This review is devoted to a rare pathology – traumatic bronchial breakage in a child. Posttraumatic tracheobronchial breakage is a rare but life-threatening injury. It is a difficult diagnosis for an emergency physician and requires a high level of suspicion. Diagnosis of this type of injury is difficult and requires a high degree of clinical alertness. Chest injuries with breakage of the trachea and bronchus are characterized by a severe clinical course, often accompanied by shock and a significant number of purulent-septic complications and, in combination with multiple injuries, entail high mortality. According to various authors, the mortality in combined chest trauma makes from 5–8 % to 18.9 %. The main cause of mortality is shock and ongoing internal bleeding. Rib fractures, flail chest, aortic injury, and diaphragmatic rupture are more common in adults, whereas pulmonary contusion, pneumothorax, and intrathoracic injury without bone fracture are more common in children. The different patterns of injury can be explained by anatomical and physiological differences between children and adults. The trachea is relatively narrow, short, and more easily compressed in children, so small changes in the caliber of the airway due to external compression or inhalation of a foreign body can lead to more serious respiratory impairment. In addition, children have a higher metabolic rate and consume more oxygen per kilogram of body weight than adults, resulting in greater vulnerability and rapid development of hypoxia in the context of severe chest trauma.

This systematic review presents data from literature sources on the development of pathological processes in teeth following radiotherapy for malignant neoplasms (MN) of the maxillofacial region (MFR). Materials from E-LIBRARY, PubMed, Google Scholar, and Elsevier Science Direct were used for analysis and evaluation. The sample consists of scientific papers devoted to the effects of ionizing radiation on the condition of teeth after radiation treatment for malignant neoplasms of the maxillofacial region. The generalized results of clinical and experimental studies presented in this review demonstrate the specific influence of remote radiotherapy for MN of the MFR on the characteristics of dental pathology manifestation, both in the short and long term after treatment completion, characterized by intensive tooth decay. Remote radiotherapy, being the main method of treatment for MN of the MFR, contributes to the occurrence of morphological changes in dental tissues. Changes in hard tissues and dental pulp are directly related to radiotherapy for MN of the MFR. However, there is currently no consensus among specialists regarding the pathogenetic mechanisms of radiation-induced destruction of dental tissues and pulp. Some authors characterize these post-radiation changes in the oral cavity as acute multiple caries, while others attribute this pathological process to non-carious lesions that develop after tooth eruption. Furthermore, patients with MN exhibit different patterns of hard dental tissue damage depending on the location of radiation exposure. After radiation treatment in the head and neck region, enamel and dentin necrosis complicated by caries and acute rapidly progressing caries are observed, while after radiation treatment in the chest and pelvic organs, acute and hyperacute caries are observed, and in some clinical cases, cervical enamel necrosis. In this regard, the problem of studying the pathogenesis of radiation-induced tooth damage is relevant for improving the effectiveness of rehabilitation of cancer patients and developing tactics for complex medical and social rehabilitation. The problem of dental condition after remote ɣ-therapy for MN of the MFR remains understudied and requires further research to determine the tactics of dispensary observation and the specifics of applied therapeutic, preventive, and rehabilitative dental measures.

Coronavirus infection CoronaVirus Disease-2019 (CVI, COVID-19) continues to be one of the most common and requires further study of infectious diseases. In combination with another common medical and social pathology, arterial hypertension (AH), the course of COVID-19 is characterized by severe course and high mortality. Based on the results of scientific research, a significant evidence base has been accumulated for early diagnosis and prediction of the course of COVID19. Objective: To describe the clinical and laboratory picture and risk factors for an unfavorable course of coronavirus infection COVID-19 in patients with concomitant arterial hypertension. The authors studied the medical histories of patients (n=200) with COVID-19 of varying severity with arterial hypertension who were hospitalized in the infectious diseases department of the Yakutsk Republic Clinical Hospital in the period 2020–2022. In patients with COVID-19 in combination with hypertension in severe forms of the disease, the following clinical manifestations were most often established: fever (79.7 %), general weakness (82.1 %), cough (62.5 %) and shortness of breath (62.6 %). Severe course of COVID-19 was significantly more often observed in the studied patients with grade 3 obesity (p=0.023) and type 2 diabetes mellitus (p=0.05). In severe course of COVID-19, in laboratory parameters at the time of admission, statistically significant increase in ALT, AST and NT-proBNP levels (p<0.05) are noteworthy, as well as significant violation of lipid profile parameters (p<0.05). The probability of a severe course of COVID-19 in individuals with hypertension is indicated by the high mortality rate, which amounted to 32.5 % (p<0.001) in severe forms. Conclusion: The most common clinical manifestations of COVID-19 in severe patients with hypertension are fever, general weakness, cough and shortness of breath. Regardless of age, for individuals with hypertension, COVID-19 occurs in a severe form with the development of complications in the presence of obesity and type 2 diabetes. Elevated levels of natriuretic peptide (NTproBNP), ALT, AST, LDL-C at the time of hospitalization can be a predictor of a severe course of COVID-19 in patients with hypertension. A fatal outcome in severe COVID-19 developed in 32.5 % of the cases.

