Aim – to evaluate the effectiveness of the developed method for local treatment of limited border burns. Material and methods. The results of treatment of 39 patients with limited first- and second-degree burns were studied. In patients of the main group (19 people), during the changing of the gel with silver ions, the wound was irradiated with ultraviolet light, followed by exposure to a low-frequency pulsating magnetic field. Patients in the comparison group (20 patients) received conservative treatment using the gel with silver ions only, without physiotherapy. Monitoring of the healing of burn wounds was carried out using the “Complex automated system for assessing the area of burn wounds” (certificate of state registration of the computer program No. 2015660700 dated 10/06/2015). The effectiveness of the proposed method was assessed by clinical results, as well as by the time patients spent in the hospital. The obtained data were analyzed using clinical statistics methods. Results. The developed method for treating local I-II degree burn wounds, which consists of covering the wound with gel with silver plus ultraviolet irradiation of the wound and magnetic therapy, turned out to be more effective compared to the method of wound coating with gel with silver, which was previously introduced into the clinic, without physiotherapeutic treatment. Conclusions. The use of the proposed method in the treatment of burn wounds statistically significantly reduces the likelihood of the development of suppuration and accelerates the cleansing of wounds, and leads to a faster recovery.

The purpose of research. Radiation diagnostics is central to the detection of malignant neoplasms. Recently, the implementation of screening programs has faced a number of obstacles, including staff shortages and limited funding. The introduction of artificial intelligence (AI)-based systems capable of absolutely accurate sorting of research into two categories - "normal" and "not normal", seems to be a promising solution to these problems. However, before they are widely used, it is critically important to verify their ability to guarantee the safety and high quality of the screening process. The aim of the study is to evaluate the possibility of using autonomous sorting of mammographic examination results in real clinical conditions. Methods. The study was carried out in 2 stages. At the first stage, 25,892 mammographic studies processed by the AI service were retrospectively analyzed. A ROC analysis of these results was carried out in order to assess the possibility of configuring the AI service for 100% sensitivity. At the prospective stage, the results of 82,372 mammograms were analyzed. All studies were processed by AI services configured for 100% sensitivity. The tasks of the AI services included the sorting of mammography results into the categories "normal" and "not normal". Next, the decisions of AI services and radiologists on categorization were compared. Results. According to the results of a retrospective study, when configuring the AI service for 100% sensitivity, the specificity was 39%. In the course of a prospective study, the proportion of defects (false attribution of research results to the "norm" category) was 0.08%, the specific weight of clinically significant defects in AI services was 0.02%, which is significantly lower than that of a radiologist. Conclusion. The use of autonomous sorting of mammographic research results in clinical practice is possible in order to optimize the diagnostic process during preventive measures, as well as under the condition of monitoring the quality of artificial intelligence technologies. Keywords: artificial intelligence, mammography, preventive examinations, radiation diagnostics. Conflict of interest: The author declares the absence of obvious and potential conflicts of interest related to the publication of this article.

The purpose of the research is assessment of the risk of herniated protrusions of intervertebral discs C4-C5, C5-C6 and C6-C7 of the cervical spine according to MR/ examination.Methods. Тhe biomechanics of the physiological processes of this department has been studied on the basis of MR/ data. A computer program «A method for assessing the risk of herniated protrusions of intervertebral discs of the cervical spine based on the results of an MRI examination» has been developed and tested. The measurements required for the above assessment were obtained during the evaluation of the MR/ examination of a particular patient, after which the data was entered into the program. Тhe calculation results were compared with the database previously obtained by the authors in the course of experimental and clinical studies.Results. Тhe model we use correctly describes the mechanical features of the vertebral junction, since it takes into account the most significant features of their structure, which affect the change in the length of the arms of the levers and the force of pressure on the center of the intervertebral disc. Based on magnetic resonance imaging data, the height of the intervertebral disc at the level of the anterior edges of the vertebral bodies and the АV value were determined, and tg was calculated. For a particular patient, the risk of intervertebral disc protrusion was obtained at the C4-C5, C5-C6 and C6-C7 levels.Conclusion. Тhe test results of the program for assessing the risk of developing an intervertebral disc protrusion in the cervical spine make it possible to describe dynamic phenomena in the cervical spine and predict an unfavorable outcome of pathology at the preclinical stage, even in the absence of clinical manifestations.

