 21 — for the period 2018–2021 (group 2).

Results. Patients from the 2018–2021 cohort were statistically significantly more likely to be employees in most cases, and there was a tendency to decrease the number of married women. Patients with high levels of anxiety in both time cohorts had complications of the gestational period such as toxicosis of the first half of pregnancy, the threat of termination of pregnancy, and moderate preeclampsia. The percentage of premature births remains consistently high. Conclusion. The results indicate the determination of the characteristics of a woman’s psycho-emotional state during the gestational period for a personalized approach to pregnancy management tactics in order to prevent unfavorable obstetric and perinatal outcomes.

Preeclampsia (PE) and gestational hypertension (GH) occupy leading positions in the structure of pregnancy pathology and adverse perinatal outcomes.

The purpose of this study was to evaluate the state of microcirculation of peripheral tissues and the hemostasis system in conjunction with proper uteroplacental circulation in pregnant women with hypertensive disorders; to determinate the patterns of changes in regional hemodynamics, significant as predictors of the occurrence and progression of hypertensive conditions.

Materials and methods. A clinical study of pregnant women with gestational hypertension (GH) (n = 36) and patients with preeclampsia (PE) (n = 12); control — women with physiologic pregnancy was performed. Clinical evaluation of the woman and newborn, assessment of peripheral microcirculation (laser Doppler flowmetry), determination of coagulation profile (thromboelastography), statistical analysis of data (Statistica 13.0) were performed.

Results. There is an increase in formation and density of blood clot with a decrease in fibrinolytic processes (relative to control by 19.33 % (p < 0.050) in GH, by 38.24 % (p < 0.050) in PE). Changes in average laboratory values included an increase in number of platelets in GH and a decrease in PE. Assessment of peripheral tissues microcirculation demonstrated a statistically significant decrease in tissue perfusion in patients with GH and PE relative to the control by 23.1 % (p < 0.050) and 33.2 % (p < 0.050) respectively, which was accompanied by changes in the regulation of microhemodynamics.

Conclusion. Development of GH and PE is accompanied by negative dynamics of microcirculation with regulation tension and an increase of contribution of systemic regulatory mechanisms of tissue perfusion, significant hypercoagulemic changes in the hemostasis system. Impaired microcirculation in pregnant women with GH is associated with a high frequency of surgical delivery and a life-threatening condition of the newborn.

Relevance. Diabetes mellitus (DM) is a chronic disease that can lead to various complications, one of which is diabetic retinopathy (DR), which can occur in more than 30 % of diabetic patients and diabetic macular edema (DME), the most formidable complication of DR. DME results in loss of central vision and significantly reduces quality of life. There are several treatments for DR including laser retinal photocoagulation, intravitreal injections of antivasoproliferative drugs, dexamethasone implant, and vitreoretinal surgery.

The aim of the work is to evaluate long-term real results of diabetic macular edema treatment depending on adherence to anti-VEGF therapy in the ophthalmoendocrinological centre of Chelyabinsk city.

Materials and methods. 76 patients with DME (including 23/76 (30.3 %) men, 53/76 (69.7 %) women) aged 64.4 [61.8; 70.0] years. In the total sample of patients, type 1 DM was diagnosed in 13/76 (17.1 %) patients, type 2 DM — in 63/76 (82.9 %) patients; nonproliferative stage of DR occurred in 51/76 (67.1 %), proliferative — in 25/76 (32.9 %) patients.

Discussion. There was a significant increase in MCOS and a decrease in retinal thickness after 3 loading injections. Stabilization of morphometric and functional results was observed after the 5th injection.

Conclusion. The study shows that the efficacy of aflibercept treatment for DME is achieved with five loading injections and regular therapy. When the drug is not administered regularly, the improving effect is not achieved, which may lead to a negative attitude to treatment and withdrawal from further follow-up.

Introduction. Acute radiation disease is one of the urgent problems of modern medicine. The new approach using mesenchymal stem cells (MSCs) show its effectiveness. Results of MSC therapy is contradictory and requires further researches to assess the production of hematopoiesis-inducing growth factors and the level of hematopoiesis activation.

The purpose of the study was modeling of autophagy process with estimation of the degree of hematopoiesis restoration using modulated MSCs.

Materials and methods. The experiment was carried out on 60 outbred mice. Animals were exposed to ionizing radiation (IR) with transplantation of modulated and unmodulated MSCs to analyze reticulocyte, leukocyte formula, bone marrow with myelogram counting and enzyme immunoassay. Statistical analysis was performed using IBM SPSS Statistics 27 program.

