Background. Early identification of risk factors (RF) associated with cardiovascular diseases (CVD) is essential for the prevention of CVDs and their complications. CVD risk factors can be identified using Artificial Intelligence (AI) systems, which are capable of learning, analyzing and drawing conclusions. The advantage of AI systems consists in their capacity to process large amounts of data over a short period of time and produce ready-made information.
Objectives. Evaluation of the efficiency of implementing an AI software application by a general practitioner for identifying CVD risk factors.
Methods. The study included data from 1778 electronic medical histories of patients aged over 18, assigned to an outpatient and polyclinic department of Muravlenkovskaya Gorodskaya Bolnitsa (Muravlenko municipal hospital), Yamalo-Nenets Autonomous Okrug (Russia). The study was conducted in four stages. The first stage involved a preliminary training of the Artificial Intelligence (AI) system under study using numerous CVD risk assessment scales. The Webiomed predictive analytics and risk management software by K-SkAI, Russia, was selected as a platform for this purpose. The second stage included an analysis of medical data to identify CVD risk factors according to the relative risk scale for patients under 40 and the SCORE scale for patients over 40. At the third stage, a specialist analyzed the previous and new information received about each patient. According to the results of the third stage, four risk groups for CVD (low, medium, high and very high) were formed. At the fourth stage, newly diagnosed patients with a high risk of CVD, who had not been previously subject to regular medical check-up, were directed for additional clinical, laboratory and instrumental follow-up examination and consultations of relevant specialists. Statistical data in absolute terms and as a percentage were obtained. Statistical processing of the results was carried out by a computer program aimed at medical decision support. Content visualization was performed in spreadsheets and charts.
Results. Based on the data obtained, the AI system under study divided all patients into CVD risk groups and identified uncounted factors. The AI system confirmed a high and very high risk of CVD according to SCORE (Systematic COronary Risk Evaluation) in 623 people, who were already receiving appropriate cardiological assistance. The RFs that had not previously been taken into account in the diagnosis were recorded in 41 (11.5%) patients from the very highrisk group and in 37 (12.7%) high-risk patients. The AI system identified a high risk of CVD in 29 people who had not been previously under care of a general practitioner or other specialists due to their infrequent visits to health care facilities. These patients were detected by the AI system following periodic and preliminary medical check-ups (35%), full in-patient treatment for other diseases (31%), when seeking help of other specialists (17%), as well as when obtaining a medical certificate for a driving license (12%), admission to a swimming pool (3%) or possessing a weapon (2%). In a group with the newly diagnosed patients at a high risk of CVD, men dominated (24 persons, 82%) and women comprised only 8% (5 persons). All these people were of working age between 40 and 50. In order to confirm the information received, the supervising physician subsequently referred patients for a follow-up examination, as a result of which only 1 person (3%) was not diagnosed with a somatic pathology.
Conclusion. The efficiency of the AI system under study comprised 97%. Permanent monitoring of all parameters of electronic medical histories and outpatient records is an efficient method for timely identification of RF at any visit of a person to a health care facility (preventive and periodic medical examinations, regular check-ups, specialist consultations, etc.) and their assignment to respective CVD risk groups. Such monitoring ensures an effective medical supervision of able-bodied populations.

Background. The development of periodontitis is strongly linked with both periodontopathogenic microflora and antioxidant-proxidant system disorders, which determines the need for the combined use of antimicrobial and antioxidant agents.
Objectives. A comparative evaluation of the antioxidant-prooxidant system of red blood cells in rats with experimental periodontitis against the background of the traditional drug therapy and its combination with Soderm®-Forte and new injectable form of Rexod®.
