Dentofacial anomalies are characterized by high prevalence and rank third after dental caries and periodontal diseases, where more than 82 % of the population have disorders of the dental system, ranging from mild cosmetic defects and minor deviations to serious pathology that causes disruption of functional life. In this regard, research aimed at improving the orthodontic treatment of dentoalveolar anomalies is relevant.

Aim. To evaluate the effectiveness of using mini-implants in orthodontic practice in the treatment of sagittal malocclusions.

Research methods. The effectiveness of treatment was assessed in 50 patients, who were divided into 2 groups. In the control group (20 people) there were patients with dentoalveolar anomalies treated with the standard direct arch technique on opening springs; in the experimental group (30 people) mini-screws were used. The duration of treatment in months, the effectiveness of installing mini-screws in various anatomical zones, and the thickness of cortical plastic surgery were analyzed.

Results. When using mini-screws on the upper jaw for 4 months, corpus distalization of the lateral group of teeth is observed, while the canines improve their position according to class I, in turn, when working on opening springs, an angulation displacement occurred due to the tilt of the coronal part of the tooth distally, which had an effect not highly effective in distalization. At the same time, the treatment period for orthodontic pathology when using mini-screws is 19 – 27 months, while when working with opening springs and elastic rods it is 26 – 33 months. The use of mini screws speeds up the movement of the lateral group on the upper and lower jaw. The effectiveness of using micro-implants in distalization was confirmed, where a strong relationship between the signs was revealed. The optimal place for installing a mini-implant is densely attached gums (~5 mm below the level of the transitional fold). Difficulties with positioning microimplants in the upper jaw are associated with the low location of the bottom of the maxillary sinus. A thinner cortical plate is observed in the distal parts of the upper jaw, which does not allow achieving adequate primary stability of the microimplant.

Conclusions. The practical use of mini-screws causes a significant reduction in the treatment period for sagittal malocclusions, where it is necessary to take into account the type of mucosal biotope and the thickness of the cortical plate on the process of microimplant integration.

Celiac disease is an immune-mediated systemic disease that occurs in response to the consumption of gluten or related prolamins by genetically predisposed individuals and is characterized by a wide combination of gluten-dependent clinical manifestations. The average worldwide detection rate of antibodies specific for celiac disease is 1.4%, while 0.7% of the world’s population has histologically confirmed disease. The prevalence of the disease is much higher in children than in adults.

The article describes cases of severe iron deficiency and B12 deficiency anemia in two children: a 3-yearold girl and a 14-year-old boy. The children significantly lagged behind in physical development, both had a pronounced underweight (weight SDS below -2.5). The girl was short (height SDS -3.39), with thin limbs and a large belly. An examination revealed severe microcytic hypochromic anemia (hemoglobin 66 g/l, MCV 57.0 fl, MCH 15.1 pg, MCHC 26.5 g/dl, RDW-CV 23.4%), decreased levels of serum iron and ferritin. The boy had severe macrocytic hyperchromic anemia (hemoglobin 44 g/l, MCV 110.6 fl, MCH 38.9 pg, MCHC 35 g/dl, RDW-CV 18.1%), low serum vitamin B12 activity. To determine the cause of anemia, both children underwent esophagogastroduodenoscopy with biopsy from the postbulbar part of duodenum. The morphological picture corresponded to celiac disease, Marsh II. The girl was found to have elevated titers of antibodies to endomysium Ig A, Ig G, to diamidated gliadin peptides of the class Ig G, Ig A. The cause of severe anemia in the children was malabsorption syndrome caused by celiac disease. This diagnosis was made for the first time. The children were consulted by a gastroenterologist and a strict gluten-free diet was recommended. When questioning the girl’s mother and the boy’s guardian by phone 4 and 3 months, respectively, from the date of discharge from the hospital, it turned out that the children did not follow the prescribed diet. This can be explained by late diagnosis, lack of awareness of parents (guardians) about celiac disease and its consequences.

