Vol 43, No 4 (2026)

The data on the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its phenotypes, the evolution of steatotic liver disease terminology and its association with cardiovascular diseases were summarized. A systematic search for relevant publications in the PubMed database was performed.

MASLD has become one of the most prevalent and underappreciated cardiovascular threats. It is closely associated with the development and progression of atherosclerotic cardiovascular diseases, arrhythmias, conduction disorders, hypertension and heart failure. Moreover, MASLD is a crucial part of the cardiohepatorenal continuum. Raising awareness of MASLD among the general public and at-risk populations, unifying existing guidelines for cardiometabolic diseases, and the development of regional and global strategies to combat MASLD are essential to tackle the cardiometabolic pandemic.

Based on a review of modern scientific literature, the organizational and functional requirements for digital solutions for dental clinic call centers was determined, and comparative analysis of the most common architectures for such solutions was conducted.

An analytical review of 26 publications from 2021-2025 from domestic and foreign sources was conducted on digital transformation in dentistry, electronic dental records, teledentistry, organizational aspects of CRM/MIS implementation, and medical data protection. Based on the literature data, a comparative matrix was created for four classes of solutions used in dental practice: integrated medical information systems, specialized dental cloud platforms, CRM/contact centers with medical integration, and hybrid architectures. The comparison was based on the criteria of contact routing, appointment support, integration with electronic documentation, analytics, information security, scalability, and implementation complexity.

It has been established that the digitalization of a call center in a dental clinic should not be viewed as isolated telephony, but rather as a single point of patient access management. The most significant requirements include a unified schedule, two-way communication with the patient, integration with electronic dental records, re-contact tools, transparent analytics, and formalized data access management. Specialized dental platforms and cloud-based solutions offer faster implementation and convenient communication, while integrated medical systems and hybrid architectures provide advantages for deep integration, management reporting, and support for large organizations. The most vulnerable areas remain interoperability, semantic data compatibility, the quality of initial data entry, and the protection of personal data.

For medium-sized dental clinics, solutions that combine patient management, appointment booking, communication channels, and electronic documentation in a single digital framework are the most rational. For large organizations and institutions with higher reporting and integration requirements, a hybrid approach that combines specialized dental functionality with a corporate medical information infrastructure is advisable.

Objective. To study the influence of medical and social characteristics of the patient on the possibility of predicting the course of ischemic stroke in the acute period.

Materials and methods. A prospective cohort study was conducted involving 162 patients with ischemic stroke, hospitalized within the first 24 hours of symptom onset, were examined. The degree of neurological deficit and stroke severity were assessed using the NIHSS at 1- to 2-day intervals for 4 weeks during the acute period (up to 21 days) and the early recovery phase. Upon admission, 38 patients (23.4 %) had a mild stroke, 44 patients (27.2 %) had a moderate stroke, 36 patients (22.2 %) had a moderate to severe stroke, and 44 patients (27.2 %) had a severe stroke. Changes in stroke severity according to NIHSS were recorded as a percentage of the baseline values obtained upon admission.

Results. When assessing the dynamics of changes in stroke severity using the NIHSS, four patterns of acute disease course were identified. In the first pattern, characterized by a rapid increase in symptoms during the first seven days, stroke severity increased significantly, while the patient’s condition remained stable over the next two weeks, with some improvement by the end of the acute period. In the second pattern a slow progression of stroke severity was noted. The third pattern was characterized by an intermittent course, with alternating periods of stabilization and deterioration. The fourth pattern was characterized by a moderate increase in clinical symptoms during the first two weeks, followed by their almost complete disappearance by the end of the acute period (day 21), corresponding to the concept of "minor stroke." Patients in the first three groups with specific patterns of acute ischemic stroke were analyzed for 12 risk factors. Based on the study results, a generalized medical and social patient profile was formulated for each identified pattern of acute ischemic stroke.

Conclusions. During the study, a model for predicting the course of the acute period of ischemic stroke was developed, which demonstrates a reliability of over 80 % in the presence of three risk factors.

Objective. To evaluate the frequency of halitosis among students of the Faculty of Dentistry at Volgograd State Medical University and the relationship between halitosis and dental and general somatic status.