Methods. The authors conducted a comparative study of the effect of traditional drug therapy (TDT) and its combination with Soderm®-Forte gel containing silver nanoparticles, recombinant human superoxide dismutase (Rexod®) and new injectable form (NIF) of Rexod® on the condition of the antioxidant-prooxidant system of red blood cells in rats with experimental periodontitis (EP). The experiments were performed on Wistar male rats of 210–230 g. EP was induced by ligature method. The rats were randomly divided into 5 comparable groups of 12 animals: group 1 — with intact periodontium; group 2 — with EP; group 3 — with EP, where TDT was used, including oral irrigation with chlorhexedine (0.05% solution) and application of Septo-Pack dento-gingival dressing; group 4 — with EP, TDT and Soderm®-Forte gel (applied into the periodontal pockets of the lower incisors); group 5 — with EP, TDT in combination with Soderm®-Forte gel and NIF of Rexod®, which was injected intraperitoneally at a dose of 8000 U/kg. Treatment of rats with EP (groups 3–5) was carried out for 12 days. The observation period for all animals lasted 42 days. The biochemical tests and the antioxidant-prooxidant index were used to assess the condition of antioxidant-prooxidant system. Statistical analysis of the obtained results was carried out with parametric and non-parametric methods of Microsoft Excel (Microsoft, USA), Analysis package and AtteStat, as well as Statistica 8.0 (StatSoft, USA) software.
Results. The application of TDT against the developed EP caused a moderate positive correction of the indicators of Antioxidant protection system (APS). The enrichment of TDT for the EP animals with Soderm®-Forte and especially Soderm®-Forte in combination with NIF of Rexod® to enhance the APS potential caused more significant positive dynamics of the balance in the antioxidant-prooxidant system compared to TDT.
Conclusion. The combination of TDT with Soderm®-Forte and NIF of Rexod® has the most significant positive corrective effect on the condition of antioxidant-prooxidant system of red blood cells in rats with EP in comparison with the complex of TDT with Soderm®-Forte and TDT used separately.

Background. The possibility of local application of autologous blood plasma (ABP) in soft tissue injuries is currently of particular interest.
Objectives. Evaluation of the effects of peri-wound (perifocal) administration of ABP on red blood parameters, microcirculation and oxygen supply of soft tissues of the limb in experimental explosive wound (EW) in rats.
Methods. EW was simulated on male Wistar rats (n=146) using a firecracker with a pyrotechnic mixture (patent RU No. 2741238 dated 22.01.2021). Animals were divided into 4 groups: control (2), comparison (1), main (1). The volume of blood loss in explosive wounds was 8 and 15% of the estimated circulating blood volume (CBV) of the animal. Blood was drawn from the rat tail to obtain ABP. 3 hours after the injury, ABP or 0.9% sodium chloride solution was injected intramuscularly into the explosive wound area at a rate of 2.0 ml/kg of animal weight. After 3, 7, 14, 28 days, the number of red blood cells, haemoglobin content, haematocrit were determined in the blood, and microcirculation and oxidative metabolism parameters were determined in the skeletal muscles of the injured area. The data were processed using Microsoft Excel 2013 (Microsoft, USA) and Statistica 10.0 (StatSoft Inc., USA).
Results. Blood loss of 8% of the CBV in injured animals did not lead to changes in the quantitative composition of peripheral red blood. After an explosive wound with a blood loss of 15% of the CBV, there was a moderate decrease in the number of red blood cells (from 8.3×1012/l to 6.5×1012/l, p < 0.02), haemoglobin level (from 149.5 g/l to 118 g/l, p < 0.01), haematocrit (from 43.8% to 33.6%, p < 0.01) with recovery by day 7 of observation. The explosive soft tissue wound was characterized by marked post-traumatic microcirculatory disorders irrespective of the amount of blood loss. Perifocal intramuscular administration of ABP in animals with an explosive wound and blood loss of 15% CBV reduced the severity of post-traumatic microcirculatory and oxidative metabolic disorders mainly in the early post-traumatic period, as evidenced by an increase in the perfusion variation coefficient Kv by 1.2–1.3 times (p < 0.05), tissue oxygen consumption U by 20–22% (p < 0.05) and fluorescent oxygen consumption by FPC by 48% (p < 0.05).
Conclusion. With an experimental explosive wound of the soft tissues of the thigh in rats, a single early (3 hours after the injury) peri-wound intramuscular administration of ABP reduces the severity of local post-traumatic microcirculatory and metabolic disorders in skeletal muscle.