Epilepsy is one of the most common neurological diseases, which is based on a persistent predisposition to epileptic seizures, leading to a variety of medical and social consequences and a decrease in the quality of life. According to the World Health Organization, epilepsy accounts for a significant portion of the global burden of disease, affecting approximately 50 million people worldwide. The estimated proportion of the general population with active epilepsy (i.e., ongoing seizures or requiring treatment) at any given time is between 4 and 10 per 1,000 people. The prevalence of epilepsy in the Russian Federation, standardized by sex and age, is 3.22 people per 1,000 population, and the incidence is 14.8 per 100,000. The population. The prevalence of epilepsy was higher in Siberia and the Far East compared to the European part of the Russian Federation. According to preliminary data, 4,566 patients with various forms of epilepsy were registered in the Republic of Sakha (Yakutia) in 2023, with a prevalence of 6.3 per 1,000 population. The majority of patients with epilepsy (59 %) live in the districts of the republic. A sample of patients from Yakutsk and the districts of the republic was studied. According to the conducted research, it was found that 67.9 % of epilepsy patients are constantly being monitored by a neurologist. A representative randomized sample shows comparative data on adult epilepsy in the Republic of Sakha (Yakutia). The median patient with epilepsy in Yakutia is a 40–year-old young man living in the district suffering from structural focal epilepsy with bilateral tonic-clonic seizures. Most of the patients were taking oldgeneration antiepileptic drugs.

Gilles de la Tourette syndrome (TS) is the most severe clinical form of tic hyperkinesis in children. According to world statistics, up to 1 % of children suffer from this disease, and the average age of clinical manifestation of TS is 6–8 years. TS is characterized by a clear gender feature – the prevalence among boys is 3-4 times higher than among girls. The etiological factor of the disease is still unknown, but it is generally believed that a genetic predisposition, perinatal damage to the central nervous system and traumatic events play a role in the development of TS. The key pathogenetic mechanisms of tic development in this case are: impaired inhibitory effect of the cortex on subcortical movement centers, predominance of excitatory neurotransmitters (dopamine, glutamate) inhibitory (gamma-aminobutyric acid) as well as microbiotic disorders that affect the central nervous system through the enteric nervous system. At the current stage of providing medical care to sick children with this diagnosis, according to international clinical guidelines, it is necessary to prescribe drugs from the group of antipsychotics, and the most effective drugs are considered to be generation 2 (aripiprazole, respiridon, quetiapine, tiaprid). However, the safety of these drugs has been poorly studied in the pediatric population; in addition, most of them are indicated for use in children from the age of 6. Accordingly, the question arises how to treat a patient with this diagnosis at an earlier age. In this clinical case, it was shown that nootropic drugs with anxiolytic activity can be effective in Gilet de la Tourette syndrome with early onset, when the appointment of antipsychotics, which are the first line of therapy, is still unacceptable.

Leishmaniasis is a parasitic natural focal zoonotic transmissible disease common in tropical and subtropical countries; it is caused by parasitic protozoa of the genus Leishmania, which are transmitted to humans through mosquito bites. The most severe form of the disease is visceral leishmaniasis, which affects the organs of the reticuloendothelial system. The lack of alertness in terms of clinical and laboratory diagnostics of this disease in non-endemic areas sometimes leads to errors in diagnostic verification. A rare imported clinical case of visceral leishmaniasis associated with fever, hepatosplenomegaly, generalized lymphadenopathy, and hematological syndrome in the form of three-line cytopenia is presented. Only detection of the pathogen in bone marrow puncture allowed us to make the correct diagnosis. Low awareness of doctors and the lack of systematic riskoriented monitoring of exotic diseases often complicates the timely diagnosis of leishmaniasis, which leads to an unfavorable clinical course of the disease and, in some cases, a fatal outcome.

