The study involved 110 pregnant women aged 18 to 44 years. The control group (group I) consisted of 21 healthy women. Due to the increased need for vitamins and minerals during pregnancy, significant changes occurred in overweight women with iron deficiency anemia who did not receive treatment (the main group). So, in the comparison group, the vitamin D level in the third trimester was 30.1±1.6 Me=32.7(28.1–33.4), while in the main group it was 14.2±0.4 Me=13.5(12.9–15.6) (pH<0.001), compared with the control group p<0.001.

In women with iron deficiency anemia, compared with the control group, there was a significant change in micronutrient levels, which was most pronounced in the last trimester of pregnancy. The main reason is that the vitamin and mineral status undergoes significant changes towards the end of pregnancy due to the intensive development of the fetus.

Over the past 10 years, 208 children with necrotizing enterocolitis (NEC) were under our treatment. The control group consisted of 50 children whose gestational age was approximately similar to the main group. A case-control study was conducted to determine the role of gestational age in the development of NEC. 89 (42.8%) children with NEC and gestational age from 30 to 36 weeks compared with 22 children from the control group of the same gestational age had significantly lower percentiles of birth weight, umbilical cord pH and 1 -minute Apgar score. In contrast, there were no significant differences between 98 (47.1%) NEC and control children (n=24) aged 25-29 weeks, except that few children with NEC received breast milk. The 21 term infants in the main and 5 infants in the control group appeared to have an obvious predisposing factor. The study showed that the predisposition to NEC depends on gestational age. In the range of 25-29 weeks, all babies are at risk due to extreme prematurity. In the 30-36 week range, asphyxia and stunted infants are at increased risk, while at full term a major predisposing factor appears to be required.

The aim of the study was to evaluate the diagnostic value (sensitivity and specificity) of lower third molar bud impaction in 121 patients aged 7 to 23 years who presented to an orthodontic clinic with complaints of different malocclusions. All patients underwent multiple panoramic radiographs during orthodontic treatment, specifically: before treatment initiation, after completion of phase 1 therapy, after fixed appliance therapy, and during the retention period.

A retrospective analysis was conducted on a total of 1,085 lower third molar buds across 551 panoramic radiographs obtained from patients with maloclusions before, during, and after orthodontic treatment, as well as during the retention phase.

The study revealed that starting from the age of 14, the inclination angle of lower third molar buds allow prediction of their impaction rate with a sensitivity of 64.8±6.5% and a specificity of 71.4±6.0%. As age increases, higher sensitivity and specificity enable impaction rate prediction even with smaller angles (less than 40°).

The application of these diagnostic methods can enhance the effectiveness of preventive measures for pathological conditions associated with delayed tooth eruption.

Aggressive laryngeal squamous cell carcinoma (LSCC) is characterized by a high metastatic potential, which is closely associated with epithelial-mesenchymal transition (EMT). Initiation of EMT is manifested by changes in the expression of some genes, including those associated with cytoskeleton reorganization. Currently, there are no effective methods for predicting metastasis in LSCC patients. In this regard, the study of SCC molecular characteristics remains relevant. In our study we assessed the relationship between the mRNA level of vimentin (VIM) and mRNA of cytoskeleton proteins: fascin-1 (FSCN1), ezrin (EZR), cofilin-1 (CFL1), profilin-1 (PFN1) and adenylyl cyclase-associated protein 1 (CAP1) in LSCC tumor tissue. The analysis was carried out using RT-PCR in paired samples from LSCC patients with and without lymph node metastases. The PFN1 mRNA level was found to be 6.3 times higher in LSCC patients with lymph node metastases than in patients without metastases. The EZR mRNA level was 17 times lower in patients with stage T3-4N0-2M0 LSCC than in patients with stage T1-2N0-1M0 LSCC. High VIM mRNA levels were associated with high FSCN1 and CAP1 mRNA levels and contributed to a stronger association between CFL1 and PFN1 mRNA levels. Thus, no direct relationship between the level of VIM as a marker of EMP and metastasis in a sample of LSCC patients was found. However, the detected relationships between the levels of cytoskeleton protein mRNA and vimentin mRNA may indicate an active reorganization of the cytoskeleton, which ensures high migration and proliferative activity of malignant cells of LSCC.

