Seizure syndrome in childhood is a clinical symptom complex that can be caused by a variety of different factors, making differential diagnosis of this condition challenging. Properly identifying the cause of seizures is crucial for selecting the optimal treatment strategy and improving the child's prognosis. Modern diagnostic methods, including electroencephalography, neuroimaging, and genetic testing, allow for a more accurate determination of the etiology of seizure syndrome and the provision of personalized treatment. This article will discuss modern approaches to the differential diagnosis of convulsive syndrome in children and the principles of therapy based on these approaches.

Urolithiasis is the most common urological pathology requiring surgical treatment. For many decades, the trend has been to abandon open surgery for patients with urolithiasis and to seek and refine the most effective, safe, and minimally invasive treatment methods to improve patients' quality of life and reduce treatment and rehabilitation time. One such method is percutaneous nephrolithotripsy, performed with small-diameter instruments without final external drainage of the upper urinary tract. Reliable hemostasis is key to the effective and safe implementation of this approach. Currently, there is no consensus regarding methods for intraoperative hemostasis of the percutaneous tract. This study presents our positive experience using a hemostatic matrix at the final stage of minipercutaneous nephrolithotripsy. Target: to evaluate the safety and efficacy of using hemostatic matrix in percutaneous surgery for urolithiasis. Materials and methods: the study included 52 patients who underwent minipercutaneous nephrolithotripsy in the urology department of the Alexandro-Mariinsky Regional Clinical Hospital in Astrakhan. As a final step in the surgical procedure, all patients underwent percutaneous tract filling with a domestically produced hemostatic matrices without the need for a nephrostomy drain. Results: the postoperative period in patients operated on using the described technique is characterized by a low need for analgesics, a statistically insignificant decrease in red blood counts, the absence of signs of urine extravasation and the formation of paranephric/retroperitoneal urohematomas. Conclusion: our experience with the nephrostomy-free minipercutaneous nephrolithotripsy method demonstrates its high efficacy and significant improvement in patients' quality of life in the immediate postoperative period, in part due to the elimination of nephrostomy drainage. The introduction of hemostatic agents into the nephrostomy tract facilitates its sealing, reduces the risk of hemorrhagic complications, and overall improves the reliability and safety of this surgical technique for kidney stone treatment.

Despite the increased level of diagnosis and treatment, regmatogenic retinal detachment remains a serious global problem, leading to disability of the able-bodied population. The aim of the work is to analyze the dynamics of statistical indicators of the incidence of regmatogenic retinal detachment over the three-year period 2022– 2024 in the regions of the Southern Federal District. The study of the epidemiology of regmatogenic retinal detachment, including in the Southern Federal District, is recognized as critically important for identifying risk factors, developing preventive measures and improving the medical care system. Materials and methods. The materials of the “Ophthalmological passport of the subject of the Russian Federation” of eight regions of the Southern Federal District of the Russian Federation for 2022–2024 were used. The study assessed the indicators of general morbidity, follow-up, surgical treatment and disability in adults and children due to regmatogenic retinal detachment. Results. An analysis of the dynamics of statistical indicators of the incidence of regmatogenic retinal detachment in the Southern Federal District for 2022–2024 revealed significant regional variability in the indicators of follow-up, surgical treatment and disability associated with regmatogenic retinal detachment. On average, the statistical indicators do not exceed the national average, but they show multidirectional dynamics in different regions of the Southern Federal District. Conclusion. The key problem is the low level of timely and complete surgical treatment of patients with regmatogenic retinal detachment, despite the high coverage of follow-up. This, in turn, may indicate.

The aim of the study was to analyze the clinical manifestations, radiological diagnostics, and the correlation between these variables in order to make an accurate diagnosis of cementum dysplasia. Materials and methods. A retrospective analysis of radiological images of patients who sought dental care for the treatment of caries and its complications, or for the purpose of oral sanitation. Conclusion. A modified cement structure can be clinically misdiagnosed as chronic apical periodontitis, osteomyelitis, tumor, etc. Incorrect diagnosis in the presence of cement dysplasia can lead to the initiation of unnecessary endodontic and surgical treatment. In the presence of a suspicion of a modified cement structure, it is recommended to carry out an X-ray examination in order to carry out differential diagnostics and make the correct diagnosis.