The aim of the study was to analyze the etiological structure of microorganisms and their resistance to antimicrobial drugs in patients with surgical sepsis. Research materials and methods. A retrospective observational study was conducted in the Department of Anesthesiology and Intensive Care Unit at the Republic Hospital № 1 – M. E. Nikolaev National Center of Medicine. The object of the study is 30 surgical patients with sepsis. All patients were treated in the period 2022–2024. The analysis of 370 microbiological studies of biological media (peritoneal exudate, sputum (tracheal and bronchial aspirate), wound discharge, blood, urine) was carried out. The results of the study. The number of samples with the growth of microorganisms was 350 (94.6 %) samples, without the growth of pathogens –- 20 (5.4 %). A total of 17 microorganisms were isolated, which were more often observed as a mixed infection. Gram-negative microorganisms were the leaders among microorganisms. Klebsiella pneumonia was isolated in 26 (24.3 %); Acinetobacter baumannii – in 18 (16.8 %) studies. Other clinically significant pathogens, Enterococcus faecium, Escherichia coli and Pseudomonas aeruginosa, were found in 13 (12.1 %), 10 (9.3 %) and 4 (3.7 %) samples. Fungal infection was detected in 21 (19.6 %) studies and is mainly represented by Candida glabrata (11.2 %) and Candida albicans (6.5 %). The analysis of antibiotic resistance showed that aminoglycosides (Amikacin) and thirdgeneration cephalosporins (Cefotaxime and Ceftazidime) are active against Klebsiella pneumonia. Activity against Acinetobacter baumannii is shown by Amikacin, carbapenems (Imipenem, Meropenem) and moderate activity of fluoroquinolones (Ciprofloxacin). High efficacy in Enterococcus faecium is noted in Vancomycin and Linezoloid. Conclusion. In patients with surgical sepsis, the microbial flora is represented by representatives of nosocomial agents with high resistance to antibacterial drugs, including reserve drugs. Microbiological monitoring, detection and control of local antibiotic resistance makes it possible to optimize and increase the effectiveness of antimicrobial therapy.

During the evolution, there were complex multicomponent and contradictory relations between humans and oral microorganisms. The presence of physiological microbiota (i.e. microbial colonization of the skin surface and mucous membranes) is vital for humans to form metabolic and immune homeostasis properly. For the favorable growth and development of microorganisms, constant humidity, temperature, pH, regular intake of nutrients, macro- and microelements are necessary, therefore, the oral cavity is a favorable environment for maintaining the life of microflora. Immediately after birth, the skin of the baby, mouth and nose, intestines are colonized by microorganisms through breathing, feeding and contact with caregivers of the newborn. In this case, the initial settlement of the nasal cavity by microorganisms occurs, and the nasopharyngeal microbiota of the child resembles the composition of the maternal vaginal or skin microbiota. After reaching the age of 65, the composition of the microbiome is gradually depleted, loses its diversity, becoming more similar to the microbiome of the pharynx and oral cavity. The consequences of the microbial background affection in the oral cavity are caries and its complications, diseases of the periodontal and mucous membranes. Studies in recent decades demonstrate the role of oral microbiota in systemic diseases, in particular the respiratory system, but the degree of influence is still at the early stage of study. In addition, respiratory diseases and their therapy cause microbiota dysbiosis and oral diseases. On the one hand, it can further aggravate diseases of the respiratory system, forming a vicious circle. Also, dysbiosis in these areas can affect the activity of the carious process and intensify its course. An in-depth study of the oral and nasal microbiota and microbiome paves the way for the prevention and treatment of various oral and respiratory diseases. In general, the role of oral dysbiosis in respiratory pathology and systemic diseases is undoubted, which requires further research to improve medical and social rehabilitation.