Relevance. In the last decade, preoperative rehabilitation has attracted considerable attention from both domestic and foreign specialists, however, its effectiveness and impact on the early recovery of patients with osteoarthritis of the knee joint after primary arthroplasty causes many contradictions and remains controversial.Objective. To analyze the scientific literature and evaluate the results, potential advantages and disadvantages of using available and modern methods of preoperative rehabilitation in preparation for primary arthroplasty in patients with osteoarthritis of the knee joint.Materials and methods. In the course of this study, data was searched using Scopus, Web of Sciеnce, Pubmed, and RSCI databases for the period from 2009 to 2024.Results. As a result of the analysis, the key methods of preoperative rehabilitation used during the preparation for total knee arthroplasty were identified, and the effect of these methods on the restoration of functional parameters in patients, changes in pain and the duration of hospital stay after surgery was studied in comparison with the standard program of preparation for total knee arthroplasty.Conclusion. During the study, it was revealed that preoperative rehabilitation before total knee replacement can significantly reduce the duration of hospital stay, however, convincing evidence of improvement in postoperative functional parameters has not been established. To determine the real effectiveness of preoperative rehabilitation, clinical studies are needed to study the effect of comprehensive preoperative rehabilitation programs on the pathogenetic aspects of osteoarthritis, clinical symptoms and functional parameters in the postoperative period.

OBJECTIVE:To evaluate the immediate results of ankle replacement with original prosthesis in a patient with severe post-traumatic deformation of the distal tibia.MATERIAL AND METHODS:When developing the original design of ankle prosthesis, we considered foreign analogues of classical and revision models of ankle prostheses taking into account their shortcomings. In this case, an integrated approach was used. Extensive work has been carried out to select materials for prosthetic components. Experimental work with mesenchymal stromal cells of bone marrow was aimed at testing cytotoxicity and biological compatibility. The staff of the department of designing biomechanical structures of the Research Institute of Bionics and Personalized Medicine of the Samara State Medical University carefully studied the proposed design of endoprosthesis using the Ansys software. After cadaver tests on full-scale models, we performed surgical intervention in a patient with severe post-traumatic deformity of the lower third of the left tibia.RESULTS:Our studies revealed convenience and certain advantages of intraoperative installation of original ankle prosthesis. Along with this, this clinical example indicated come features that must be taken into account in revision ankle replacement to avoid possible postoperative consequences.CONCLUSION:Original ankle prosthesis makes it possible to replace the distal tibia and preserve limb function.

Complex decongestive therapy is a cornerstone of conservative chronic lymphedema treatment. There are other conservative treatment options that include intermittent pneumatic compression. Its mechanism of action is based on pressure applying on the underlying tissues and promoting the lymph flow through the lymphatic structures. Pneumatic compression was invented in 1972; nevertheless it has not found widespread support of professional community as a self-sufficient method of conservative lymphedema treatment, though it’s used a lot in many rehab clinics worldwide.Aim. To determine the indications and effectiveness of pneumatic compression, as well as to identify the possibility of using this method in the practice of treating lymphatic edema.

To assess the patient's maxillofacial area (MFA) morphology of the patient, an orthodontist needs to measure on X-ray images in various views, photos of the face, gypsum or digital models of the jaws. A variety of techniques makes diagnosis time-consuming and requires a lot of equipment; therefore, the issue of searching for a technology for multifunctional craniometric analysis is relevant. Increasingly, the data on diagnostics based on three-dimensional X-ray images are found in the literature, it being the most informative method of examining patients. The aim of the study was a systematic review of modern methods of three-dimensional cephalometric analysis, and the assessment of their efficiency. The scientific papers describing modern diagnostic methods of MFA in dental practice were searched in databases PubMed, Web of Science, eLIBRARY.RU, as well as in a searching system Google Scholar by the following key words: three-dimensional cephalometry, three-dimensional cephalometric analysis, orthodontics, asymmetric deformities, maxillofacial anomalies, 3D cephalometry, CBCT. The literature analysis showed many methods of cephalometric analysis described as three-dimensional to use two-dimensional reformates for measurements. True three-dimensional methods are not applicable for practical purposes due to the fragmentary nature of the studies. There is the disunity in choosing landmarks and supporting planes that makes the diagnosis difficult and costly. The major issue is the lack of uniform standards for tree -dimensional measurements of anatomical structures of the skull, and the data revealed can be compared to them. In this regard, the use of artificial neuron networks and in-depth study technologies to process three-dimensional images and determining standard indicators appear to be promising.