The article presents a clinical case of an extremely rare orphan pathology of the kidneys: Dent’s disease (DD). It is a rare X-linked recessive proximal tubulopathy characterized by low molecular weight (LMW) proteinuria, hypercalciuria, nephrolithiasis, and slowly progressive renal failure. According to the few literature data, 30-80% of male patients have progression of renal failure to the terminal stage at the age of 30-50 years. A little over 15 years ago, Dent’s disease was not diagnosed in Russia, and the pathology was often described as nephrotic syndrome due to high proteinuria. According to the limited literature data, 30-80% of male patients experience progression of renal failure to the terminal stage at the age of 30-50 years. The question of hereditary kidney pathology arises if a child has urinary syndrome: increased levels of albumin, red blood cells, leukocytes, and cylindruria in the urine. Patients may also be short, but this is more common with Dent’s disease type 2. Diagnosis of congenital and hereditary kidney diseases, when they are not accompanied by bone or other external symptoms, is quite difficult. In addition, when the skeletal system is affected, Dent’s disease is often confused with hypophosphatemic rickets. To confirm the diagnosis of Dent’s disease, a molecular genetic study is necessary. Treatment is mainly aimed at preventing stone formation. Dent’s disease was first described by C.E. Dent and M. Friedman in 1964. In most cases, the disease is caused by mutations in the CLCN5 gene (type 1 Dent’s disease) and the OCRL1 gene (type 2 Dent’s disease). Due to the clinical heterogeneity of this disease, the epidemiology is unknown. Around the world, about 250 families with this pathology have been described. Many phenotypic variants of Dent’s disease are described as a separate entity, for example, X-linked recessive nephrolithiasis with renal failure, X-linked recessive hypophosphatemic rickets, familial idiopathic low-weight proteinuria (LMW) with hypercalciuria in the Japanese population. Early diagnosis of Dent’s disease is problematic; detection of low molecular weight proteinuria is not available in every laboratory, and it is not always possible to trace a genetic connection. Therefore, the fact of prolonged urinary syndrome in children, especially accompanied by a family predisposition to renal pathology, should always be alarming.

From ancient times to the present, malaria has caused enormous damage to mankind, deteriorating the health of the population and causing high mortality. Currently, there is a gradual return to Europe of malaria and epidemics associated with environmental causes (the development of resistance to insecticides in vectors and to antimalarial drugs in pathogens) and socio-economic conditions (economic crises and mass migration of the population). Malaria is registered in 101 countries of the world: in 92 – tropical malaria, in 9 – only 3-day one. With the annual number of cases of malaria in the world at 300 – 500 million, the number of deaths is 1.5 – 2.7 million, mainly in Equatorial Africa and Southeast Asia. Imported malaria for our country has two aspects. Firstly, clinical: there is death from tropical malaria due to a late visit to the doctor, and in some cases due to late diagnosis and late etiotropic therapy. Secondly, the epidemiological aspect is the possibility of resuming the transmission of malaria in local conditions and the formation of local foci (three-day and oval malaria). In the Russian Federation, there are mainly imported cases of malaria from endemic regions of the world; in Yakutia, sporadically imported cases of malaria are recorded. The clinical course of malaria depends on the type of pathogen and the immune status of the infected person. The epidemiological history plays a significant role in the diagnosis. This article presents a clinical case of an imported case of mixed malaria in the Republic of Sakha (Yakutia).

Purpose of the study: To assess the frequency of arterial hypertension and some risk factors for its development in the indigenous and non-indigenous population of Yakutia.

Materials and methods of research. A study was conducted of the working indigenous and non-indigenous population of the Anabar and Aldan regions of Yakutia. A total of 395 people were examined, of which 216 were indigenous, 179 were non-indigenous.

Results. A high incidence of abdominal obesity was found to be more common in non-indigenous men and women of both groups, with the greatest trend in indigenous women. A high incidence of arterial hypertension was revealed: 56.9% in the indigenous and 56.4% in the non-indigenous population. A study of the average values of the lipid spectrum showed that in the non-indigenous population the average concentrations of total cholesterol, HDL and TG are significantly higher compared to indigenous people. But the average LDL cholesterol level was significantly higher in the indigenous population, most characteristically for women. Average TG concentrations in both men and women were significantly higher than in the non-indigenous population. A correlation with SBP of total cholesterol, its atherogenic fraction and TG in indigenous residents was revealed, and with TG and blood glucose in non-indigenous people.

Conclusion. A study of the indigenous and newcomer population of Yakutia revealed a number of negative aspects. There is an increase in the prevalence of arterial hypertension and atherosclerosis in the indigenous population due to global changes in lifestyle and nutrition. The same incidence of arterial hypertension was revealed in the indigenous and non-indigenous populations of Yakutia. More than half of the respondents had abdominal obesity, more often in non-indigenous men, and in women without a significant difference in ethnicity. Disorders of lipid metabolism are more associated with arterial hypertension in indigenous peoples, and carbohydrate in the non-indigenous population of Yakutia.

