Pelvic inflammatory disease (PID) remains a leading cause of impaired reproductive health in women. This study aimed to identify clinical and anamnestic characteristics associated with PID and to evaluate subsequent reproductive outcomes following inpatient management. We retrospectively analyzed clinical and anamnestic data from 66 women diagnosed with PID and assessed fertility-related outcomes in those who completed inpatient treatment. Early menarche and sexual debut before age 16 were significantly associated with an increased risk of complicated PID (p=0,033), likely attributable to alterations in vaginal microbiota secondary to high-risk sexual behavior. The clinical presentation of PID was notably non-specific: 90.9 % of the patients reported abdominal pain, and 90.9 % exhibited elevated C-reactive protein levels. Notably, 77.3 % of the cases were initially misdiagnosed as acute appendicitis, underscoring the persistent diagnostic challenges in differentiating PID from other acute abdominal conditions. Etiologically, all identified pathogens in this cohort belonged exclusively to opportunistic microflora; no sexually transmitted infection (STI) agents, including Chlamydia trachomatis or Neisseria gonorrhoeae, were detected. Polymicrobial (mixed) infections were present in 29.5 % of the cases and were significantly associated with tubo-ovarian abscess formation and more severe pelvic adhesions (p=0.024). Uncomplicated PID predominated (86.4 % of the cases), whereas the presence of a tubo-ovarian abscess correlated strongly with extensive adnexal adhesions. Among the patients with uncomplicated disease who received timely, fertility-sparing laparoscopic intervention, pregnancy occurred in 16.7 % and live birth was achieved in 12.1 %. The annual fertility rate in this subgroup was 88.9 live births per 1,000 women, which is comparable to the agematched national population rate reported by Rosstat (Russian Federal State Statistics Service). These findings demonstrate that appropriate broad-spectrum antimicrobial therapy combined with minimally invasive, organpreserving surgical management can effectively preserve fertility even after an episode of PID.

The aim of the study was to establish diagnostically significant morphological and biomechanical criteria of hidden microcracks of the tooth crown formed during forced jaw clenching, enabling reconstruction of the mechanism, direction, and intensity of compressive loading. Methods. Macro- and micromorphological analyses of hard dental tissues were applied, along with morphometric assessment of microcrack parameters and modeling of controlled axial occlusal loading followed by comparison of experimental and expert specimens. The analysis was based on the study of spatial orientation, depth, and density of microdamage in enamel, dentin, and the dentinoenamel junction. Results. Characteristic damage patterns were identified, including subsurface enamel microcracks of radial and oblique orientation, concentration of defects in the dentinoenamel junction area, and deformation changes in the dentinal tubular structure without destruction of the organic matrix. Enamel microcrack length ranged from 0.4 to 2.1 mm, their propagation depth reached 80–240 μm, and dentin involvement varied from 0.3 to 1.2 mm. The spatial configuration of damage reflected the direction of the applied force and occlusal relationships. The practical significance of the study lies in the possibility of using the identified morphological and morphometric features as objective forensic medical criteria in the expert assessment of dentoalveolar injuries. The obtained data increase the accuracy of reconstructing the trauma mechanism and differentiating violent jaw clenching from other types of mechanical impact. The results may be applied in forensic medical and forensic dental examinations, as well as in the development of methodological guidelines and diagnostic algorithms for hidden crown injuries. Conclusions. Hidden microcracks of the tooth crown form a stable morphological “imprint” of compressive loading, allowing reliable differentiation of this trauma mechanism from impact and chronic overloads. A comprehensive analysis of morphological and quantitative features enhances the objectivity of forensic medical assessment of dentoalveolar injuries in the investigation of violent acts against the person.