Introduction. Information about the health status of children with nephrological pathology includes many manifestations of functional system disorders. However, early diagnosis of chronic kidney disease (CKD) is rarely carried out due to the lack of reliable predictors of this process.The aim: To analyze the association of anamnestic signs, laboratory and genetic research results with chronic kidney disease in children to identify potential predictors of the disease.Material and Methods. The data were obtained from a single-center retrospective catamnestic cohort study (2011–2022). The main group included 128 children with chronic kidney disease aged 1 to 17 years. The comparison group consisted of 30 children without diagnosed kidney pathology aged from 1 to 17 years. There were no statistically significant differences in sex and age between the two groups. The informative value of more than 150 features, including anamnestic ones, the state of the mother’s health during pregnancy, antenatal and perinatal factors, features of the child’s development and manifestation of the disease, the results of clinical, laboratory, and genetic research methods were evaluated. An integrated approach to the study included methods for hypotheses testing on statistical significance of indicators differences, regression analysis, and ROC analysis.Results. Hereditary burden of nephrological pathology in the family, unfavorable course of pregnancy (anemia, toxicosis of the first half), obstetric and somatic pathology in the mother, the serial number of childbirth are associated with the subsequent development of CKD. Erythrocytes in the urine and daily protein loss were detected only in the group of children with CKD. In this group, a decrease in the number of red blood cells, increased erythrocyte sedimentation rate (ESR), allergies at an early age, otitis media, persistent viral and bacterial infections, and a number of signs of connective tissue dysplasia were more common. The main group statistically significantly differed from the comparison group by a number of polymorphic genetic markers. It can be assumed that the polymorphisms AGT1 Thr174Thr, AGT2 Thr235Thr, NO3 C786T are associated with a predisposition to CKD, and the products of polymorphisms AGT1 Thr174Met, AGT2 Met235Met, R1 AGT2 C1166C, NO3 T786T may have a protective effect according to development of CKD.Conclusion. The risk factors for CKD identified in this study can be used to develop software to support medical decision making for early detection of children at high risk of disease progression.

Background. Periodontitis is a progressive lesion of periodontal tissues and one of the most important causes of tooth loss. According to recent publications, periodontitis affects from 11% to 50% of the world’s adult population. Therefore, the problem of developing effective methods for treating and preventing this disease remains relevant. Metabolic disorders in the periodontium are known to contribute to the development of periodontitis. A pronounced change in hemodynamics and microcirculation leads to trophic disturbance of periodontal tissues, thus triggering the development of pronounced hypoxia in these tissues. Thus, prevention and elimination of hypoxia is one of the most important stages of pathogenetic treatment. Objective. To experimentally evaluate the efficacy of injectable carboxytherapy in the treatment of periodontal diseases using an in vivo model of periodontitis in rats. Methods. A preclinical experimental study was conducted on 30 sexually mature Wistar rats. The animals were randomly divided into 4 groups, including I–III experimental groups (n = 27) and a control group (n = 3). In all experimental groups, periodontitis was modelled. In group I (n = 9), no treatment was performed. In group II (n = 9), carboxytherapy with a carbon dioxide flow rate of 5 ml/min was conducted. In group III (n = 9), carboxytherapy with a flow rate of 10 ml/ min was conducted. The experimental animals were injected with carbon dioxide once, twice, or three times 7 days after surgical intervention at weekly intervals. The efficacy of injected carboxytherapy in rat periodontium with respect to the control was evaluated by histologic analysis. The norm criteria were the lamellar structure of compact alveolar bone, the presence of periodontal ligament between the alveolar bone and the tooth, represented by oriented collagen fibers with orderly arranged fibroblasts between them (final signs). The intermediate outcome was considered based on the launch of neovascularization and neocollagenogenesis processes. The criterion of neovascularization and neocollagenogenesis activation was considered to be an increase in the number of young collagen fibers, an increase in fibroblast-like cells of outgrowth form with a high expression of procollagen in the connective tissue matrix (intermediate signs). Integral indices on intermediate signs and on final signs were brought to normalized indices as a fraction of the maximum possible sum of points in the group. The dynamics of the normalized indicator for intermediate and final signs was considered. The results were processed using IBM SPSS Statistics version 26 (IBM Inc., USA). Results. The histological study of the mandible of rats from group I demonstrated that the destruction of the periodontal ligament in the absence of treatment leads to the widening of the periodontal gap, accompanied by inflammatory processes and thinning of collagen fibers due to the growth of edema, the appearance of resorption lacunae and, further, to the resorption of alveolar bone. At the same time, groups II and III showed a gradual decrease in the inflammatory reaction, formation of young collagen fibers, and, as a consequence, restoration of the periodontal space. In these groups, the histologic pattern corresponded to the norm in the case of three times carboxytherapy injection with a flow rate of 5 ml/min and already in the case of two times injection with a flow rate of 10 ml/min. Conclusion. The use of injectable carboxytherapy to treat periodontal ligament lesions not only restores its microarchitectonics, but also prevents further resorption of alveolar bone. This may have a positive effect in the treatment of periodontal disease.

