Purpose: Аn analysis of the clinical and laboratory parameters of ischemic stroke (IS) associated with the new coronavirus infection COVID-19 (NCVI). Materials and methods: the study provided a comparative analysis of 52 IS cases in combination with NCVI (main group) and 253 IS cases without NCVI (comparison group). All the patients were analyzed in terms of the IS severity according to the NIHSS scale; stroke subtypes according to the TOAST classification; locations of the affected vascular territories, and clinical outcomes. We also evaluated hemostasis parameters, inflammatory markers and D-dimer levels in 149 patients. Results: it was revealed that in the IS group with NCVI compared with the group without NCVI, the stroke severity according to the NIHSS scale was higher at the moment of admission (8.0 [2.0; 14.0] points versus 5.0 [2.0; 11.0] points; p = 0.049); lacunar stroke subtype was diagnosed less often (p = 0.03; OR = 0.23; 95% CI 0.05-0.97); disease progression was observed more frequently (p = 0.04; OR = 2.66; 95% CI 1.01-6.95); and the mortality rate was significantly higher (p < 0.001; OR= 9.04; 95% CI 4.12-19.82). Among the inflammatory markers, higher ferritin and IL-6 levels were recorded in the IS group in combination with NCVI compared to the IS group without NCVI (p = 0.002 and p = 0.017). Conclusions: ischemic stroke associated with a new coronavirus infection is characterized by a more frequent disease progression, more frequent large ischemia, and high mortality rate. An increased level of markers indicates the effect of systemic inflammatory response on the ischemic stroke with NCVI.

Carpal tunnel syndrome is a common polyethological neuropathy of the peripheral nervous system characterized by compression of the median nerve in the carpal tunnel area. The disease is more common in middle-aged and elderly women, as well as in people whose professions involve intensive manual work, for example, engineers, programmers, medical professionals, seamstresses. The main risk factors for carpal tunnel syndrome include: old age (over 60 years), overweight (BMI > 30 kg/m2), type 1 and type 2 diabetes mellitus, other endocrine disorders (acromegaly, myxedema, Bazedov’s disease), rheumatoid arthritis and other diseases of the musculoskeletal system, genetic predisposition, metabolic disorders (gout, amyloidosis), as well as the presence of bulky formations in the carpal tunnel. The pathogenesis of carpal tunnel syndrome is caused by compression of the median nerve, leading to ischemia and dysfunction of nerve fibers. The clinical picture of carpal tunnel syndrome varies depending on the degree of nerve compression and includes characteristic symptoms: night pain, which increases during routine activities; paresthesia and numbness in the thumb, index, middle fingers, as well as in the radial half of the ring finger; muscle weakness and atrophy of the tenar muscles in advanced cases. Diagnosis of carpal tunnel syndrome is based on the collection of medical history, neurological examination and instrumental methods (electromyography, electroneurography, ultrasound). Treatment can be either conservative (immobilization, drug therapy, physiotherapy) or surgical (decompression of the median nerve). The choice of treatment method is determined by the stage of the disease and the severity of the symptoms.

A prospective study was conducted in a group of patients with venous stroke to investigate the risk factors, clinical manifestations, and neuroimaging characteristics of cerebral venous thrombosis (CVT). The study covered 39 patients. Venous strokes due to thrombosis of cerebral sinuses and veins were more frequently observed in women (61.5%). There were no significant differences in the age of patients with venous stroke based on gender (p = 0.129), with a mean age of 40 years within the study cohort. In the investigated group, the prevalence of risk factors such as cardiovascular diseases was significantly lower compared to patients with arterial stroke. The most common risk factors for cerebral venous thrombosis included hematological disorders (congenital or acquired thrombophilias, iron deficiency anemia, hypovolemic states) (51.2%), the use of combined oral hormonal contraceptives (20.5%), pregnancy and childbirth (15.4%), and sinusitis (15.4%). The most frequent sites of thrombosis were the superior sagittal sinus, transverse sinus, sigmoid sinus, and internal jugular veins. Hemorrhagic transformation of the brain edema at the site of sinus or venous thrombosis occurred more frequently in women (76.2%) compared to men (12.8%) (p = 0.042, χ2 = 4.127; OR = 4.00; 95% CI: 1.018- 15.717). The clinical picture of cerebral venous thrombosis is variable and depends on the severity of generalized and focal symptoms. The most common symptom reported was cephalalgia, present in 90% of the cases; in 25% of the patients, it was the only registered symptom. This condition has a favorable outcome with timely diagnosis and initiation of treatment. The mortality rate in the studied group of the patients with venous stroke was 2.6%.