Background. One of the key components of energy metabolism is the pyruvate dehydrogenase complex (PDC), the activity of which can be targeted by some cytoprotectors. However, their role remains unclear. It is known that the activation of the PDC in tumor cells leads to an inversion of anaerobic glycolysis with an increase in the generation of free radicals in the respiratory chain and a decrease in viability. At the same time, there is evidence of increased resistance of normal cells to hypoxia and reperfusion.
Objectives. Analysis of current information on the role of PDC in the development of pathologic biochemical changes in ischemic reperfusion syndrome and methods of metabolic correction using agents for regulating the activity of the considered multienzyme complex.
Methods. The bibliographical search was carried out across the eLIBRARY and PubMed databases with a selection of articles published over the past 10 years in the English and Russian languages, as well as some parts of fundamental works in the selected field, published more than 10 years. To be selected for bibliographical review, the article can be of any design, reflecting the ideas about the role of PDC in the development of pathologic biochemical changes in ischemic-reperfusion lesions of various organs and tissues.
Results. The bibliographical analysis indicates a decrease in the activity of PDC in myocardial tissue during a heart attack or heart failure, the activity of the enzyme in skeletal muscles decreases against the background of acute hypoxia. PDC activity also decreases under chronic stress and extensive muscular exercise. At the same time, the PDC activity remains at the normal level in the ischemic period, and the transition to the reperfusion period is accompanied by a sharp decrease in the activity of the multienzyme complex. The PDC inactivation occurring under these conditions can result from a damage by reactive oxygen species, as well as by regulatory control changes through phosphorylation/dephosphorylation. Assuming the key role of PDC in the development of energy exchange disorders against the ischemic-reperfusion injuries 2 main strategies might be offered for metabolic correction: 1) an increase in the activity of PDC (activator — sodium dichloroacetate) or compensation for its lack with substrates of the tricarboxylic acids (acetylcarnitine, β-ydroxybutyrate); 2) protection of PDC from damage (antioxidants).
Conclusion. The basis of energy exchange disorders in the reperfusion period is a decrease in PDC activity, and modification of its activity is a promising direction for metabolic prevention or correction of ischemic-reperfusion injures.

Background. Eosinophilic esophagitis (Ee) is a chronic immune-mediated disease of the esophagus, which is characterized by symptoms of esophageal dysfunction and marked eosinophilic infiltration of the mucous membrane (MM) of the organ. Currently, interest in the problem of eosinophilic esophagitis in the global medical scientific community is steadily growing. Eosinophilic esophagitis has no pathognomonic symptoms, which causes a great difficulty for diagnosis.
Clinical case description. The paper describes two clinical cases of eosinophilic esophagitis in patient T. (4 years 10 months) and patient M. (5 years 2 months). Patient T. was admitted to the gastroenterology department of the Children’s Regional Clinical Hospital (CRCH), with complaints of hiccups, flatulence, intermittent abdominal pain, coughing when swallowing. The medical history showed that the child has been ill since the beginning of March 2021, when pain appeared in the epigastric region and along the esophagus when eating. Parents sought help in the Central District Hispital, where surgical and ENT pathologies were excluded. The child was referred to the gastroenterological department of the CRCH, where, according to the results of esophagogastroduodenoscopy (EGDS), the diagnosis of “Erosive reflux — esophagitis” was made. After stopping the erosive process the patient underwent repeated EGDS with biopsy, and was diagnosed with “Eosinophilic esophagitis”. Prescribed treatment: hypoallergenic diet, topical glucocorticosteroids (fluticasone propionate), proton pump inhibitors (PPIs), antacids. As a result of the treatment, no improvement was noted — it was decided to transfer the patient to budesonide therapy in the form of a viscous suspension, after which a persistent positive effect was observed. In the second case, the girl M. was admitted to the gastroenterological department of the Children’s Clinical Hospital with complaints of constant nausea after eating and abdominal pain. The medical history showed that the child has been sick since she was 1. The examination also revealed moderate eosinophilia, an increase in the level of alkaline phosphatase. Fibrogastroduodenoscopy with biopsy revealed endoscopic signs of EoE. A diagnosis of eosinophilic esophagitis was made. Treatment: hypoallergenic diet, glucocorticosteroids, PPI, antacids, antiemetic drugs. The treatment brought about certain positive dynamics.