In recent years, the number of oncological diseases of the facial area and the nasal area has increased. The consequences of surgical treatment of these diseases lead to the formation of functionally and aesthetically significant defects of the face and external nose, leading to disruption of such functions as breathing and speech. In this article, we propose a method for nose reconstruction using an individualized titanium implant in combination with a radial flap. Due to the use of additive technologies in combination with visualization and 3D modeling programs at the stage of preoperative planning, it becomes possible to analyze the defect, its localization, volume, tissue composition, as well as to model and create an individual implant. This approach allows you to get good functional and aesthetic results in one operation, reduce the number of complications and rehabilitation period.

Morphological organization of the levator ani muscle still remains unclear due to methodological problems in the study of the pelvic floor muscles. Therefore, the study of the histological structure of muscle tissue m. levator ani in animals is of not only theoretical but also practical importance for the study and modeling of pelvic floor dysfunction conditions in animal models. The aim is to study the enzymohistochemical and ultramicroscopic organization of the levator ani muscle in white laboratory rats. Material and methods. The study was performed on 10 laboratory Wistar rats (5 females and 5 males) aged 12–14 months. The metabolic profile of muscle fibers was determined using the Nachlass succinate dehydrogenase test. Imaging and linear measurements were carried out on a Leica UC 7 microscope (Germany), using its software. Ultrathin sections were counterstained with uranyl acetate and lead citrate, viewed nd photographed using a Hitachi HT 7700 Exalens (Japan) electron microscope. Results. All types of muscle fibers are present in levator ani muscle: slow fibers and rapid muscle fibers of typs IIA and IIB. It has been established that the total cross-sectional area of white type fibers is 3 times greater than the total area of other fibers. Significant sex differences were found in relative square parameters of glycolytic fibers in m. levator ani (p=0,009). At the ultrastructural level, it was found that in some muscle fibers the mitochondrial apparatus is well developed, in others, mitochondria are few in number, have smaller sizes, are located singly between myofibrils, without forming clusters. In such fibers, there are large accumulations of glycogen between the myofibrils. Conclusion. In the laboratory rat, the levator ani muscle is heterogeneous both in metabolic activity of muscle fibers and in ultrastructural organization. This feature of the muscle involves not only static work in creating intra-abdominal pressure and retaining the pelvic organs, but also isotonic contraction, acting as a synergist to ensure the movement of the tail.

OBJECTIVE:To assess the prevalence and quantitative characteristics of skeletal asymmetries of the body and lower jaw branches in three-dimensional space.MATERIALS AND METHODS:Using depersonalized data archive, of 400 CBCT scans, forty studies were picked randomly. Patients aged 25 to 35 years participated in research, no history of maxillofacial reconstructive surgery; gender, race, and facial anomaly were ignored. Three experienced doctors, independently, identified 15 reference points on radiographic images of AUTOPLAN software. Expert consensus found in the orientation determination. Six planes and eight points were constructed, using Math algorithms and the Python OOP; body and branches of the lower jaw length measurements performed and processed automatically.RESULTS:The study identified symmetry, using a method for determining parameters of the lower jaw in 3D space (Priority Reference No.2023100466 at 10.01.2023), modern dentistry research method. Both sides of data obtained shown asymmetry of the body and branches of the lower jaw occurred in 45% (18 people) and 67.5% (27 people) of cases. Forty percent of cases were noted with Mild asymmetry of the lower jaw body (16 people), moderate asymmetry noted in 5% (2 people). These parameters were 57.5% for branches, (23 people) and 10% (4 people). Combined form of anomaly observed in 37.5% (15 people) of cases, among which 12 people (75%) showed adaptive compensation of anomalies, which requires further investigation on a larger number of patients.CONCLUSION:Lower body jaw asymmetry is prevalent (80%). Patients with moderate and serious anomaly form appeared in 15% of cases.