A potential new method for predicting the course and outcome of ischemic stroke in the acute period developed against the background of COVID-19 is proposed based on qualitative and quantitative measurement of the autonomic regulation indices of the cardiovascular system, namely the autonomic circulation index. Today, stroke is the leading cause of disability in the population and the second leading cause of death worldwide. The increase in the number of strokes against the background of COVID-19 is explained by the fact that the SARS-CoV-2 coronavirus infection, due to its pathogenic effect, triggers a chain of morphological, metabolic and functional disorders, which, ultimately, are the trigger factors of ischemic stroke. The autonomic circulation index allows one to assess the state of the autonomic tone of the cardiovascular system quantitatively and dynamically, and compare it with the clinical condition of the patient. The aim of this work was to study the state of the autonomic circulation index in patients who had ischemic stroke against the background of the new coronavirus infection SARS-CoV-2 and without it. We examined 165 patients with ischemic stroke against the background of COVID-19, included in the main group, and 85 patients with ischemic stroke without confirmed COVID-19. On days 1, 7 and 14 after admission, all the patients had their autonomic circulation indices and the severity of ischemic stroke recorded according to the NIHSS scale. In addition, in all patients, concomitant and comorbid diseases were assessed using the Charlson Comorbidity Index and the Cumulative Illness Rating Scale. The study revealed that the concomitant comorbidity indices in patients in both groups did not differ statistically significantly. This indicates that in this sample of the patients, comorbidity had no prognostic significance in relation to the severity and outcome of ischemic stroke. However, it was found that pronounced sympathicotonia, developing on day 7, is precisely a prognostically unfavorable factor in the course and outcome of ischemic stroke both in the main group and in the comparison group, which is clinically proven by the NIHSS scores. In the main group, autonomic blood circulation parameters reached values of pronounced sympathicotonia, which is explained by the pathogenic effect of the SARS-CoV-2 virus on the microcirculatory bed, which leads to functional disorders of the midline structures of the brain responsible for the autonomic regulation of the body.

Biliary atresia is a rare disease detected in the neonatal period, considered both extrahepatic and intrahepatic bile ducts, leads to secondary biliary cirrhosis, liver failure and, ultimately, death of the child during the first two years of life. The causes of biliary atresia remain unclear. Most of the main etiologic methods for ensuring the development of biliary atresia currently consider CMV infection. The aim of this study is to present a clinical case of congenital biliary atresia in a newborn with a generalized form of congenital CMV infection. A prospective and retrospective analysis of the medical record of a newborn with congenital biliary atresia was performed, who was examined and visited the departments of the neonatal and premature infants department, was carried out. A comprehensive study was conducted in the department. A dangerous case of a newborn with the implementation of intrauterine infection, congenital cytomegalovirus infection, with atresia of the extrahepatic bile ducts is described. In our clinical case, a congenital malformation, biliary atresia, was detected, which proves an earlier intrauterine infection. The boy had light-colored stool, closer to acholic. In the first days of life, yellowness of the skin and sclera of the eyes is observed. With the beginning of phototherapy, the stool did not become colored. At the level of the central district hospital, any jaundice (congenital developmental pathology, atresia of the common bile duct) were detected during laboratory and instrumental examination. At the level of the perinatal center, the diagnosis was confirmed, and this was the decisive cause of this malformation with the development of pneumonia of cytomegalovirus etiology. The child was transferred to the pediatric surgical department at the age of 1 month for planned surgical treatment. The presented clinical case of biliary atresia in a newborn child allows pediatricians, neonatologists, and resuscitators to focus their attention on the clinical features, diagnosis, and treatment of this disease.