The work focuses the attention of primary care physicians and dentists on the timely detection and adequate treatment of chronic diseases and precancers of the oral mucosa in order to prevent their transition to malignant neoplasms.The prevalence of oral mucosal diseases ranges from 5 % to 20 %, among which there are many obligatory and optional precancers susceptible to malignancy. The occurrence of precancerous diseases of the oral cavity and the red border of the lips and their malignancy are influenced by various factors, including chronic trauma from sharp edges of decayed teeth, poorly manufactured parts of orthodontic and orthopedic structures, irritating hot and spicy food, and bad habits (alcohol, smoking, chewing tobacco, etc.), occupational hazards, meteorological, climatic conditions and others. In addition, the growth of advanced cases of oral mucosal diseases is facilitated by late patient referral, the lack of a comprehensive approach to the treatment of precancerous diseases, insufficient oncological alertness of doctors, failure to comply with the terms of conservative treatment, etc., which in the future can lead to malignancy of precancerous pathological processes. At a dental outpatient and inpatient appointment, it is necessary to pay special attention to the lack of proper effect from treatment, changes in the color of the mucous membrane, the appearance of papillomatous growths in the area of   erosions and ulcers, compaction of the edges of the lesions, which should alert the doctor and require urgent referral of the patient for consultation with an oncologist. In this regard, a visit to the dentist should begin with an examination of the oral cavity to exclude pathology of the mucous membrane, early detection, timely conservative or surgical treatment, elimination of local unfavorable factors, and further dispensary observation. To support these positions, the authors presented a number of clinical observations of patients with precancerous lesions of the oral mucosa. In general, the doctor must remember that “from a precancerous condition to malignancy there is only one-step!” and explain to the patient the need to observe all precautions in the prevention and treatment of precancerous diseases.

This article examines the clinical, epidemiological, and laboratory parameters of whooping cough in children in the Republic of Mordovia. Materials and Methods: A retrospective analysis of the inpatient records of the patients with whooping cough hospitalized in 2023–2024 in the Republic Clinical Hospital for Infectious Diseases of Saransk. A significant increase in whooping cough cases among children was observed in the Republic of Mordovia in 2023 (with a peak in the summer-fall period). Infections in children occurred primarily in family settings, where the main sources of the infection were older children and adults. Whooping cough was most common in children under one year of age, often in children under three months of age who had not reached the vaccination age, or in the second half of the year (6–12 months) in unvaccinated children (mainly due to parental refusal to vaccinate). Cases of illness in vaccinated individuals were registered primarily among children aged 3–6 months who were in the process of active three-dose immunization without yet developed protection against whooping cough, as well as among adolescents aged 13–14 years, which is associated with a decrease in post vaccination immunity. In most cases, moderate whooping cough was diagnosed with typical clinical symptoms. In half of the sick individuals, the infection was accompanied reprises (more often in children under a year of age). A third of the patients did not have a fever, and half had a subfebrile temperature. Severe cases were reported in children under two years of age, characterized by frequent coughing fits, apnea, and, in half of cases, pneumonia. A leukemoid reaction, predominantly with a lymphocytic shift, was observed in 15.8 % of the cases.

Mood disorders in Parkinson’s Disease (PD) have traditionally been viewed as reactive conditions arising in response to motor deterioration and reduced quality of life. However, emerging evidence indicates that affective disturbances represent a distinct and integral component of the disease, reflecting profound dysregulation of neurotransmitter systems within the central nervous system. Of particular interest is the early manifestation of depression, anxiety, and apathy, which may precede the onset of motor symptoms and thus serve as prodromal markers of the disease. These early affective symptoms are frequently underrecognized by both patients and clinicians, leading to delayed diagnosis and postponement of targeted treatment interventions. The clinical and pathophysiological heterogeneity of affective symptoms in PD has led to the conceptualization of non-motor phenotypes analogous to the established motor subtypes. This article presents a comprehensive review of Russian and international studies published between 2009 and 2024, focusing on the neurochemical and clinical dimensions of depression, anxiety, and apathy in PD. Special attention is given to the roles of the noradrenergic, serotonergic, dopaminergic, and cholinergic systems in the development of mood disturbances. It is emphasized that imbalances among these neurotransmitter networks contribute to the persistence of affective disorders and diminished cognitive flexibility. Contemporary approaches to the phenotypic classification of emotional disturbances are discussed, incorporating data from neuroimaging and neurochemical profiling. Integrating these affective phenotypes into the broader typology of PD holds promise for enhancing diagnostic precision, risk stratification, and the development of personalized therapeutic strategies. The review also explores the interplay between affective and motor symptoms and their combined impact on the clinical trajectory and prognosis of PD. Identifying characteristic patterns of non-motor manifestations, including mood disorders, advances our understanding of the clinical heterogeneity of PD and informs the development of more effective diagnostic and therapeutic frameworks aimed at improving patient quality of life and reducing the risk of social maladaptation.