Purpose of the study. Comparing magnetic resonance imaging (MRI) abilities in differential diagnostic of three types of primary extra‑ axial brain tumors (benign and malignant meningiomas, and neuromas) based on standard semiotics and radiomic features. Patients and methods. Retrospective research included 66 patients with primary extra‑a xial tumors who were divided into two groups: the instructional (39 patients) and the valid (27 patients). MRI was used towards all patients before surgery. The one method of statistical modeling – discriminant analysis – was used to compare the abilities of differential diagnostic based on semiotic features and radiomic parameters. Results. The features of tumor semiotics MRI didn’t allow to differentiate effectively benign and malignant meningiomas. Several parameters were certainly varied for all those tumor types (neuromas, benign and malignant meningiomas). The modelling based on the discriminant analysis demonstrated that radiomic features can be used for primary extra‑a xial tumors differential diagnostic. The area of the radiomic model ROC‑curve took 0.86 which exceeds the result of the model based on semiotic features (AUC 0.78). Conclusion. The best results of the tumors classification by radiomic model demonstrate expediency to continue research the primary extra‑ axial tumors differential diagnostic with support of histogram and textural parameters of MRI imaging.

Pelvic floor and perineum muscles play an important role in the formation of an apparatus supporting pelvic organs. The functional insufficiency of myofascial structures frequently leads to the development of urinary and fecal incontinence, erectile dysfunction, prolapse of internal organs, and perineal hernias formation. Back in the 20th century, morphologists focused on the skeletal muscles in pelvic floor and perineum, highlighting their leading role in supporting organs and creating intraabdominal pressure. However, in the past two decades, particular attention has been paid to the smooth muscle structures and their relationship with the musculoskeletal system in the pelvic outlet area. The new concept of the striated–smooth muscle complex provides the basis for revising various aspects of pelvic organ prolapse and urinary and fecal incontinence pathophysiology. We believe that this may lead to improved early diagnosis and prevention of diseases of the pelvic floor and perineum.

Aim to study the linear dimensions of the right and left kidneys in patients with urolithiasis and in individuals without kidney disease. Material and methods. We assessed the average values of length, thickness and width at the level of the poles and hilum of the kidney in urolithiasis (main group 65 patients) and in the control group (87 healthy people) using the method of 3D reconstruction of the computed tomography data and the method of variational-statistical analysis. Results. The linear dimensions of the kidneys: length, thickness, width at all levels were larger in the main group than in the control group, due to the expansion of the pyelocaliceal system, as well as edema and, as a result, an increase in the size of the parenchyma in patients with urolithiasis.

The treatment of localized oncological process requires a reconstructive intervention in the vast majority of cases. Thus, the problem of reconstructive plastic material is acute. There is no standard material for reconstruction, due to the variability of defects in length, composition and localization of the tumor process. Both cover tissues and fragments of the gastrointestinal tract can be used as the autologous graft. The presented clinical case describes the esophageal reconstruction with the radial forearm flap. The radial flap is easy to cut out, survives well, and its use excludes the presence of complications from the donor area, in comparison with the techniques of using fragments of the gastrointestinal tract. The ability to perform simultaneous tumor removal and reconstruction allows for full restoration of vital functions eating, breathing, speech, achievement of good aesthetic and functional results, including long-term ones, and a satisfactory quality of life.

Aim of the review to analyze the principles of the use of wound dressings for limited borderline burns. We have made an attempt to systematize the use of wound dressings depending on the state of the wound surface, the stage of the wound process. The proposed system simplifies the selection of the dressing and increases the chance for optimal treatment leading to positive clinical results.

Aim an electron microscopic study of the muscle tissue of levator ani muscle in human. Material and methods. The paper describes the muscle tissue of levator ani muscle. The data was obtained by light-optical and electron microscopic examination of muscle tissue. Results. The study of the ultrastructural organization of the muscle tissue of levator ani muscle in human shows that it corresponds to the structure of skeletal muscle tissue it consists of muscle fibers that are cellular-symplastic structures. The main volume of the myosimplast is occupied by myofibrils located along its longitudinal axis, having a distinct sarcomeric organization sarcomeres are separated by Z-lines, a dark disс is located on both sides of the centrally located M-line, light disсs are located on both sides of the Z-lines. Conclusion. Levator ani muscle in human belongs to the striated skeletal muscle tissue of the locomotor type.

Criteria for the quality of digital images of the skull in the lateral projection are identified and the most common errors in the diagnosis of dentomaxillofacial anomalies (DMFA) by cephalometric analysis of teleroentgenography (TRG) investigations are addressed. Analysis of digital TRG images taken by orthodontists for the diagnosis of DMFA pointed to a low level of awareness of teleroentgenogram quality criteria among practitioners. A method for determining the quality of teleroentgenograms using artificial intelligence functionality is proposed.