Purpose. To study the opinion of practicing dentists on the prospects and possibilities of introducing telemedicine technologies into dental practice at the level of a separate region – Donetsk. Materials and methods. Based on the developed questionnaire, a sociological survey of practicing dentists in Donetsk (n=118) with experience in the specialty from 3 to 25 years was conducted. The attitude of respondents to telemedicine technologies was analyzed, taking into account their gender, age, experience in the specialty and specialization. Results. Dentists noted the undoubted relevance of using teledentistry in their professional activities. It is necessary to note the absence of reliable differences in the analysis of the possibilities and prospects for the introduction of telemedicine technologies in dentistry among male and female respondents, as well as the absence of reliable differences in the readiness to introduce teledentistry depending on the age of doctors. Conclusion. The use of teledentistry can contribute to a significant reduction in the number of inappropriate referrals, a decrease in the workload of a specialist while increasing the coverage of the population with dental care. At the same time, the limited use of teledentistry in Donetsk was revealed along with the recognition by dentists of the relevance of the active implementation of teledentistry services

Objective. To determine the frequency and nature of comorbid pathology in patients with psoriatic arthritis (PsA) and to evaluate the effectiveness of multidisciplinary therapy in a specialized hospital and outpatient clinic. Materials and methods. Based on the data from 68 outpatient charts of patients with PsA, we studied the multimorbid pathology. At the outpatient level, 84 patients suffering from psoriasis were examined, and 47 (56.0%) of them had PsA verified, and 53 (63.1%) had joint pain. Results. We found that concomitant pathology of the musculoskeletal and cardiovascular systems was involved in the pathological process in 88.2% of patients, the gastrointestinal tract in 41.2%, and their simultaneous damage with damage to the kidneys and nervous system was recorded in 17.65%. With active detection, at the early stages of PsA development, the proportion of hand arthropathy was 27.7%, which is lower than in the group of patients who self-applied due to a sharp deterioration in quality of life and were hospitalized for PsA – 82.35% (p < 0.001). At the same time, the incidence of lower limb joint involvement is high in both groups: dispensary – 74.5%, inpatient – 64.71%. PsA therapy in a multidisciplinary hospital led to a slight improvement in joint mobility in only 5.9% of patients. As a result of outpatient therapy in patients with psoriasis with pain and arthropathy, there was a deterioration in joint condition (19.2%) and pain (17.0%), which was not recorded in patients who received therapy in a multidisciplinary hospital. Conclusions. Given the resistance of late-identified PsA to standard therapy, an integrated approach is needed in the management of psoriasis patients with the involvement of doctors of related specialties during dynamic follow-up in order to prevent the development of destructive variants of arthropathies against the background of comorbid pathology. Regular monitoring of the condition of the lower extremities is advisable

In modern personalized medicine, there is a transition from the phenomenological description of clinical cases to the predictive modeling of individual patient trajectories. In this context, the concept of medical digital twins seems to be not so much a technological innovation as a qualitatively new epistemological tool that requires rethinking traditional approaches to the organization and structuring of medical data. In this regard, the fundamental challenge is not the very possibility of computational modeling of physiological processes, which is technically feasible in one way or another, but the formation of an adequate information infrastructure capable of ensuring the representativeness and validity of the source data for predictive algorithms. The methodology of forming databases of potential digital counterparts in medicine is currently under development. Our research has allowed us to develop an approach to the formation of a database of medical digital twins and formulate several fundamental provisions that determine the directions for further development of the information infrastructure for predicting the condition of patients based on them.

Infertility affects up to 17.5% of couples of reproductive age, which significantly increases the demand for assisted reproductive technologies (ART). Despite various transformations and modernisation of programmes, the live birth rate with in vitro fertilisation (IVF) remains low, resulting in the need for several protocols to achieve live births. An important factor in the success of IVF is the qualification of specialists, but despite its high level, the human factor and a certain amount of subjectivity in the work of reproductologists and embryologists cannot be avoided. Artificial Intelligence (AI) offers significant opportunities to improve various aspects of IVF, for example, AI models can accurately predict hormone doses, and automate ultrasound monitoring, reducing examination time. AI also improves sperm selection for intracytoplasmic injection and helps select embryos with the best chance of implantation, improving accuracy and reducing subjective evaluation. In addition, AI can play an important role in training professionals, improving their skills and increasing the accuracy of decision-making. The introduction of AI into clinical practice is a promising area for improving IVF outcomes

Heart failure with preserved ejection fraction (HFpEF) accounts for up to half of all cases of HF. Left ventricular diastolic dysfunction is the main link in the pathogenesis of HFpEF. This HF phenotype is often associated with extensive comorbid pathology (arterial hypertension, type 2 diabetes mellitus, atrial fibrillation, obesity, etc.). Until now, the features of the clinical portrait of a patient with hypertension complicated by HFpEF, occurring without known concomitant diseases and conditions, have not been sufficiently covered.