Conclusion. The presented clinical cases show the difficulty of diagnosing eosinophilic esophagitis, since the symptoms of this disease are not very specific.

Background. Complexity of anatomical structure, diversity of clinical pattern, lack of a unified theory of etiology, pathogenesis and treatment of this pathology, individual aspects of the course of the disease complicate the diagnosis and choice of relevant treatment for patients with various nosological forms of the temporomandibular joint diseases.
Clinical case description. Patient P., 32 years-old, went to the clinic of orthopaedic dentistry with complaints of noise phenomena in the temporomandibular joint (clicks in the joint area have been registered for five years, the noise increased six months ago), dental crowding, absence of tooth 3.5. The patient underwent clinical examination with creating diagnostic models, electromyography of the masticatory muscles, axiography, computed tomography and MRI of the temporomandibular joint. Through computed magnetic resonance imaging of the temporomandibular joint, electromyography and axiography the patient was accurately diagnosed with deforming arthrosis of the temporomandibular joint complicated by dislocation of the intra-articular disc. A therapeutic-diagnostic plastic milled splint on the mandible was implemented. Dynamic observation during treatment was carried out. The effect of the treatment was observed after three months. The control cone-beam computed tomography of the temporomandibular joint showed positive dynamics in the form of an even expansion of all regions of the joint cavity on both sides, centered position of the heads of mandible in the mandibular fossa, but the cortical bone destruction of the upper contour of the mandibular head on the left was still present. After six months of treatment, electromyograms showed a decrease in bioelectrical activity at rest and an increase in bioelectrical activity during chewing on all the masticatory muscles within normal limits. The re-examination after six months revealed smoother vertical movements of the lower jaw, an increase in the amplitude of laterotrusion and protrusion, their symmetry, no “blockage” of lower jaw movements.
Conclusion. An integrated application of radiologic imaging, electromyography and axiography in the diagnosis of temporomandibular joint diseases is crucial for objective analysis of the results, assessment of the quantitative and qualitative characteristics of the masticatory muscles and lower jaw movements, which ultimately determines the optimal patient surveillance and controlled treatment outcomes.

Background. Fluoroscopy of the esophagus and stomach provides a reliable assessment of the specific radiological criteria for achalasia (of cardia), which underlie the classification of the disease by stages. The stage of achalasia is one of the key factors to determine the management of treatment, including the choice of a specific type of surgical intervention. However, no methodological standards for performing and interpreting fluoroscopy of the esophagus and stomach in achalasia have been developed.
Objectives. Creation of a unified protocol for performing and interpreting fluoroscopy of esophagus and stomach in achalasia and development of an algorithm for diagnosing achalasia based on fluoroscopy of the esophagus and stomach, which will help to determine the appropriate surgery.
Methods. The developed algorithm was applied in a study of 104 patients. The examination was carried out using Duodiagnost X-ray machine by Philips, equipped with a remote control. The X-ray technician’s workplace was tooled with a personal computer, a digital identifier (ID) and a digitizer-scanning device. Drystardt 5000B film (by AGFA) was used for X-ray examinations. The description of X-ray examination was carried out by a radiologist in a separate office equipped with two workstations.
Results. A protocol for fluoroscopy of the esophagus and stomach in patients with achalasia and a checklist for the description of fluoroscopy in achalasia have been developed.
Conclusion. The developed algorithm for diagnosing achalasia of cardia based on fluoroscopy of the esophagus and stomach showed its high efficiency for clarifying the stage of the disease, and, consequently, choosing the right treatment and method of surgical intervention, as well as for providing objective control over the dynamics of the disease after surgery. In addition, the introduction of the developed algorithm into the widespread practice of radiologists will ensure continuity at all stages of treatment of patients with achalasia in different medical institutions: from diagnosis to dynamic monitoring of the patient’s condition after surgical treatment in specialized centers.