The presented review provides information on the characteristics of the main causes of neglected malignant neoplasms (MN) in the oral mucosa and maxillofacial area. To evaluate these literary sources, PubMed, Google Scholar, and E-Library materials were used, devoted to the main topic of the article. The treatment of patients in late-stage medical institutions has a wide range of causal factors covering various medical and social aspects. Among the main common causes of neglected fever in the oral cavity and maxillofacial area are particularly mild symptoms in the early stages. At the same time, there is a low level of awareness of the disease among patients, one third of whom refuse to carry out diagnostic measures and timely organization of therapeutic and preventive measures. The majority of the population of the Russian regions has a low level of sanitary awareness, which has a direct impact on morbidity rates and their detection in the late stages of acute respiratory viral infections. To a certain extent, iatrogenic factors may affect the late treatment of patients at stages III and IV, which are associated with a violation of the principle of oncological alertness at dental outpatient and inpatient appointments, as well as insufficient modern diagnostic equipment. In addition, there is insufficient coverage of the population during screening activities, which increases the rates of neglect. In general, the low level of public health awareness in matters of “oncological alertness” and the prevention of precancerous diseases, inadequate coverage of the population in the framework of medical examinations and oncological examinations of the oral cavity at the dentist’s office, to a certain extent, have an impact on the “neglect” of the disease. This situation requires research aimed at the prevention and early detection of precancerous and oncological diseases, as well as optimal routing of patients with acute respiratory viral infections in the early stages of their development.

Objective: using the sialography method, to determine the signs characteristic of acute inflammatory diseases of the salivary glands in childhood. Materials and methods. A retrospective analysis of 147 case histories of children with acute and exacerbated chronic sialoadenitis was performed. The localization of the inflammatory process, the nature of the discharge from the excretory ducts of the salivary glands, the severity of the intoxication syndrome (temperature, ESR, leukocyte count) and ultrasound examination protocols were studied. Results. In sialoadenitis, the parotid salivary gland was affected in 96 % of cases, and the submandibular salivary gland was affected in 4 %. The ESR index in acute sialadenitis changed in 50 %–65 % of the cases; increased body temperatures were observed in 21.4 %–50 %; leukocytosis – in 25 %–62 % of the cases. In acute sialadenitis, saliva was not released from the duct in 78 %–92 % of the cases, purulent discharge was observed in 5 %– 21.5 % of the cases; in acute chronic sialadenitis, there was no saliva in 69.6 %, purulent discharge – in 26.1 %, and cloudy saliva – in 4.3 % of the cases. Sialography showed that in acute sialadenitis, the salivary glands were enlarged in 81–90 % of the cases. Decreased echogenicity was observed in 4 %–20 % of th ecases, increased echogenicity – in 30 %–35 % of the cases. Enlargement of intraorgan and extraorgan lymph nodes was noted in 69.4 % and 60.48 % of the cases, respectively. Thickening of the duct walls was recorded in 4.8 % of the cases, increased vascular pattern in 12.1 % of the cases. Conclusion: Ultrasound data in exacerbation of chronic sialoadenitis differ from acute in a higher frequency of detection of hypoechoic areas, thickening of the duct wall, increased vascular pattern, and the appearance of a larger number of intraorgan lymph nodes. The use of the sialography method allows us to determine the entry gate of infection, differentiate pathology and assess the impact of the anatomical changes on the occurrence and outcome of the disease.

In modern high-performance sports, mental reliability is a decisive factor for success. The specificity of various combat sports forms unique complexes of psychological qualities, requiring a differentiated approach to the training process. A comparative analysis of the mental profiles of athletes in different combat disciplines allows for the identification of targets for psychological correction. Objective. To conduct a comparative analysis of mental reliability components in student-athletes practicing mas-wrestling and boxing. The study was conducted at the North-Eastern Federal University involving 41 students: 24 mas-wrestlers and 17 boxers (average age 20.3 years). V. E. Milman’s standardized questionnaire was used to assess four components: Competitive Motivation (CM), Competitive Emotional Stability (CES), Self-Regulation (SR), and Stability-Noise Resistance (SN). Statistical data processing was performed using SPSS v.22.0 software (Mann-Whitney U test, Pearson’s χ², OR). It was established that athletes in both groups possess high competitive motivation, yet demonstrating a critically low level of emotional stability (low CES was found in 83.34 % of the mas-wrestlers and 82.36 % of the boxers). However, differences were revealed in regulatory components: the boxers showed better results in self-regulation (47 % with a high level vs. 33 % for mas-wrestlers). The most pronounced difference was found in noise resistance: the mas-wrestlers were 3.5 times more likely to manifest a low level of SN compared to the boxers. High motivation without developed self-control skills does not guarantee mental reliability. Due to the specifics of their sport, the boxers demonstrated better adaptation to stress conditions through more developed self-regulation and noise resistance skills. For the mas-wrestlers, the implementation of psychological training programs aimed at developing emotional stabilization techniques is recommended.