The study of antibiotic resistance of Klebsiella pneumonia and Escherichia coli isolates and the distribution of carbapenemase genes was conducted in the multi-profile emergency hospital in the Republic of Sakha (Yakutia).

The structure of isolated microorganisms is dominated by pathogens of Enterobacterales genus: K. pneumonia was isolated in 29.9% (n=3314) and E. coli 20.8% (n=2306) of samples. The proportion of meropenem-resistant K. pneumonia strains was 47.5% of isolates, E. coli 13%. As a result of the study, totally 8 carbapenemase genes were isolated. The most common genes for K. pneumonia and E. coli isolates by detection frequency were OXA48 (24.9%), ctxM-1 (24.0%), SHV (21.8%), TEM (12.9%) and NDM (10.8%). In this case, combinations of 3 to 5 gene types were most often observed: 3 types were isolated in 86 (33.9%) strains, 4 types in 56 (22.0%) and 5 types in 54 (21.3%). The presence of 1 gene type was found in 33 (13.0%) strains, 2 types in 16 (6.3%), 6 types in 3 (1.2%) and 7 types in 6 (2.4%). Microbiological monitoring, control of local resistance to antibiotics in the hospital and the study of resistance mechanisms can increase the effectiveness of antimicrobial therapy, and also serve as an effective method of combating the spread of resistant strains of microorganisms.

In the previous study, we found a high prevalence of the m.1555A>G variant of the MT-RNR1 gene, which causes mitochondrial hearing loss (OMIM 561000) among deaf patients living in the Baikal Lake region. In this regard, in the present study, a genotype-phenotypic analysis of the hearing function in individuals with the m.1555A>G variant was carried out in the discovered Siberian region. Clinical and audiological analysis was performed in 48 people with this mitochondrial variant, whose average age was 51.3±15.5 years. The obtained genotype-phenotypic data are consistent with previously conducted studies of the features of the auditory function in individuals with m.1555A>G, which note incomplete penetrance of the manifestation of the pathological phenotype. Of particular interest in our cohort are three cases of mixed hearing loss, including both sensorineural (inner ear defect) and conductive (middle ear defect) components. We do not exclude the possibility that the detected clinical signs may be a consequence of systemic damage to the hearing organ in this mitochondrial variant. On the other hand, the detected cases may be associated with a cross-pathological effect caused by another form of a less common or rare disease, which requires further molecular genetic studies.

Clinical experience shows that during radiological examination of the pelvis, patients are often diagnosed with a sacrum with five pairs of sacral openings, while normally there should be four. Purpose: To which form of dysplasia should cases of diagnosis of the sacrum with five pairs of sacral openings be attributed. The clinical material for the study was the results of computed tomography of the lower lumbar spine and pelvic bones in 78 patients who were diagnosed with a sacrum with five pairs of sacral openings. The CT examination of the patients was carried out on a 128-slice «General Electric» device. The study established that the analyzed group of 78 patients was heterogeneous and consisted of two subgroups. Patients of the first subgroup (52 (66.7%) patients) had fused upper sacral vertebrae by transverse processes to the left and right of the sacral crest. Patients of the second subgroup (26 (33.3%) patients) had similar bone fusion of two upper sacral vertebrae on one side, there was no such concrescence on the contralateral side, and synchondrosis was clearly defined. The presence of such a bright radial symptom of sacral pathology as five pairs of sacral openings allows for timely diagnosis of cases of transitional lumbosacral vertebrae, informing patients about the nature of the disease, and, if necessary, prescribing therapy adequate to the severity of the condition.

The effectiveness of dental prosthetics based on dental implants was assessed in patients with diabetes mellitus (DM), hypertension (HT) and gastrointestinal tract (GIT) pathology. The control group consisted of patients without chronic diseases.