Thrombotic events are frequent complications in patients with a cardiac profile, the probability of which, according to some authors, increases in the presence of traditional cardiovascular risk factors (gender, obesity, etc.). In real clinical practice, diagnostics of prethrombotic status – the state of thrombotic readiness (STH) is of great importance. It has been established that STH is detected in almost half of patients with cardiovascular pathology and an aggravated oncologic anamnesis; however, the influence of cardiovascular risk factors on the severity of STH in this category of patients has not been assessed. Objective: to assess the influence of gender and the presence of excess body weight/obesity on the severity of the state of thrombotic readiness according to thrombodynamic characteristics of blood in cardiac patients with an aggravated oncologic anamnesis. Material and methods. 100 patients with cardiac pathology and an aggravated oncologic anamnesis were examined. The global test for assessing the hemostasis system state, the Thrombodynamics test, was used to analyze the hemocoagulation status. Results. STH was diagnosed in 51 patients based on the thrombodynamic characteristics of the blood in accordance with the required criteria, and the influence of gender and excess body weight/obesity on the severity of the detected hypercoagulation changes was analyzed. The subgroups of men and women amounted to 11 people and 40 people, respectively. The subgroup of patients with normal body weight included 14 people, with excess body weight/obesity – 37 people. It was found that the severity of hypercoagulation changes in thrombodynamic velocity and structural parameters is comparable in men and women (p> 0.05), as well as in patients with and without excess body weight/obesity (p> 0.05). Conclusion. The obtained data indicate that in comorbid patients with a combination of cardio- and oncopathology in the conditions of prethrombotic state (STG), there is a modification of the influence of such traditional cardiovascular risk factors as male gender and overweight/obesity. This is important to take into account in real clinical practice.

In 2021 – 2024, 10 children with a diagnosis of emergency abdominal pathology were transferred from the Children’s Infectious Diseases Clinical Hospital to the surgical hospital of the Pediatric Center, which amounted to 0.78% of the number of children hospitalized during this period with urgent diseases of the abdominal organs. A confirmed diagnosis of intestinal infection – salmonellosis, was diagnosed in only 1 child. All the patients had an infectious history, paroxysmal abdominal pain, repeated vomiting, stool disorders, inflammatory changes in the blood test. 6 patients were admitted to the infectious diseases hospital from home, after a day of treatment and observation, 3 children were sent to the surgical hospital, the rest were treated with a diagnosis of enterocolitis from 2 to 5 days. At the onset of the disease, 40% of the patients contacted the admission and diagnostic department of the Pediatric Center; after the surgeon excluded acute surgical pathology, they were sent for treatment to the Children’s Clinical Infectious Diseases Hospital. Nine out of ten patients transferred from the CCIDH were operated. Complicated appendicitis in this group of patients was detected in 4 children, in 2 cases the operations were performed due to intestinal obstruction. 30% of the patients were young children; it is in this group of patients that the diagnosis of surgical pathology is difficult due to the anatomical and physiological features, the severity of intoxication symptoms, and the complexity of interpreting abdominal symptoms. Atypical localization of the appendix was detected in 2 patients with the clinical picture of an infectious disease. All the patients were discharged with recovery, there were no repeated hospitalizations to the surgical hospital. The article provides a scoring scale for assessing the totality of clinical symptoms, which can help the doctor establish the correct diagnosis and avoid diagnostic errors.