Results and discussion. After IR exposure, a decreased in lymphoid (–45.0 %), neutrophilic (–19.5 %) and megakaryocyte lineages (–52.2 %) was noted. Expression of SCF and Flt3-ligand was higher in the MSC + trehalose group compared to rapamycin by 16.3 % and 19.7 %. Using MSCs increased bone marrow cellularity by +11.1 % due to neutrophilic and lymphoid cells. MSC with activated mTOR-independent autophagy increased in bone marrow cellularity among the studied groups: lymphocytes +12.9 %, megakaryocytes +15.2 %. Inhibition of autophagy in MSC decreased numbers of myelokaryocytes (–8.7 %), neutrophilic (–14.5 %) and lymphoid (–9.8 %) cells.

Conclusion. The use of MSCs with activated mTOR-independent autophagy has a greater therapeutic potential in the restoration of hematopoiesis. Inhibition of autophagy in MSCs worsens their biological properties in terms of growth factor production and myeloid tissue regeneration after IR exposure.

Introduction. The study of histochemical features of the proliferative activity of the endometrium in conditions of microsatellite instability in the endometrium in women with precancerous damage to the mucous membrane is of clinical interest for determining the prognosis of malignancy and tactics of managing patients with this pathology.

The aim of the study was to analyze the state of the nucleolar organizer system in conditions of microsatellite instability in the uterine mucosa in patients with precancer and endometrial cancer in a comparative aspect.

Materials and methods. A one-stage non-randomized retrospective study was performed using histological, immunohistochemical and statistical methods.

Results. An increase in the activity of nucleolar organizers was established in microsatellite instability, indicating an increase in protein-synthetic activity in cells and, as a consequence, the proliferative potential of glandular epithelial cells and endometrial stromal cells in its hyperplasia and carcinoma.

Conclusion. The obtained results can be used as an additional factor in determining the tactics of managing patients with precancer and endometrial cancer.

Introduction. Currently, the clinical course of syphilis has changed, which leads to a decrease in the alertness of the population. Therefore, it is very important to conduct a screening serological examination of the population in order to detect and reduce the incidence of syphilis in a timely manner.

The aim of the study was to study the incidence of syphilis during a screening examination of patients and caregivers of a multidisciplinary children’s hospital.

Materials and methods. A retrospective analysis of the results of serological screening for syphilis of 9262 patients and child caregivers of the multidisciplinary children’s hospital of the Regional Children’s Clinical Hospital (Ekaterinburg, Russia), which includes the Regional Perinatal Center, from 1 January 2023 to 30 September 2024.

Results. In 2023, 2 cases of acute syphilis were detected in women hospitalized for child care, and in 2024, 1 in a pregnant woman who did not complain and considered themselves healthy and posed an epidemic danger to others and medical personnel. There were also 2 cases of early congenital syphilis in 2024.

Discussion. The presence of IgM to Treponema pallidum indicates a recently acquired disease (4–6 weeks after infection). The detection of IgG only in adult patients speaks in favor of a current now or a history of syphilis, and in newborns about the transmission of IgG from mother to child throu

Conclusion. The high sensitivity of treponemal tests used in screening studies reduces the likelihood of missing hidden forms of syphilis by enzyme immunoassay.

gh the transplacental barrier.

Background. Cystic fibrosis (CF) pharmacotherapy aims to restore CFTR protein function. Comparing CFTR modulators’ effectiveness can inform personalized treatment approaches.

The aim of the study is to evaluate the effectiveness of CFTR modulator therapy in children with cystic fibrosis.

Materials and methods. An open prospective comparative non-randomized study (December 2022 — November 2023) included 81 CF patients aged 2–17 years: 35 received triple therapy (elecsacaftor/tezacaftor/ivacaftor), 23 received double therapy (ivacaftor/lumacaftor), and 23 were controls without CFTR modulators. Evaluations occurred at baseline and after 12 months.

Results. Triple therapy improved nutritional status, lung function (FEV1, FVC, MEF25–75), sweat chloride levels, pancreatic elastase, and liver enzymes (alkaline phosphatase, GGTP); double therapy improved cholestasis markers (OB, alkaline phosphatase, GGTP). Controls showed declining lung function, worsening pancreatic insufficiency, and persistently elevated alkaline phosphatase. Targeted therapy reduced hospitalizations due to bronchopulmonary exacerbations.

Conclusion. CFTR modulator therapy decreased hospitalization risks (HR = 2.09–11.00). Triple therapy had greater benefits than double therapy in improving nutrition, respiratory function, and lowering sweat chlorides (normalizing in 35.5 % of patients). Double therapy effectively reduced cholestasis.

Introduction. The primary local treatments for knee osteoarthritis (OAKS) include hyaluronic acid (HA) and platelet-rich plasma (PRP) injections. The visual analogue pain scale (VAS) is often used to assess their effectiveness. Ongoing debate persists regarding which method provides the most sustained efficacy in reducing pain and improving joint function, complicating therapeutic decisions.

Aim — to evaluate the efficacy of OACS treatment, as measured by VAS, 12 months after the initiation of intra-articular PRP injection compared to HA injection.

Materials and methods. We included only English-language articles with full text available that presented treatment outcomes as VAS in patients treated for OACS with HA or PRP over a 12-month period.