The number of missing teeth in patients with somatic pathology was 1.7 times higher than in the control group. The production of single crowns on dental implants was carried out with the same frequency in patients with DM and HD, exceeding the rates of individuals with GIT, but significantly less often than in the control group. A similar pattern was observed in the orthopedic treatment with dental implant bridging prostheses, which were used 3 times less frequently in DM patients than in HD individuals, 2 times less frequently than in GIT patients, and 1.8 times less frequently in controls (p<0.01). Bone grafting was performed in patients with DM in 46.2% of cases, with HD – 36.4%, with GIT – 33.3%, compared to 41.7% in the group of individuals without somatic pathology (p<0.01). Complications were observed in half of the DM patients 46.2%, which is 2.3 times higher than the comparator group 20.0%.

Performing bone grafting on patients young and middle-aged with aggravated somatic status were accompanied by early complications, late – occurred only in patients with DM (15.4%) and HD (9.1%). The period of osseointegration in patients with somatic pathology increases to 5-6 months compared to the indicators of the control group – 4.3± 0.3 months (p˂0.001). All subjects had a favorable outcome of dental implantation at long-term follow-up.

А comparative analysis of the effectiveness of conservative and surgical treatment of acute thrombosis of hemorrhoids. Was performed: 125 (61.6%) patients who received conservative treatment and 78 (38.4%) operated patients. The conservative treatment program contained recommendations on nutrition, formation of a bowel movement regime, use of thermal baths, and taking systemic and topical medications. Patients of the second group underwent surgical intervention in the amount of thrombectomy or excision of a thrombosed hemorrhoid node under local infiltration anesthesia.

Results of the study: patients who received conservative therapy and patients who underwent surgery were comparable in gender, age, and stage of acute hemorrhoidal thrombosis. Statistically significant differences were found between the patients of the two groups in pain assessment on the 1st and 7th days of treatment (p=0.043 and p=0.037, respectively) and the duration of temporary disability (p=0.032). Surgical intervention in hemorrhoids complicated by acute thrombosis of hemorrhoids is a method of choice with many advantages. The key ones are to reduce pain on the 1st day after treatment to 3 points on the visual-analog scale (VAS), on the 7th day – to 1 point according to VAS. Compared with the group of patients receiving conservative therapy, after surgical treatment of acute hemorrhoidal thrombosis, a lower incidence of disease recurrence was noted. During the study period, a recurrent course was observed in 1 (2.0%) patient after surgery versus 5 (10.2%) cases in the conservative treatment group. Surgical treatment provides faster labor rehabilitation and reduces the period of temporary disability to 6.3 ± 0.3 days.

Currently, dental implantation is widely used in practical dentistry to restore defects in dental arches with fixed orthopedic structures. At the same time, complex anatomical and topographic conditions of the bone tissue of the alveolar process of the upper and lower jaws cause a number of clinical difficulties that require bone grafting before installing dental implants, which requires an individual approach. In case of severe atrophy of the alveolar process of the jaws in the frontal and lateral sections, the choice of surgical correction method is bone augmentation by distraction osteogenesis, splitting of the alveolar ridge, grafting of autogenous, allogeneic and xenogeneic bone blocks, as well as the method of tissue regeneration. In general, restoration of dental arch defects and the function of the dental system requires the necessary placement of dental implants in the most correct position for their subsequent osseointegration and fixation of fixed orthopedic structures, which ensures the achievement of the expected clinical result with full restoration of the patients’ aesthetic requirements and an improvement in the patient’s quality of life.