The aim of the work was to identify the relationships between the constitutional features of athletes and indicators of respiratory function. 81 martial artists participated in the study, the average age of the surveyed was 20.9 ± 0.36 years. All the surveyed sportsmen were pupils of the Republic’s Center for Sports Training of national teams of the Republic of Sakha (Yakutia). The research program included anthropometric measurements (body length and weight, transverse diameter of the chest), somatotyping using the Rees-Eisenck method (classification into asthenic, normosthenic and picnic types of constitution) and examination of respiratory functions (SPIRO S-100 spirometer). During spirometry, the following parameters were recorded: respiratory volume, reserve volume of inspiration, reserve volume of expiration, inspiration capacity and vital lung capacity. Resistance to hypoxia was assessed using the Stange and Genche tests, and the integrated assessment of the adaptive capabilities of the cardiorespiratory system was based on the Skibinsky index. Statistical processing of the obtained data was carried out using the SPSS 22,0 application software package. The results of the study revealed a statistically significant relationship between the somatotype according to the Rees-Eisenck index and indicators of respiratory function. In particular, the athletes with the picnic type of constitution had higher values of spirometric parameters: reserve inspiratory volume, inspiratory capacity and vital lung capacity. The value of the VLC depends on the type of sport and must be taken into account when assessing the functional state of athletes. The athletes with the normosthenic type demonstrated greater resistance to hypoxia, which was expressed in an increase in the time of holding their breath in the Stange and Genche tests compared with those with the asthenic type. The asthenic type of constitution was characterized by the predominance of “satisfactory” levels of the Skibinsky index, indicating a lower adaptive reserve. The data obtained emphasize the importance of taking into account the constitutional characteristics of athletes when assessing their functional state and developing individualized training programs aimed at optimizing adaptation to physical exertion and improving athletic performance.

Ensuring the health of teaching youth is considered as one of the key social tasks for the whole society. Modern students are specialists, on whose future decisions the development of our country will largely depend. However, the educational process in higher education institutions often causes an overload of students, which leads to an increase in psycho-emotional tension, exhaustion of adaptive resources of the nervous, endocrine and immune systems, as well as an increased risk of developing diseases. This article presents data reflecting the state of health of students of the Institute of Medicine, M. K. Ammosov North-Eastern Federal University. Purpose of the study was to study the lifestyle and morbidity of students of the Institute of Medicine, M. K. Ammosov NEFU. Materials and methods: 1. Analytical – literature review. 2. Sociological (cross-sectional study). A retrospective study of the annual preventive medical examination log, analysis of the dispensary registration log for 2019–2022 was conducted. 3. Processing of questionnaire data and statistical analysis were carried out using Microsoft Office Excel. Results: In order to analyze the impact of the educational process on the health of university students, a sociological study was conducted at the Institute of Medicine, M. K. Ammosov NEFU. 40 students participated in the survey. Additionally, data on morbidity were obtained based on the results of annual preventive medical examinations of students at the NEFU clinic, which was carried out through the analysis of a medical journal. The examination was attended by 198 students of various courses of the Department of Dentistry and Nursing. In the course of the research, it was found that the morbidity rate of students of the Institute of Medicine is at an unsatisfactory level, which, in turn, is not unexpected. In the new conditions of social university education, yesterday’s schoolchildren are faced with a complex socio-psychophysiological process that causes tension in the compensatory and adaptive systems of the students’ body. This condition is characterized by mental and psycho-emotional stress that accompanies violations in work, rest and nutrition regimes. Students of the Institute of Medicine are mainly susceptible to diseases such as iron deficiency anemia, diseases of the digestive system (in particular, chronic gastritis, which accounts for 59 % of cases of diseases of the gastrointestinal tract), diseases of the cardiovascular system (where essential hypertension is the most common, accounting for 55 %), the endocrine system (53 obesity accounts for % of cases), respiratory diseases (in particular, chronic tonsillitis – 38 %, bronchial asthma – 24 %) and eye diseases (refractive and accommodation disorders). Findings: The health of medical students during their studies shows a tendency to deteriorate. The key factors contributing to a negative impact on health include significant intellectual stress, non-compliance with the daily routine and diet, insufficient physical activity, as well as the presence of bad habits. These circumstances confirm the need to optimize the work of higher education institutions in the field of health, as well as to coordinate the efforts of all participants in the educational process aimed at attracting students to a healthy lifestyle.