Materials and methods. The study involved students of the Faculty of Dentistry at Volgograd State Medical University, selected randomly. A survey was conducted on the presence of prosthetic and orthodontic appliances in the oral cavity, dental and general somatic pathology, and manifestations of bad breath. Caries intensity of dental (DMFT – the total number of decayed, missing and filled teeth per individual) and the presence and severity of gingivitis (PMA – papillary-marginal-alveolar index) were instrumentally assessed. A portable HC 312 halimeter was used for objective assessment of halitosis manifestations. Statistical calculations were performed using STATGRAPHICS Centurion 19 package (Statgraphics Technologies, Inc., USA).

Results. In 16 % of the students partial tooth loss was revealed. 22 % of students had prosthetic appliances in the oral cavity; among them, 62 % had artificial crowns, and 38 % had post-and-core restorations. 29 % of students are under the care of an orthodontist; among them 46 % are affected by halitosis.

28 % had diagnosed gastrointestinal diseases, and 23 % had ENT disorders. 33 % of the surveyed students of the Faculty of Dentistry reported subjective bad breath. As a result of the study, the degree of correlation varied widely: Spearman's rank correlation coefficient ranged from 0.004 to 0.8212 in absolute value, covering almost the entire Chaddock scale range, from very weak to strong correlation. There is a probabilistic relationship between the halimeter and PMA index readings, which makes it possible to predict the value of one indicator based on the known value of the other.

Conclusions. The prevalence of intraoral halitosis ranged from 30 % to 35 % among the surveyed students of the Faculty of Dentistry. Among the causes contributing to the development of halitosis, both local factors (gingivitis, inadequate maintenance of prosthetic and orthodontic appliances in the oral cavity, poor oral hygiene), and systemic factors (ENT disorders and gastrointestinal diseases) were identified. Spearman's rank correlation coefficient showed a direct correlation between halitosis and the PMA index (the higher the PMA index, the higher the halitosis level).

Objective. To determine predictors of the risk of developing adverse outcomes in patients with comorbid pathology, including broncho-obstructive and cardiovascular diseases, during remote follow-up.

Materials and methods. The study included 79 patients (aged 40 to 88 years, 73.4 % men), predominantly urban residents, with combined respiratory and cardiovascular diseases. As predictors of adverse outcomes during dynamic observation, the frequency of outpatient visits, emergency medical service calls, and recurrent hospitalizations within one year after discharge from the pulmonology department were identified based on the electronic medical records from the Unified Healthcare Information System of the Perm Region.

Results. During the one-year observation period, the mean number of outpatient visits was 9 [4; 13], emergency medical service calls 1 [0; 3], hospitalizations 1 [1; 2], and the Charlson comorbidity index was 6 [4; 7]. The mortality rate was 40.5 %. A Charlson index ³ 6 and ³ 2 repeated hospitalizations reflected the severity of patients’ condition and significantly increased the risk of death by 4.2 (95 % CI: 1.56–11.21) and 2.8 (95 % CI: 1.02–9.38) times, respectively. A score of ³ 14 points on the integral scale of dynamic monitoring effectiveness increased the risk of death by 3.6 times (95 % CI: 1.16–11.2). The highest risk of adverse prognosis was having ³ 2 emergency medical service calls, corresponding to an over 4.4-fold increase in mortality risk (95 % CI: 1.34–14.78).

Conclusions. The key predictors of mortality are the Charlson comorbidity index, frequency of emergency medical service calls, recurrent hospitalizations, and the integrated scale for assessing the effectiveness of remote follow-up.

Objective. To develop and evaluate a prognostic model based on clinical and laboratory data to predict the risk of failure of systemic immunosuppressive therapy in patients with psoriatic arthritis.

Materials and methods. A total of 51 patients with psoriatic arthritis who required systemic immunosuppressive therapy were followed up; they had not received it for the preceding 6 months. Prior to treatment, clinical and immunological parameters were assessed. The efficacy of therapy was determined by achievement of PASI 50 (a decrease in the PASI index by 50 % or more) and a decrease in clinical arthritis activity. A prognostic model was developed using binary logistic regression, and its discriminatory ability was tested using ROC analysis.

Results. Improvement was noted in 62.7 % of patients (32 out of 51 patients). Responders had significantly higher baseline PASI scores (median 29.0 vs. 18.0; p < 0.001) and BSA scores (median 35.0 vs. 16.0; p < 0.001). Baseline serum IL-12 differed significantly between the groups, with lower values observed in patients with improvement (8.98 pg/mL vs 9.59 pg/mL; p = 0.001). Baseline IL-17 and TNF-α levels showed no prognostic significance. The binary logistic regression prognostic model based on IL-12 was statistically significant (p < 0.001). In ROC analysis, the area under the curve (AUC) was 0.771 (95 % CI: 0.629-0.912), indicating good discriminative ability of the model. At the selected threshold, the model sensitivity was 84.2 % and specificity 62.5 %.