The study presents the results of the analysis of regulatory legal acts and the practice of applying the rules related to mandatory vaccination against tick-borne encephalitis. In 2023, most of the territories of the constituent entities of the Russian Federation were endemic for tick-borne encephalitis. In 2024, 4 million citizens of the Russian Federation were vaccinated against tick-borne encephalitis. Historical retrospective has shown that vaccination against tick-borne encephalitis was started for the purpose of disease prevention in endemic territories in relation to certain professional categories of the population. At the same time, immunoprophylaxis was mainly carried out according to epidemiological indications, with the exception of 1980-1997, when it was included in the routine vaccination. When establishing the mandatory vaccination, 4 acts are taken into account: Federal Law "On Immunoprophylaxis of Infectious Diseases"; Calendar of Preventive Vaccinations; SanPiN 3.368621; List of works, the performance of which is associated with a high risk of infectious diseases and requires mandatory preventive vaccinations. SanPiN 3.3686-21 expands the contingent that receives preventive vaccinations against tickborne encephalitis. Conclusions and discussion: mandatory vaccination is defined by the list of professional risk groups and requires a decree of the chief state sanitary doctor or an order from the head of the organization. To increase the effectiveness of immunoprophylaxis and prevent abuse, it is necessary to systematize regulatory and legal acts.

Cases of the introduction of pathogens of hemocontact viral hepatitis and HIV infection into medical organizations pose a potential threat of infection of medical workers in the course of their professional activities. The purpose of the study is to study the awareness of medical professionals about the dangers of occupational infection. Within the framework of this study, a survey of medical professionals was conducted according to the author's questionnaire. The results of a survey of 1,046 respondents on the issues of awareness of medical professionals in ensuring safety in the provision of medical care are presented. Cases of workplace emergencies were identified among 14.2 % of the surveyed medical workers. At the same time, 28.1 % do not register emergency cases in the "Emergency Register for medical procedures", and 10.7 % of doctors do not have vaccination against viral hepatitis B. This requires the development of measures to prevent and raise awareness of occupational infection among medical professionals.

Differences in vaccination coverage among patients with IBD, JIA, and healthy children, as well as to identify differences in vaccination attitudes between parents and physicians, including barriers and facilitators of immunization were assessed. Vaccination coverage, reasons for refusal, trust in vaccines, and physician involvement in immunization were assessed. Statistical analysis was performed using Pearson’s χ² test and the MannWhitney test. Insufficient vaccination coverage among patients with IBD and JIA is influenced by both parental concerns and the cautious approach of specialists. The main barriers include medical exemptions, concerns about disease exacerbation, and inadequate coordination between primary care physicians and specialists. Improving vaccination coverage requires the development of personalized immunization strategies, interdisciplinary collaboration, and educational programs for both physicians and parents. To increase vaccination coverage, personalized immunization strategies, interdisciplinary collaboration, and educational programs for doctors and parents are needed.

The aim of the study was to identify ways and opportunities to improve the system of specialized training of healthcare management personnel in the specialty ‘Public Health and Healthcare’. Currently, graduates of medical universities, in addition to professional competencies, should demonstrate universal or supraprofessional competencies, including those related to the issues of competent management of medical organizations of various forms of ownership. The article presents an opinion on the ways to improve the training of specialists in the field of public health and health care, substantiates the necessity of teaching the discipline (module) "Management" for students of medical specialties. The goals, objectives and range of issues to be studied within the discipline "Public health and public health care" at the stages of preand postgraduate education in medical universities of Russia are outlined. The conclusion is made that management training, including project-based learning, will allow future doctors to form competencies necessary in modern professional activity.

The article presents a retrospective analysis of COVID-19 morbidity and mortality in the Arctic zone of the Republic of Sakha (Yakutia), and also considers key aspects of organizing medical care during a pandemic in this territory, which differs significantly in all conditions from most of the region.

In 2020, the incidence of COVID-19 in the Yakut Arctic exceeded the Russian average by 2 times, the republican average by 1.8 times, by 2023 the share in the Arctic zone of the Republic of Sakha (Yakutia) in the overall morbidity structure decreased. For 2019-2023. In the Arctic zone of the Republic of Sakha (Yakutia), 211 deaths were recorded (6.2% of the total number in the republic), the peak of mortality occurred in 2021 (124 cases) due to the spread of the Delta strain.

The COVID-19 pandemic has clearly demonstrated that in the modern world, the inaccessibility of populated areas does not guarantee their epidemiological safety. The experience gained emphasizes the need for investment in equipping remote medical institutions, digitalization of healthcare and adaptation of anti-epidemic measures taking into account the geographical and social characteristics of the Arctic.