Results. A total of 196 articles were initially selected, with 170 remaining after removing duplicates, and 4 meeting inclusion criteria. Meta-analysis of VAS at 12 months post-therapy indicated a Hedges’ g effect size of 0.26, without statistical significance. Study heterogeneity was high (I 2 = 93.48 %). Publication bias tests found no significant bias, and Trim and Fill analysis identified no missing studies needing adjustment.

Conclusion. The study revealed no significant difference between PRP and HA in treating knee osteoarthritis over 12 months. The absence of publication bias supports the reliability of these findings.

Introduction. Simultaneous exposure to unfavorable weather and climate conditions and environmental chemicals poses risks of human health impairment, realization of which depends on individual characteristics of the organism and can be controlled by biological prophylaxis comprising measures to increase the resistance and strengthen the adaptive mechanisms of the body.

Objective — to review the scientific experience of taking preventive measures aimed at increasing the body resistance to adverse effects of anthropogenic and climatic factors in the northern territories of Russia.

Materials and methods. We conducted an electronic bibliography search in the PubMed, Google Scholar, eLibrary.ru, and CyberLeninka information databases. Of 100 original articles found, 61 full-text publications were eligible for inclusion in the review.

Results. A gradual switchover to the Western pattern diet of the northerners leads to increased consumption of carbohydrates but insufficient intake of fats and proteins. The researchers have observed deficiency of iodine, vitamins A, E, C, and D, with the latter being aggravated by the genetic factor in indigenous peoples. Levels of heavy metals, particularly those of lead and mercury, in biological fluids are often associated with geochemical characteristics of the territory and local fish consumption.

Conclusion. To maintain health of the population living in the northern territories of Russia, it is important to develop a preventive strategy aimed, on the one hand, at enriching the diet with vitamins and minerals and, on the other hand, increasing the body resistance to adverse effects of toxicants potentially present in traditional foods.

Introduction. Acetaminophen overdose (AM) is a common cause of toxicity with a high risk of acute kidney injury and death. Provision of emergency care and development of alternative methods of intensive therapy of AM overdose is a vital area of interest for critical care medicine.

Aim — to assess the current knowledge of the pathogenesis, manifestations and intensive therapy of acute AM overdose and discuss new and experimental treatments.

Materials and methods. Relevant publications were found in the Cochrane Library, PubMed and Medscape using the following terms: “acetaminophen”, “overdose”, “intensive therapy”, “N-acetylcysteine”, “mitochondrial dysfunction”, “oxidative stress”. 76 papers were selected for review.

Results and discussion. The pathogenesis of hepatic and renal injury in acute AM overdose is driven by mitochondrial oxidative stress, inflammation, autophagy, apoptosis, and disruption of endoplasmic reticulum. Clinical manifestations include 4 main stages, starting with nausea and vomiting with gradually worsening acute kidney injury, proceeding to cerebral and cardiac insufficiency and sometimes death. Emergency care in AM overdose is provided in the ICU and includes detoxification, hemodynamic maintenance, and treatment of cerebral edema. The only antidote with proven efficacy approved for AM poisoning is N-acetylcysteine. New treatments are being developed to mitigate mitochondrial stress and endoplasmic reticulum disruption, curb inflammation and activate autophagy.

Conclusion. The low efficacy of pathogenesis-driven intensive therapy of acute AM poisoning indicates the need for in-depth research in order to improve the quality of emergency care for these patients.

Introduction. Endometriosis is a chronic pathological process characterized by the presence of an endometrium-like epithelium and/or stroma outside the uterine cavity. Endometriosis or endometrioid disease occupies the third position in the structure of gynecological morbidity and is a serious medical and social problem. The urinary system occupies the second position in terms of the frequency of involvement in endometriodic infiltration.

The purpose of the work is to systematize information on the clinical course and diagnosis of deep infiltrative endometriosis involving the bladder based on domestic and foreign publications.

Materials and methods. Literary search and analysis of scientific publications in Russian and English by keywords “endometriosis”, “deep infiltrative endometriosis”, “urinary tract endometriosis”, “bladder endometriosis”, “symptoms of the lower urinary tract”, as well as “deep infiltrating endometriosis of urinary tract”, “diagnosis of bladder endometriosis”, “urinary dysfunction”. Selection criteria for publications: original articles (randomized and non-randomized clinical trials), reviews (meta-analyses and systematic reviews) relevant to the topic under consideration.

Results and discussion. The literature review presents data on the symptoms of urinary disorders, urological pain syndrome/interstitial cystitis; clinical picture; diagnosis of endometriosis of the bladder.

Conclusion. Endometriosis is a complex interdisciplinary problem that requires the joint constructive work of a gynecologist, urologist and surgeon to diagnose, treat and manage it. It is necessary to focus the attention of urologists on the problem of deep infiltrative endometriosis, which can lead to the development of neurogenic detrusor dysfunction and imitation of interstitial cystitis.