Conclusions. Higher baseline PASI and BSA scores are associated with a better response to methotrexate, whereas IL-17 and TNF- α are not prognostic markers. Low baseline IL-12 levels represent a promising biomarker of treatment efficacy. The developed prognostic model can be used for personalized prediction of response to methotrexate in patients with psoriatic arthritis.

Objective. To analyze morphological and functional transformations of the mucous membrane and bone structures of the maxillary sinus during subantral augmentation using β-tricalcium phosphate.

Materials and methods. The experiment was conducted on 14 sheep (control and experimental groups of 7 animals each). All animals, kept under standard conditions with their usual diet, underwent subantral augmentation using an open technique according to the author's method (patent RU 2729651). In the experimental group, β-tricalcium phosphate granules were applied to the mucosa; in the control group, the defect was left to fill with a blood clot. Follow-up biopsies were performed under general anesthesia at 1, 2, and 3 months after surgery. The evaluation included a qualitative analysis of changes in the epithelium, lamina propria of the Schneiderian membrane, bone plate, and periosteum.

Results. The results demonstrate a biphasic response: initial necrosis and inflammation, followed by reparative processes such as epithelial metaplasia, lamina propria fibrosis, bioresorption of the material, and the formation of reticulofibrous bone tissue. In the experimental group, ramolithic cysts (bone cysts resulting from tissue necrosis) with osteogenesis were observed, confirming the osteoinductive properties of β-tricalcium phosphate. These changes highlight the importance of monitoring tissue responses to optimize implant procedures in the maxilla.

Conclusions. This study demonstrates that subantral augmentation using a bioresorbable composite material based on β-tricalcium phosphate induces a complex tissue response, including initial necrosis and inflammation of the mucosa and bone, followed by bioresorption and osseointegration.

Objective. To evaluate the effect of acrylic removable denture materials on the growth of a representative of the normal oral microbiota using Streptococcus salivarius M18 as a model.

Materials and methods. The study was performed in vitro. S. salivarius M18 strain was cultured in the presence of MMA at concentrations of 0.01; 0.1 and 1.0 µg/mL. The growth kinetics, biomass accumulation indicators, and bacterial cycle phase characteristics were assessed. Statistical processing was carried out using parametric and non-parametric methods at a significance level of p < 0.05.

Results. No statistically significant inhibitory effect of MMA on integral growth indicators was found (p > 0.05). However, a dose-dependent modulating effect was observed: the low concentration (0.01 µg/mL) was accompanied by a tendency to stimulate growth, while 0.1–1.0 µg/mL was associated with a decrease in biomass accumulation in the stationary phase. The obtained data indicate the preserved viability and functional activity of the probiotic strain under conditions close to the clinical functioning of acrylic prostheses. This is of practical importance for the development of probiotic care products for prosthodontic appliances.

Conclusions. Methyl methacrylate at concentrations corresponding to the residual monomer levels of acrylic dentures does not have a critical suppressive effect on the growth of S. salivarius M18. The preservation of its biological activity substantiates the possibility of using probiotic components for the prevention of microbial colonization of removable dental prostheses and reduction the risk of inflammatory complications in prosthetic dentistry.

This article is dedicated to Professor Pavel Ivanovich Pichugin, a distinguished pediatrician, public health organizer, and public figure, Head of the Department of Pediatric Diseases and founder of the first Children's Clinic in the Western Urals. The institution that laid the foundation for organized efforts to combat child mortality in Perm and the Perm Province and played a crucial role in the development of specialized pediatric medical and preventive services for children. It was recognized as exemplary and one of the best clinics in the Soviet Union. It was on February 5, 1922, that, thanks to the tireless energy of Professor Pichugin, his strong civic and professional stance, and his selfless devotion to his work, the history of organized pediatric care in the Western Urals began.

Alexander Vasilyevich Tuev, an outstanding Russian clinician and scientist, cardiologist and internist, Doctor of Medical Sciences, Professor, Honored Scientist of the Russian Federation, and the founder of one of the largest scientific schools of cardiologists and internists in the Western Urals. His scientific studies and those of his students focus on clinical cardiology (arterial hypertension, atherosclerosis, coronary heart disease, arrhythmias), comorbid conditions in internal medicine, as well as pharmacological and non-pharmacological methods for the treatment of socially significant diseases.