The article examines the contribution of production-related and non-production risk factors to the development of arterial hypertension in workers in ethylbenzene-styrene (EBS) and ethylene-propylene (EP) chemical industries, which differ in the degree of automation of the technological process, using the gradient boosting method.

The factors that have the greatest impact on the prognosis of arterial hypertension development have been identified. For EBS production workers, the major factors influencing AH risk were work experience, age, and smoking. For the Ethylene-Propylene (EP) operators, the key factors were work experience, smoking, and LDL levels.

Taking into account the identified risk factors, targeted measures have been developed to minimize them.

The aim of the survey was to assess the population mortality from preventable causes in the Sakha Republic (Yakutia) using the Russian classification.

It was found that 37.2% of the total number of deaths in the republic in 2020¬–2023 could have been avoided, including 71.8% of the cases by primary prevention measures (Group 1 of the causes); 3.2% – by early diagnosis of diseases (Group 2 of the causes); and 25.0% – by adequate treatment (Group 3 of the causes). In the mortality structure in the Arctic zone of the republic, these causes accounted for 75.1%, 2.6%, and 22.3%, respectively. The greatest contribution to preventable mortality of the population in Yakutia is made by lifestyle-related diseases. Losses due to injuries and poisoning account for 35.7% in the preventable mortality in the republic as a whole and for 45.0% in the Arctic zone of the region. 24.9% of fatal cases in the Arctic zone (10.5% in the republic) directly depended on the quality of medical care. To minimize these losses, it remains important to identify diseases at early stages; to address them with adequate treatment; and, for district hospitals, to refer patients to level 3 medical institutions in a timely manner.

The results of a survey of 1,118 Barnaul children aged 0 to 17 to determine the etiological structure of community-acquired pneumonia pathogens from January to October 2024 are presented. Mycoplasma pneumoniae was the predominant pathogen 36%, less often COVID-19. The clinical picture of mycoplasma pneumonia in children is atypical. Etiotropic therapy brings good results.

The article presents a cross-sectional retrospective study of cases of malignant neoplasms (MN) of the liver and intrahepatic bile ducts (C22) in the Republic of Sakha (Yakutia) (RS (Y) for 2010–2019 based on statistical registration forms No. 7 and 35. During the study period, significantly increased levels of morbidity and mortality from malignant neoplasms of the liver and intrahepatic bile ducts were recorded. At the same time, the proportion of detection of the studied pathology at early stages remains low, despite the strengthening of diagnostic measures within the framework of preventive examinations and screening programs. In the dynamics for 2015–2019 in the RS (Y), the proportion of patients with MN of the liver and intrahepatic bile ducts who were under observation for 5 years decreased, while the contingent of patients with this pathology increased. The obtained data substantiate the need to improve organizational approaches to early diagnosis and treatment, optimize patient routing, and study pre-cancerous factors of liver cancer in residents of the Republic of Sakha (Yakutia).

The purpose of the study is to assess direct and indirect economic damage from cervical, uterine, and ovarian cancer in the Tomsk region. The maximum loss of DALY values for cervical cancer was in the range of 35–49 years, for uterine cancer and ovarian cancer in the range of 55–69 years. The highest expenditure was allocated to the treatment of ovarian cancer (325.24 million rubles), followed by lower amounts for uterine cancer (205.5 million rubles) and cervical cancer (189.8 million rubles). The total economic impact (including direct and indirect costs) amounted to 3.9 billion rubles for cervical cancer, 2.8 billion rubles for ovarian cancer, and 2.3 billion rubles for uterine cancer.

The findings of the study, quantified in monetary terms, are recommended for use in optimizing the allocation of budget funds under current conditions.