Over 28 years (from 1995 to 2023), the number of suicides per 100,000 people worldwide (suicide index – SI) decreased by approximately 47 % – from 15 to 8. Over the past twenty-eight years, the suicide rate in the United States has been steadily increasing, with a 20 % increase in the suicide index since 1995. In the Russian Federation, SI decreased by 5.4 times during the same period. The purpose of this study was to compare the effectiveness of suicide prevention in the United States and Russia. A comparative study of the principles and methods of suicide prevention in the United States and Russia was conducted, identifying key challenges. The study materials were statistical data published on the websites of the US Centers for Disease Control and Prevention (CDC); Letter of the Ministry of Health of the Russian Federation of March 6, 2020 No. 15-2 / I / 2-2645 “On the methodological recommendations “Suicidal behavior of minors (preventive aspects)”; Order of the Government of the Russian Federation of April 26, 2021 No. 1058 “On approval of a set of measures until 2025 to improve measures for the prevention of suicide among minors”. It was established that preventive activities to reduce suicide attempts in the United States are not effective enough, with the SI not showing a downward trend due to the following systemic problems: 1) a smaller scale of preventive impact on suicides with this activity being coordinated not at the presidential or ministerial levels, but at the level of departments (Substance Abuse and Mental Health Services Administration – SAMHSA, Centers for Disease Control and Prevention – CDC, Foundation for Suicide Prevention – American Foundation for Suicide Prevention, AFSP); 2) not all segments of the US population can afford a consultation with a qualified psychotherapist, psychiatrist, and the problem of accessing psychological care remains; 3) there is a problem of easy access to firearms. The Russian Federation has created an effective suicide prevention system. This system is distinguished by a greater scale of preventive impact than in the United States, starting from the Decrees of the President, orders of the Government of the Russian Federation, and four ministries (health, education, internal affairs, labor and social development). Problems in suicide prevention in the Russian Federation: 1) more attention is paid to issues of suicide prevention among minors, less attention is given to other age groups; 2) there are regions with high suicide rates, located mainly in the North, with a low level of social and economic development, which provokes the emergence of suicidal thoughts; 3) a shortage of qualified personnel (clinical psychologists, psychiatrists, psychotherapists) in remote regions; 4) stigmatization of mental disorders: many Russians are afraid or ashamed to consult a psychiatrist or psychologist. In order to achieve a sustainable reduction in the level of social development among residents of the Russian Federation and the United States, it is necessary to implement a comprehensive state policy aimed at realizing the economic potential of each region (state) and promoting the spiritual development of each individual. To do this, we need to learn from the positive experience of suicide prevention in the United States and Russia. Russian healthcare should adopt the US method of suicide prevention, which involves screening in primary healthcare. Russia should also promote the de-stigmatization of mental disorders.

The article presents an analysis of the dynamics of cancer morbidity and mortality in the Sakha Republic (Yakutia) for the period from 2020 to 2022. The focus is on the possible connection between cancer morbidity and the environmental situation in the republic. There is an observed increase in cancer morbidity both worldwide and in the Russian Federation, which is one of the most important problems in medicine. In this regard, an assessment of the morbidity level in the republic was carried out, as a result of which a growth trend was identified. A hypothesis was put forward, the essence of which lies in the presence of a connection between high cancer morbidity and an unfavorable environmental situation. The environmental situation in the region is generally characterized as unfavorable: high levels of pollutant emissions into the atmospheric air, pollution of surface waters, and soil contamination with petroleum products and heavy metals have been identified, which may contribute to the increase in cancer pathology. This is especially true for industrial districts (Aldansky, Lensky, Neryungrinsky, Ust-Maisky), as well as several northern districts (Abyisky, Allaikhovsky, Bulunsky, Verkhnekolymsky), where the incidence exceeds the average republic’s values. Based on a comparison of statistical data on cancer incidence and environmental condition indicators in the republic, areas were identified where a high incidence rate coincides with an unfavorable environmental situation. In this context, a possible relationship between the level of industrial activity and morbidity is observed. Attention is drawn to the combination of radiation factors (elevated radon content) and high cancer incidence in Aldansky and Neryungrinsky Districts. An Arctic paradox was identified: abnormally high morbidity in sparsely populated northern districts with low industrial activity but significant environmental pollution (water and soil). The results of the study emphasize the need to develop regional programs for the prevention and early diagnosis of oncological diseases, especially in environmentally disadvantaged areas, as well as conducting more in-depth studies to confirm the identified patterns.