To date, a high level of detecting major dental diseases among the population is determined, which results in tooth loss and impaired function of the dental system, especially in young people. At the same time, preventive and predictive measures of dental anomalies are based on the results of clinical and epidemiological studies, which make it possible to clarify and detail the level and structure of occurrence of various forms of occlusion disorders, deformations of dentition, changes in the anatomical position and shape of teeth. The conducted examination of 1,574 people aged 18 years revealed a high prevalence of dentoalveolar anomalies, where the indicator was 75.1%. At the same time, the frequency and structure of dentoalveolar anomalies in the examined groups, stratified by the studied parameters and anamnestic data of the orthodontic treatment, were clarified and detailed. The prevalence of dentoalveolar anomalies in residents of the Kemerovo region is characterized by the fact that 30.7% of those examined by the age of 18 underwent orthodontic treatment. In addition, 60% of those with a normognathic bite type underwent complete orthodontic treatment with correction of dentoalveolar anomalies. A certain influence on the change in anthropometric characteristics of the size of teeth and dental arches with the change of generations over the recent period, which is confirmed by the results of biometric studies of jaw models, is exerted by changes in environmental and socio-economic factors. At the same time, by ethnicity, a statistically significant difference was determined: most Mongoloid race had a wide, average face type and a straight profile compared to Caucasians, which proves the existence of anthropometric features in different ethnic groups that must be taken into account when carrying out therapeutic and preventive measures.

The article is a brief summary of various theories of the origin of osteomyelitis - a purulent-necrotic process affecting all structural elements of the bone: compact and spongy substance, as well as the periosteum and surrounding soft tissues. Throughout the existence of mankind, views on the pathogenesis of inflammatory diseases of the jaw bones have been constantly changing. The works of ancient Egyptian and ancient Indian healers first mentioned information about the mechanism of osteomyelitis; according to Ibn Sina, Galen and Hippocrates, the cause of this pathological condition is trauma to superficial and deep anatomical formations. Only at the end of the 19th century was it established that the decisive factor in the occurrence of osteomyelitis is the microbial factor. A great contribution to the development of the theory of inflammatory bone diseases was made by Russian scientists A.M. Sobolev, N.I. Pirogov, P.P. Zablotsky-Desyatovsky: it was they who established the relationship between complications of the carious process and osteomyelitis of the jaws. In the first half of the twentieth century. an active discussion devoted to this issue flared up, in which P.P. Lvov, A.I. Evdokimov, V.M. Uvarov, A.A. Limberg and other prominent clinicians and morphologists actively participated. For several decades, there were disputes about the terminology used to describe the morphological features of the inflammatory process occurring in bone tissue (“panostitis”, “osteitis”, “haversitis”, “osteophlegmon”). It is generally accepted that the modern theory of the pathogenesis of osteomyelitis is a set of theories confirmed by research by Russian and international scientists. The article covers the history of the study of the etiopathogenetic aspects of inflammatory diseases of bone tissue in the Russian Empire and the USSR, as well as the contribution of A.A. Bobrov, E. Lexer, V.M. Uvarov, S.M. Derizhanov and other researchers to the study of the theory of the occurrence of osteomyelitis.

High incidence of acute respiratory viral infections in children is a pressing issue in pediatrics, since frequent illnesses can affect the overall health and development of the child. The aim of the study was to identify the most common risk factors for acute respiratory viral infections in children in Yakutsk. Materials and methods. The study included data from 392 children aged 0 to 17 years (186 girls and 206 boys), divided into groups of frequently and infrequently ill. For statistical analysis, the Pearson chi-square test with Yates’ correction and the odds ratio (OR) were used to assess the influence of various factors, including smoking of relatives, vaccination, and living conditions in which children live. Results. It was found that 78.06% of children belong to the group of infrequently ill children, and the lowest incidence rate was noted in the age groups of 0-1 year and 11-17 years. It was noted that among children with chronic diseases, such as bronchial asthma, chronic bronchitis and chronic tonsillitis, their presence was detected both in the group of frequently ill and infrequently ill. This may indicate independent risk factors for the development of these diseases, which do not always correlate with the frequency of acute infectious diseases, which emphasizes the importance of taking into account individual predisposing factors. When analyzing the odds ratio (OR) to assess the impact of various factors on the incidence rate, a relationship was found between the incidence and the presence of relatives with respiratory diseases (OR = 1.677), which may indicate the influence of a chronic source of infection in the home. The effect of vaccination was ambiguous: vaccination against influenza (OR = 1.414) and Haemophilus influenzae type b (OR = 1.316) potentially reduces the incidence of acute respiratory viral infections, but the group of frequently ill children could have children with medical exemptions. Conclusion: The data obtained emphasize the need to take into account individual risk factors when developing preventive measures.