The aim of the study was to identify the characteristics of carbohydrate metabolism, pancreatic hormones, and adiponectin in practically healthy Arctic population, depending on their ethnicity and lifestyle was conducted (populations of the local Caucasian population and aborigines (nomadic and sedentary) of the Arctic (Nenets) from 18 to 74 years old.). The lowest levels of glucose and insulin found in nomads against the background of increased proinsulin and adiponectin may indicate a decrease in the secretory activity of pancreatic beta cells and an improvement in insulin resistance; in sedentary aborigines, the predominance of anaerobic processes over aerobic ones is associated with a restriction of proinsulin production and is associated with an increase in insulin resistance with low levels of adiponectin, while in the local Caucasian population, insulin levels increase slightly while maintaining a higher level, which leads to an increased load on beta cells of the pancreas, causing an increase in adiponectin synthesis.

The aim of the study was to study the effect of elevated and physiological concentrations of catecholamines on the formation of immune responses in residents of the northern territories of the Russian Federation. Thus, it has been established for the first time that practically healthy residents of the European North of the Russian Federation experience changes in the content of catecholamines and immunological parameters. An increase in the average dopamine content and a slight increase in the average IdM content was found. Studies have shown that patients have a tendency to increase the content of IgE immunoglobulin. In addition, abnormally high concentrations of IdM and elevated concentrations of IgG were detected. There was also a slight increase in the concentrations of cells capable of proliferation (CD10+). These changes correlate with the impact of negative climatic factors. Such factors include violation of the light regime and low temperatures, which provoke a chronic state of stress in the body and, as a result, increased stress on the immune system. This phenomenon leads to a malfunction of the immune system and accelerated physiological wear of the body, which can become a predisposing factor for the development of various diseases.

This systematic literature review analyzes the risk factors for anastomotic leakage (AL) in the surgical treatment of colorectal cancer. Based on 42 studies, key risk predictors for AL were identified. The incidence of AL in the studies included in this review ranged from 2,8% to 24,7%. The introduction of the RALAR scale significantly improved the objective assessment of AL risk. A comprehensive approach to prevention, based on risk stratification and treatment personalization, can significantly improve the outcomes of surgical treatment for colorectal cancer.

Nowadays, there is a high prevalence of major dental diseases among the population, which are associated with carious lesions of teeth and their complications, as well as periodontal diseases leading to tooth loss, which are the main causative factors. The development of secondary deformities of dental rows contributes to the functional activity disorder of the entire dental-mandibular system, where the main etiologic factor is the loss of teeth in various pathological processes. In this case, there is a violation of the functional activity of the dental-mandibular system, which requires timely complex medical and social rehabilitation of patients, which is of great practical importance. One of the restoration types of lost teeth is the installation of dental implants, where in the conditions of pronounced atrophy of the alveolar process of the jaws there are complex clinical situations that are not an easy task for the specialist, as well as for patients. Meanwhile, the restoration of partial secondary and complete adentia with pronounced atrophic changes of the alveolar bone on artificial supports is performed with previous bone grafting, which is a challenging task on the way to improve the quality of life in patients. In spite of the wide study this problem remains unsolved, which determines its further research aim improving the provision of medical care.

The scientific review examines chronic kidney disease (CKD) in combination with chronic non-communicable diseases. Chronic kidney disease is a serious and growing public health problem worldwide, characterized by a gradual and irreversible decline in kidney function and is one of the leading causes of death worldwide. The priority task of healthcare is the prevention of chronic non-communicable diseases, among which the most significant include cardiovascular diseases, bronchopulmonary diseases, diabetes mellitus, and oncological diseases. The association of CKD with chronic non-communicable diseases, in particular with cardiovascular diseases, makes this pathology especially dangerous, which leads to a deterioration in the quality of life of patients and an increase in mortality. The treatment of patients with comorbid pathology requires a comprehensive and interdisciplinary approach.