The aim of the research. An analysis and systematization of scales and questionnaires used to diagnose discogenic chronic pain syndrome (DCPS) in Russia and abroad. The analysis of Russian-language and foreign literature was carried out with a search depth of 5 years (2016– 2021) in the following databases: e-Library, PubMed, Oxford Press, Clinical Keys, Springer, Elsevier, and Google Scholar. To diagnose back pain and assess the characteristics of its course in dynamics, a standardized study is used: collection of complaints, anamnesis, objective examination, assessment of neurological status, as well as valid scales and questionnaires. For a timely diagnosis and monitoring of the development of DCPS in patients with intervertebral disk degeneration, a wide range of scales and questionnaires were proposed, which we ranged into 4 groups: scales for assessing the quality of life of patients with DCPS; scales for assessing the characteristics of pain in VCPS; scales for assessing disease outcomes in DCPS; and scales for assessing disability in DCPS. The first part of the thematic review presents an analysis of the advantages and disadvantages of scales for assessing the quality of life of patients with DCPS. The group of scales for assessing the quality of life of patients with DCPS is the most popular in the world neurological practice; however, it is necessary to adapt it to the use in domestic clinical practice of such scales as the Stratford Functional Back Pain Scale, the Index of Disability Associated with Pain, and The Patient Assessment for Low Back Pain–Impacts (PAL-I). It was also noted that there are no Russian scales used to diagnose back pain and assess the characteristics of its course.

Issues of satisfaction with medical care are relevant all over the world, but this concept is subjective. There is a relationship between objective criteria for the quality of medical care and the level of patient satisfaction. A professional approach to the analysis of the quality of medical care on the part of the patient is unquestionable; however, it is them who are the main customers of medical care and determine the justification for the use of resources from the point of view of the society. It is required to create a tool that will allow the obtained results of patient satisfaction to be used as a criterion for the social effectiveness of the healthcare system. In addition, with this approach, the level of patient satisfaction can be used as an indicator of the effectiveness or efficiency of measures taken to improve the system of medical care. It is possible to solve such a task of creating such a tool using the standardization method.

The purpose of the study: to analyze the dependencies between determinants that affect the level of patient satisfaction with medical care provided in outpatient settings.

Materials and methods of the research. Nine determinants affecting the patient’s assessment of the quality of organization of medical care provided in outpatient settings were considered: demographic characteristics (age, gender); social determinants (level of education, recognition of the patient’s responsibility for their own health, marital status of the patient, the degree of compliance of the patient); economic determinant (the amount of disposable income); and the patient’s life priorities (“the standard structure of life priorities, the importance of the life priority “Health”).

Results. A symmetric correlation matrix with a dimension of 9×9 elements was formed, the analysis of which showed that no strong dependence was detected in any case. However, during the analysis, combinations of features were identified that need to be taken into account during further consideration (at subsequent stages).

Conclusion. According to the results of the analysis of the dependence of the patient’s satisfaction with the received medical care on each factor or group of related factors, 11 related signs were selected. No independent signs were detected. The dependencies between the studied parameters are very complex, and typical methods of variational statistics do not allow us to obtain unambiguous results. Only the use of special methods can make it possible to obtain a result in a form suitable for its use for practical purposes.

The development of new and improvement of existing methods of diagnostics and surgical interventions on the skull are based on knowledge of the craniofacial complex. The purpose of the article is to determine the typical morphometric characteristics of the cerebral and facial parts of the skull. The linear dimensions of 64 skulls of both sexes were studied. The cranial index of preparations was ≥80.0, which corresponds to brachycranial type. 36 skulls belonged to men and 28 to women of mature age. Longitudinal (length of the vault and base of the skull, length of the base and upper height of the facial part) and transverse (width of the vault and base of the skull, width and depth of the facial part) parameters of the skulls were studied. The basilar and upper facial indexes are also studied. The limits of the values of these parameters are determined. The results of the study did not reveal a statistically significant difference in skull parameters of males and females. At the same time, the variability of the length of the base of the cerebral part of the skull was greater than the variability of the width on male skulls. The width of the facial part of the skull had greater variability compared to the length of the base of the facial part in preparations of both sexes. The depth of the upper and middle parts of the facial skull had similar values (p>0.05). The depth of the lower part of the facial part of the skull exceeded the depth of the upper and middle parts, as well as the length of the base of the facial part of the skull (p<0.001). Among all the considered brachycranial skulls, the brachybasilar form of the skull base and the euryprosopic form of the facial part predominated. In addition, combinations of the studied type of skull with mesobasilar and dolichobasilar forms of the base and with mesoprosopic and leptoprosopic forms of the facial part of the skull were revealed.

