Objective. To analyze the clinical course of allergic rhinitis and conjunctivitis and the extent of drug therapy among smoking and non-smoking patients, and to estimate the need for antiallergic drugs in these patients during the grass pollen season using statistical modeling tools. Materials and methods. The prospective observational study included 27 patients (7 of whom were smokers) aged 18–44 years with a confirmed diagnosis of hay fever and sensitization to grass pollen, examined during the exacerbation period from June 6 to July 26, 2023 (a total of 1,377 observations). A mixed model with fixed and random effects was developed to assess treatment need. Results. It was established that during the exacerbation of hay fever, the symptoms of allergic rhinitis and conjunctivitis were more pronounced in smokers than in non-smokers, as assessed by symptom scores and the extent of therapy. A one-point increase in such symptoms as nasal discharge, nasal congestion, nasal itching, and eye itching was associated with a higher probability of taking antiallergic drugs. Smokers of conventional cigarettes had a 10.7-fold higher need for therapy. Conclusions. The constructed mixed model showed that smoking conventional cigarettes increases the need for antiallergic drugs in patients with sensitization to grass pollen during exacerbation of hay fever.
Objective. To analyze infant mortality rates in the Republic of Sakha (Yakutia). Materials and methods. A retrospective analysis of infant mortality rates in the Republic of Sakha (Yakutia) for the period 2012–2024 was conducted. Results. During the analyzed period, a historic decrease in infant mortality rates was observed, resulting from years of work implementing large-scale federal and regional programs for maternal and child health protection. The presence of the unique Perinatal Center at the Republican Hospital No. 1 – National Center of Medicine (RH No.1-NCM) and the commissioning of the new Perinatal Center at the Yakutsk Republican Clinical Hospital (YRCH) played a significant role in reducing infant mortality in the Republic of Sakha (Yakutia). A clear patient routing system for pregnant women has been established. The achieved reduction in the overall infant mortality rate in the Republic of Sakha (Yakutia) is not incidental but systemic, ensured by the synchronous improvement of all its components: early neonatal, late neonatal, and post-neonatal mortality. Conclusions. The obtained results will provide a scientific rationale for improving the obstetric-gynecological and neonatal services in the Republic of Sakha (Yakutia) and will form the basis for the national projects "Family" and "Long and Active Life".
Currently, problems associated with pathologies of hard dental tissues remain relevant in modern dentistry. For therapeutic dentistry, these diseases are the object of treatment, including filling, remineralization, and other methods of restoring tooth structure. However, in cases of extensive lesions, conservative approaches may prove ineffective, and prosthetic methods are then used, such as dental prosthetics, the purpose of which is to restore the shape, function, and aesthetics of teeth using removable or fixed prostheses. Therefore, a literature review analyzing modern classifications and methods of treatment for hard dental tissue lesions is presented. During data collection, special attention was paid to publications from the last ten years. The methodological basis of the study included a detailed analysis of scientific articles and a comparative analysis of various classification systems for carious and non-carious dental lesions. Pathologies of hard dental tissues represent one of the pressing problems of modern dentistry. In clinical practice, hard tissue defects are classified as carious and non-carious. In prosthetic dentistry, correct assessment of the type and extent of the defect is a key step in treatment planning. Thus, prosthetic dentistry considers hard tissue defects as indications for prosthetics. The best results are achieved with timely diagnosis, accurate classification of the defect, and elimination of its cause. Modern classifications help to standardize diagnostics and select the optimal treatment strategy, ranging from therapeutic methods to prosthetics.
This review synthesizes current evidence to identify unresolved challenges in the diagnosis, treatment, risk prediction, and prevention of complications and recurrence of choledocholithiasis, and to outline priority areas for future research. Choledocholithiasis occur in approximately 30 % of patients with gallstone disease, with recurrence rates averaging 12.6 %. Magnetic resonance cholangiopancreatography (MRCP) remains the non-invasive diagnostic gold standard; however, its widespread adoption is constrained by high cost and limited accessibility. Machine learning-based risk stratification models represent a promising strategy to optimize patient selection for MRCP and reduce unnecessary procedures. Among the endoscopic transpapillary treatment methods for choledocholithiasis, endoscopic sphincterotomy plus balloon dilation is the most effective and safe approach. Contact lithotripsy guided by peroral transpapillary cholangioscopy has been shown to have the highest efficacy for stones larger than 15 mm. In surgical management, there is growing interest in single-stage laparoendoscopic rendezvous procedures combining cholecystectomy with endoscopic transpapillary intervention. Although randomized trials have demonstrated their efficacy, broad implementation is hindered by the requirement for hybrid operating suites and the absence of validated patient selection criteria. Effective prevention of postoperative complications and stone recurrence hinges on the early identification and modifiable risk factors. Existing predictive data remain fragmented, and the development of unified models is challenged by complex, non-linear interactions among multiple variables. Machine learning algorithms offer a robust framework to overcome these limitations, with their clinical applicability expanding rapidly due to advances in digital health technologies. Priority directions for future research in choledocholithiasis management include: personalization of diagnostic and therapeutic algorithms through integration of novel surgical techniques and optimized perioperative care; validation of machine learning-driven predictive models for individualized risk stratification and prevention of complications and recurrence.
The evaluation of the effectiveness of the Limberg flap in the treatment of trophic ulcers in patients with type 2 diabetes mellitus was carried out. The Limberg flap plays an important role in the comprehensive treatment of trophic ulcers in patients with diabetes mellitus. This method allows closure of deep wounds and accelerates ulcer healing by using a tissue flap from an adjacent area. Treatment effectiveness is assessed by wound appearance, healing rate, preservation of foot function, and the patient's satisfaction with the surgical outcomes. A clinical case of treating a trophic ulcer on the plantar surface of the left foot in a patient with type 2 diabetes mellitus demonstrates the effectiveness of the Limberg flap, as confirmed by positive results in all assessment criteria: improved wound appearance, accelerated healing, preserved foot function, and high patient satisfaction with the treatment outcome.