This study presents a comprehensive analysis of the genetic, clinical, and therapeutic aspects of muscular dystonias — a heterogeneous group of neurological disorders characterized by pathological postures and disabling hyperkinesias. Based on a synthesis of data from recent decades, the authors highlight key advancements: the identification of 25 hereditary forms (DYT1–DYT25), the role of mutations in the TOR1A gene (DYT1) in disrupting intracellular transport, and progress in symptomatic treatments such as botulinum toxin therapy, deep brain stimulation, and MR-guided focused ultrasound (MRgFUS). Special attention is given to the limitations of current approaches, including an incomplete understanding of pathogenesis and therapeutic resistance observed in 30-40% of patients. The necessity of integrating genetic testing, neuroimaging, and emerging biotechnologies (e.g., CRISPR, recombinant toxins) is emphasized as a pathway toward developing targeted treatment strategies. The paper also summarizes epidemiological data (prevalence: 3–60 cases per 100,000), presents the current classification framework, and outlines prospects for personalized medicine – offering a roadmap for future research.

A systematic review of available scientific publications on this topic from 2015 to 2025 was conducted. The surgical treatment of hiatal hernias, including giant paraesophageal hernias, remains a challenging task requiring high precision in anatomical restoration and minimization of intraoperative risks. Currently, the laparoscopic approach is considered the gold standard; however, the introduction of robotic systems (such as Da Vinci) has opened new possibilities due to improved visualization, increased instrument maneuverability, and enhanced ergonomics for the surgeon.

RALF is a promising method for the surgical treatment of GERD, particularly in patients with refractory disease, obesity, and anatomical peculiarities (short esophagus). The technical advantages of the Da Vinci Si robotic system help reduce intraoperative complication risks and improve long-term functional outcomes. However, the high cost and the need for specialized surgeon training limit the widespread adoption of this technique.

In order to study the clinical, morphological and immunohistochemical features of inflammatory fibroid polyp, a literature review was conducted. It was found that inflammatory fibroid polyp is one of the rare benign tumors of the gastrointestinal tract, the clinical picture of which depends on the size, location and complications. The complexity of diagnosis is due to its morphological similarity to malignant tumors of the gastrointestinal tract. Immunohistochemical testing is used to exclude malignancy. It was found that inflammatory fibroid polyp is characterized by pronounced diffuse expression of CD34, reactions to DOG1, CD117, S-100 are negative.

The review to systematize scientific literature data on the topic of post-traumatic flatfoot has been conducted. We applied search filters to find literature in the text summarization domain from eLibrary, pubMED, Scopus. The arches of the foot, formed by the calcaneal bone at the back and two heads of the metatarsal bones: I and V. Post-traumatic flat feet occurs after fractures of the calcaneus or metatarsal bones. Fractures of the metatarsal bones associated with post-traumatic flatfoot in the outcome of the disease. The literature review indicates clinically significant correlations between fractures of the foot bones and occurrence of post-traumatic flatfoot. Most of the material presented on the influence of calcaneal fractures on the occurrence of post-traumatic flatfoot with a direct correlation. There are sources on the correlation between metatarsal bone fractures and post-traumatic flatfoot. In the studies, the authors link metatarsal fractures and flat feet. They also note a direct correlation between the disease and its complications. The literature review show correlations between fractures of calcaneus or metatarsal bones and occurrence of post-traumatic flatfoot.

Research in the field of fractures of the bones of the foot and post-traumatic flat feet, is relevant now and requires further scientific research.

There was also a small amount of material on studies of post-traumatic flatfoot in children.

The study is devoted to assessing the impact of nutrition on accelerating or slowing down biological age in the indigenous population of Yakutia. The study involved 84 participants aged 18 to 89 years living in the central region of Yakutia. The average age of respondents was 58.0 (21.1) years. To analyze the food composition, the frequency questionnaire containing 30 questions were used. Using K-means method of the cluster analysis, two types of the nutrition were identified among the respondents. We assessed the age acceleration, calculating using three biological clock models: Horvath DNAm, Hannum DNAm, GrimAge in these groups of participants. Binary logistic regression showed that the odds of slowing biological ages increased with a moderate diet for Hannum DNAm by 6.3 times, Horvath DNAm by 21 times, and GrimAge by 15.8 times. The frequent overeating had a negative impact on the biological age of respondents. The frequency of consumption of dairy, fried, canned, salted products, and processed meat statistically significantly affected biological age. Acceleration of epigenetic age was observed in respondents with nutritional errors in the form of overeating and frequent consumption of easily digestible, high-calorie, canned foods.