The spleen is represented by two compartments with different cellular elements differing in immunophenotype, origin, and functions. This determines not only the different sensitivity and difference in reactivity to external irritating factors, but also specific changes within the compartment, both normal and pathological, depending on the duration and type of the active stimulus. The aim of the research was a comparative study of the morphometric parameters of the spleen structures against the background of isolated hypoxic hypoxia and hypoxia combined with natural gas inhalation. The experiment was carried out on 113 white male mongrel rats using seed chambers of the Erisman Institute with the supply of a controlled composition of the air-gas mixture. The beginning of the experiment was considered to be a decrease in oxygen concentration to 17.5%. The animals were placed in a depleted oxygen mixture for five days a week, four hours a day, until an oxygen concentration of 13.5 – 14% was reached. The experiment lasted 120 days, the animals were removed once a month: after 30, 60, 90 and 120 days. Mixed hypoxia was modeled using the same seed chambers, in addition to the depleted air mixture, natural gas from the Astrakhan field was added through the nozzle at a concentration of 3 mg/m3. A control group (n=13) was isolated, which was placed in a chamber in a similar time mode, but with the usual composition of air. For the manufacture of histological preparations, the spleen was extracted from the abdominal cavity. The preparations were stained with hematoxylin-eosin and Van Gieson. The analysis and visualization of the preparations were carried out using a ZeissAxioScopeA1 light microscope (Germany) and a LeicaAperioCS2 digital scanner of micropreparations. It was found that by Day 120 of the experiment, in both experimental groups there were changes on the part of the capsule: thickening and loosening with the phenomena of edema; similar changes occur on the part of the trabeculae: thickening due to the phenomena of collagen formation and edema. On the part of the spleen compartments in the group of animals with isolated hypoxic hypoxia, there was an increase in the total volume of white pulp by the end of 90 days of the experiment, which is associated with an increase in the size of the structural components of the white pulp. However, by Day 120, there was a decrease in the volume of white pulp compared to the previous period and control. In the group of animals with mixed hypoxia, the combination of hypoxic and toxic effects of natural gas caused changes in the distribution of volume fractions of the structural zones of the spleen at earlier periods. Thus, a reduction in the volume and density of the distribution of cellular elements in lymphoid nodules occurs already by Day 90 the experiment, while the disappearance of germinative centers in a number of lymphoid nodules is observed, that is, the breakdown of adaptive capabilities occurs after 60 days of the experiment.

Data on formation and transformations of human prostate glands from the epithelial cords into the complex alveolar-tubular glands and the characteristics of their growth and developmental dynamics during prenatal ontogenesis and children are ample but fragmented and not systematized. Establishing the time of emergence and formation of various structures is important for observing the proper development of the fetal genitourinary system and boys in the postnatal period. The purpose of this study is to identify age-related features of the structural organization of the main glands in the all prostate zones in the prenatal and postnatal ontogenesis of boys. The study was performed on serial histological sections of the pelvic region of 51 human prefetuses and fetuses and 36 prostate glands of boys of neonatal periods to second child age. The morphometric study included the measurements of acini, the acinar lumen areas, their shape factors, and the epithelium height. The study showed that the formation of prostatic ducts begins in the early neonatal period. The changing in the area of acini, acinar lumens, their shape and the reduction in the height of their lining epithelium, which was detected in the prostate of prenatal period. The features of structural formations were detected in the different prostate zones.

Conclusions. The prostatic glandular acini form sequentially rather than directly from the epithelial cords: the latter are transformed into the prostatic ducts, from which the glandular acini are then formed. Age from 1 year to 12 years is a period of slow growth of the terminal ends of the prostate glands. At 1-12 years old, there are features of the structural organization of the main glands in different zones of the prostate. In children’s age periods, the forms of the terminal ends of the glands and their acinuses in different zones of the prostate differ.