Purpose. To study the differences in the indicators of autonomic regulation in children and adolescents with recurrent headaches (RH). Materials and methods. 84 people aged 7–17 years were examined – patients of the pediatric department, of which 40 (47.6%) were boys and 44 (52.4%) were girls; the median age was 16 (15; 17)] years. The features of vegetative regulation were assessed by the method of cardiorhythmography with the orthostatic test and cardiovascular tests according to the method of R.M. Baevsky using the device "VNS-spectrum". The indicators were compared in groups with the presence of RН (n=68) and without RН (n=16), as well as in groups formed taking into account the presence/absence of RН, gender and age. Results. In patients with RН, a predominance of the sympathetic division of the autonomic nervous system (ANS) was revealed, confirmed by the presence of statistically significant differences in the quantitative values of the studied indicators of autonomic regulation. Discussion: Considering the significant role of the ANS in regulating the activity of organs and systems, the sympathicotonic orientation of the regulatory function of the ANS that we have identified, this can be regarded as a state of tension in the adaptive capabilities of the body of children and adolescents associated with the presence of RН. This assumption can be confirmed by further studies. As a medical correction, it is possible to use the sedative Nervo-Vit and the adaptogen Leveton P.

Objective. To evaluate the impact of different anticoagulant prophylaxis regimens on the state of the haemostasis system and the frequency of thrombohemorrhagic complications in patients with stage II–IV ovarian cancer undergoing chemotherapy. Materials and methods. A prospective, comparative, randomised, interventional cohort study was conducted, including 313 women with histologically confirmed ovarian cancer in stages II–IV. The patients were randomised into three groups: I (n=104) who received prophylactic doses of low-molecular-weight heparins (LMWH); II (n=104) who received direct oral anticoagulants (DOAC) and III (n=105) – the control group without anticoagulant prophylaxis. All patients received standard chemotherapy as required. The state of haemostasis was evaluated using a set of laboratory parameters, including fibrinogen levels, D-dimer, thrombin-antithrombin complexes, prothrombin F1+2 and platelet aggregation. The patients were classified into four diagnostic categories according to the degree of disturbance to the haemostatic system: patients without signs of disseminated intravascular coagulation (DIC); compensated DIC with hyperfunction of platelets; subcompensated DIC with pronounced hypercoagulability; decompensated DIC with consumption thrombocytopathy. Results. Before the start of chemotherapy, the frequency of normocoagulation was comparable in all groups (21–23%), with compensated and subcompensated forms of DIC predominant and no decompensated forms identified. During chemotherapy without anticoagulant prophylaxis, the proportion of normocoagulation decreased to 1,9%, while the proportion of subcompensated and decompensated DIC increased to 48,6 and 34,3%, respectively. In groups I and II, normocoagulation was maintained in 16,3–17,3% of patients, with compensated forms predominating and the frequency of decompensated DIC not exceeding 14,4%. The frequency of deep vein thrombosis and pulmonary embolism in the control group was 16,2 and 7,6%, respectively, whereas in group I it was 9,6 and 2,9%, respectively, and in group II it was 7,7 and 1,9%, respectively. Moderate bleeding was less common in the prophylaxis groups (4,8–6,7%) than in the control group (18,1%).

A clinical case of a patient with a mixed form of cystic fibrosis with bronchopulmonary and gastrointestinal manifestations is presented. Despite the screening of newborns, as well as the active use of available diagnostic sweat tests and genetic analysis, the diagnosis cannot always be accurately confirmed, the problem of diagnosing cystic fibrosis both at the manifestation of the disease and at the subsequent stages of its development remains relevant. Diagnosis of cystic fibrosis requires physicians to be alert to cystic fibrosis in pulmonary and intestinal disorders, to inform physicians of the diagnostic signs of cystic fibrosis, to adequately assess the clinical picture and internosological diagnosis, to be aware of possible false-negative and false-positive results when using a modern set of diagnostic tools. Diagnosis and treatment of cystic fibrosis are in the process of continuous improvement. Timely therapy, taking into account the origin of the syndrome, can significantly improve the patient's condition, increase the duration and quality of his life. Recent advances in the field of cystic fibrosis gene modification open up new avenues in the treatment of this disease

In a rapidly changing biosphere, the formation of a new system of human relations with the surrounding and the inner world occurs, which contributes to the development of noosphere and anthropogenic disharmony. There was a transition in the idea of the essence of somatic diseases from the organ and tissue level, as a consequence of disorders of the regulatory role of the central nervous, endocrine and immune systems, to the molecular level, where the pathology, first of all, will be determined by low -molecular primary metabolites. It is known that the deficiency of these primary metabolites occurs in all periods of life due to their insufficient intake with water, food or low level of their formation in the digestive organs. There is a need for the effective prevention of various diseases, especially at the initial stage of their formation, as evidenced by the results of various studies devoted to the study of the role of endoecology and microbiota, water and nutrition, the antioxidant system, connective tissue, etc. Regulation of such processes requires the development of fundamentally new ideas about the essence of diseases, their prevention and treatment, as well as the allocation of an individual nozological unit.

Modern diagnosis of infectious-inflammatory diseases and imbalances in the female urogenital tract microbiota requires selecting an optimal laboratory method. Based on a review of the literature, a comparative analysis of quantitative polymerase chain reaction and culture (microbiological) methods is conducted. The advantages and disadvantages of the methods are considered. Rational use of both methods, guided by their strengths and limitations, is key to effective clinical practice.