The article presents a clinical case of enteritis-associated juvenile idiopathic arthritis in a 16-year-old teenager during the therapeutic stage of consolidation of acute promyelocytic leukemia. Arthritis in a patient with leukemia is usually associated either with an exacerbation of the underlying disease; or with an infectious process in the joint or adjacent bone. Leukemic arthritis is manifested mainly by monoarthritis, with damage to large joints, severe night pain, lymphadenopathy, and hepatosplenomegaly. A reduction in joint pain is a sign of a clinical response to chemotherapy. An infectious lesion of the musculoskeletal system is usually also represented by a local inflammatory process with fever, intoxication, local hyperemia, hyperthermia, inflammatory changes in blood tests and requires intensive antibacterial therapy and temporary cessation of chemotherapy in an oncological patient. The development of juvenile idiopathic arthritis during leukemia therapy caused diagnostic and therapeutic difficulties due to the very rare association of the two diseases, which required the exclusion of a recurrence of leukemia and an infectious complication. NSAID therapy brought temporary relief, the use of the janus kinase blocker upadacitinib was ineffective, and subsequent switching to etanercept allowed for remission of arthritis. Leukemia treatment was carried out in conjunction with JIA treatment.

Among all published studies, it has been noted that in COVID-19, in addition to respiratory system dysfunction, one-third of patients (30–35%) exhibit signs of nervous system (NS) involvement. Descriptions of various neurological diseases complicating the course of coronavirus infection (COVID-19) or representing its unique clinical manifestation are available. One of the neurological complications of COVID-19 is meningoencephalitis.

This article examines the clinical presentation, diagnosis, and treatment of acute disseminated meningoencephalitis (ADME) that developed in a child following COVID-19. Special attention is given to the pathogenesis of the disease, which is associated with the body's immune response to the SARS-CoV-2 virus, leading to inflammatory processes in the central nervous system. Data from instrumental and laboratory diagnostics, as well as treatment are presented. The importance of early detection and comprehensive treatment to prevent severe neurological complications and improve prognosis in young patients is emphasized.

Langerhans cell histiocytosis (LCH) is a rare myeloid disorder with a variable clinical presentation, based on the activation of the MEK-ERK signaling pathway in dendritic cell precursors. The localization of pathological lesions varies: the most common sites include the skeleton, skin, posterior pituitary gland, lymph nodes, liver, spleen, bone marrow, lungs, and central nervous system [2].

This article presents a clinical case of Langerhans cell histiocytosis in a newborn delivered at the Perinatal Center of the M.E. Nikolaev Republican Hospital No. 1-NCM. At birth, the child exhibited characteristic skin lesions in the form of a bumpy, dark cherry-colored rash on the scalp, fingers, and toes, with some areas showing light inclusions and a firm texture. Over time, with treatment, the pustules and vesicles ruptured, forming ulcers, crusts, and hemorrhages. The stages of diagnosis, including histological and immunohistochemical studies (CD1a+, Langerin+, S100+), differential diagnosis, and a comprehensive treatment approach, are described in detail. Special attention is given to the challenges of diagnosing newborns and the importance of interdisciplinary collaboration.

Stomach cancer during pregnancy is extremely rare and accounts for 0.025-0.1% of all pregnancies, while most cases of stomach cancer associated with pregnancy are diagnosed by specialists at a late stage, since its main symptoms (vomiting, nausea, loss of appetite, increased abdominal size) are mistaken for early toxicosis during pregnancy and the likelihood of the development of malignant neoplasms is underestimated. Optimal management of this category of patients requires a multidisciplinary approach (including oncologist, obstetrician, surgeon, anesthesiologist, gastroenterologist, radiologist and neonatologist), which establishes the sequence of therapy. In the article, we presented our own experience of treating and monitoring this category of patients in the form of two clinical cases that clearly demonstrate an extremely unfavorable prognosis for a combination of stomach cancer and pregnancy. According to the literature, the five-year survival rate in this category of patients is zero, while in most cases the patient's death occurs within six months after surgery.