Violations of occlusal relationships are an urgent problem in dental practice due to their high prevalence, complexity of diagnosis and treatment, as well as their association with common somatic diseases. These pathologies reduce the quality of life of patients and complicate the process of medical rehabilitation. Prevention aimed at early detection of risk factors is especially important. The purpose of this study is to identify the main risk factors for the development of disorders of occlusal relationships. Materials and methods. A randomized controlled trial was conducted with 72 patients aged 18 to 44 years. The study did not include patients with acute infectious diseases, decompensated chronic diseases, cancer, mental disorders, and periodontal inflammation. The assessment included a clinical examination, cone beam computed tomography, electromyography, ultrasound examination of the temporomandibular joint, and occlusion analysis. Methods of 3D modeling and analysis of cranial symmetry were used, as well as the Hamburg test to assess the functional state of the temporomandibular joint. The results of the clinical examination were subjected to a hierarchical cluster analysis. Results and discussion. Based on the results of the examination, a group of key risk factors influencing the development of occlusive disorders was identified. The analysis of the data showed that the most significant components are the muscular, articular and jaw complexes, including electromyographic parameters, the size of the articular gap and occlusal contacts. The average value of the Hamburg test among patients was 3.82 ± 0.71 points, indicating a high prevalence of the temporomandibular joint dysfunction. Cluster analysis allowed us to identify three main groups of risk factors, including muscle, joint, and dental signs. Conclusion. Identification of risk factors for occlusive disorders plays a key role in improving diagnosis and treatment of patients. The use of cluster analysis and modern technologies, such as 3D modeling and artificial intelligence, makes it possible to increase the effectiveness of prevention and treatment of this pathology.

Most children with attention deficit hyperactivity disorder have comorbid pathology, which complicates rehabilitation. The aim of the study. Improving the results of rehabilitation measures in children suffering from attention deficit hyperactivity disorder. Materials and methods. An examination of 87 patients aged 3 to 11 years with attention deficit hyperactivity disorder was conducted. Upon admission, all patients were examined by the State Autonomous Institution of the Astrakhan Region “Regional Rehabilitation Center for Children and Adolescents with Disabilities”: doctors (neurologist, pediatrician, exercise therapy specialist, psychiatrist, orthopedist, physiotherapist, functional diagnostics specialist), teachers (psychologist, speech therapist, defectologist), as well as an instructormethodologist in adaptive physical education. The effectiveness of non-drug rehabilitation methods included in the individual rehabilitation program was monitored. Results. It was revealed that the most common clinical type of attention deficit disorder was the “mixed” form (p < 0.05), compared to “inattentive” and “hyperactive-impulsive”. Based on an interdisciplinary approach, a scoring system was developed, and schemes of comprehensive medical and pedagogical rehabilitation for three types of attention deficit hyperactivity disorder were created and tested. The applied schemes allowed us to develop practical recommendations for each group of patients. Conclusion. The group of children with a score of 0 points decreased by 17.2 %, with a score of 1 point – decreased by 26.4 %, with a score of 2 points – increased by 10.3 %, with a score of 3 points – increased by 33.3 %. A clearly traceable trend towards increased independence, motivation and socialization of children with such a severe combined pathology is evident.

Respiratory mycoplasmosis is a group of infectious and inflammatory diseases of the respiratory tract in which Mycoplasma pneumoniae acts as the main etiological agent. This pathogen is considered a relevant risk factor for the development of chronic lung diseases in children, such as bronchiolitis obliterans, bronchial asthma and bronchiectasis, due to its ability to trigger a hyperimmune response, disrupt the epithelial barrier and exert prolonged cytotoxic effects on the components of mucociliary clearance. Aim. To present our own clinical observation of the development of bronchiectasis in adolescents in the outcome of mycoplasma pneumonia. Methods. A retrospective analysis of the medical history was performed. A case of a hospitalized patient in a specialized pulmonology department with mycoplasma bronchopneumonia and the formation of local cylindrical bronchiectasis in segments S6– S8 of the left lung and subsequent catamnestic clinical and instrumental follow-up for 12 months is described. Results. It has been shown that with timely verification of the etiology of the disease and the appointment of adequate macrolide therapy, the reverse development of bronchiectasis is possible with the restoration of normal pneumatization of the pulmonary parenchyma, which is typical for children with preserved mucociliary clearance. Conclusions. The inclusion of computed tomography of the chest organs in the examination algorithm for patients with community-acquired pneumonia of atypical etiology makes it possible to identify changes in the bronchopulmonary tree that require longterm follow-up.

This article presents a method for assessing the individual anatomy of the jaws in patients with congenital cleft of the upper lip, palate, and alveolar process of the upper jaw at the stages of complex treatment by combining a digital optical impression and a cone-beam computed tomography of the jaws in special software. An overview of the advantages and disadvantages, as well as the methods of conducting such a method of examination of patients, has been performed.