Background. Dilation of the external cerebrospinal fluid spaces is one of the most common echographic findings in children in the first months of life, while the echographic criteria of dilation of the external cerebrospinal fluid spaces remain debatable, and the clinical significance of dilation of the external cerebrospinal fluid spaces is unclear. Objective. To determine the normative echographic values of the external cerebrospinal fluid spaces in children. Materials and methods. The external cerebrospinal fluid spaces were measured in 628 conditionally healthy infants aged from 1 day to 11 months 29 days. In all cases, the external cerebrospinal fluid spaces were represented by the subarachnoid space. The results of our own   research are compared with the literature data. Results. The terminological diversity concerning the external cerebrospinal fluid spaces dilatation has been discussed and the literature data have been analyzed on its clinical significance. All the main provisions are illustrated by observations from our own archive. A statistically significant increase in the sizes of the external cerebrospinal fluid spaces in infants after the neonatal period has been revealed, with the maximum external cerebrospinal fluid spaces value observed in children aged 3–6 months (0.712 ± 0.039 mm in newborns and 2.585 ± 0.087 in infants aged 3–6 months, p < 0.01). The maximum value of the norm for infants under 1 month of life should be considered to be 2 mm, for children aged 3–6 months — up to 5 mm, 2–3 and 7–11 months — up to 4 mm. The average values of the external cerebrospinal fluid spaces in infants under one month are about 1 mm, in 2–11 months — 2–3 mm, which corresponds to most of the literature data. Conclusion 1. Normally, the external cerebrospinal fluid spaces in infants is represented only by the subarachnoid space. Dilation of the subdural space cannot be considered a normal variant. 2. The average value of the subarachnoid space in children of the first month of life does not exceed 1 mm, in infants older than the neonatal period it is 2–3 mm. The maximum value of the subarachnoid space should not exceed 2 mm in newborns, 3 mm at the age of 1 month, 4 mm at the age of 2 months, 5 mm in infants 3–6 months. In infants at the age 7–12 month, the subarachnoid space should not exceed 4 mm. 3. External cerebrospinal fluid spaces dilataton cannot be considered a completely benign condition and, regardless of the presence or absence of clinical manifestations, requires dynamic observation.

At this time, radiographic diagnostic methods are among the most informative and accessible technologies for detecting dental and facial bone injuries. In cases of multiple and combined mechanical damage to teeth and jaws at the diagnostic stage, it is essential to understand significant factors in choosing an informative method of radiation examination. The purpose of the study. To evaluate the informative value of modern X-ray diagnostic techniques in the diagnosis of dental and jaw injuries in an experiment. Materials and methods. A pig skull preparation was prepared for the experimental study of teeth and jaws. Radiovisiography, cone beam and multi-slice computed tomography were used as radiation diagnostic methods. Studies of the skull were performed before and after applying mechanical damage to the teeth and jaws. Results and discussions. The informative value of diagnostic methods and techniques was analyzed and compared with the literature data. Cone beam computed tomography has shown high spatial resolution in visualizing the anatomy, topography of teeth and jaws, as well as in   detecting isolated, multiple and combined injuries of teeth and jaws. Conclusion. Radiovisiography is the method of choice for the diagnosis of isolated fractures of single-root teeth. Computed tomography (mainly CBCT) of teeth and jaws allows to obtain high-quality diagnostic images with detailed visualization of anatomical features of teeth, as well as to identify isolated, multiple and combined injuries of teeth and jaws.

Objective. To evaluate the diagnostic value of cone beam computed tomography in the   assessment of chronic generalized periodontitis in patients with seropositive and seronegative rheumatoid arthritis. Materials and methods. From February 2023 to May 2024 92 patients diagnosed with chronic generalized periodontitis and rheumatoid arthritis participated in the study, the average age of patients was 50 ± 6.9 years: 53 women (57.6 %), 39 men (42.4 %); the comparison group was represented by 49 patients with chronic generalized periodontitis without RA. Patients underwent cone beam computed tomography (CBCT) (n = 92), orthopantomography (n = 45). Results. The main dental indices were analyzed before and after RA treatment. It was found that RA remission was achieved within 1 month with joint management of a rheumatologist and dentist in 75 (81.5 %) patients. According to objective criteria, chronic generalized periodontitis   of moderate severity prevailed in the main group. In an intergroup analysis, caries were most common in the group of male patients with seropositive RA (p < 0.05). A decrease in densitometric parameters in both groups was noted in the area of the interdental septum between teeth 1.1 and 1.2. A decrease in densitometric parameters of the compact layer of bone tissue in the area of the lateral sections of the upper and lower jaws was more common in women from the seropositive RA group. Conclusions. 1. During RA therapy, there was a worsening in the main dental indices, which was associated with the characteristic of RA treatment. 2. In men with seropositive and seronegative RA, plaque was most common in the dentogingival area compared to the control group (p < 0.05); in women with seropositive RA, periodontal destruction predominated in areas of inflammation, in women with seronegative RA — plaque in the dentogingival area predominated, which was statistically significant in comparison with the control group (p < 0.05); adentia was most common in patients with seropositive RA, which was statistically significant in comparison with patients with seronegative RA (p < 0.001) and the control group (p < 0.05). 3. When analyzing the radiation pattern, the greatest changes according to CBCT data prevailed in the group of patients with seropositive RA in comparison with the group of patients with seronegative RA (p < 0.01) and the control group (p < 0.05).

Objective. To systematize CT changes in lesions of soft tissues, lungs, mediastinal organs and chest bones in combat trauma and to determine their value for solving expert forensic medical problems. Materials and Methods. As part of solving the tasks set in this group of observations, we studied 40 cases of chest injuries from gunshot and mine-explosive wounds (hereinafter referred to as MBR). Results. In the course of the study, 40 people with penetrating wounds of the thoracic cavity were selected. Using computed tomography data, the wound canal was visualized, represented by a consolidation zone, along which air accumulations, bone fragments and foreign bodies of various densities may be noted. Based on changes in the pulmonary parenchyma, it is possible to assume the trajectory of the wound canal and the duration of the injury. Conclusion. To determine the trajectory of a wounding projectile according to CT scans of the thoracic cavity, the following data should be used: traumatic changes in the pulmonary parenchyma, which are represented by a consolidation zone, fractures of bone structures and the presence of foreign bodies of varying densities.

Objective. To analyze the level of awareness of remote ultrasound consultation technologies among physicians in the public and private health care sectors. Materials and Methods. In order to assess the awareness of USD physicians about the possibility of using teleconsultations, a questionnaire was developed and physicians from all federal districts of the Russian Federation were surveyed. The questionnaire was conducted anonymously, electronically, as well as with the collection of information on paper. The results were evaluated in Excel program. Results. The data of 192 questionnaires were processed. The reasons for the limited use of the technology of remote consultations during ultrasound examinations in doctors of medical institutions of public health care and medical institutions of private ownership were revealed. Conclusion. Heterogeneous technical support, insufficient information support for the development and implementation of new technology, and limited time resource are the main reasons for the incomplete application of remote teleconsultation during ultrasound examinations.

Objective. To demonstrate the role of echocardiography (EchoCG) in the dispensary observation of patients with pulmonary arterial hypertension (PAH) in the PAH office at the Regional Cardiological Dispensary and Rheumatology Center at the City Clinical Hospital No. 5 in Nizhny Novgorod, taking into account the ongoing therapy and verification of diagnosis using catheterization of the right chambers of the heart on the example of clinical observation. Materials and methods. The results of examination, treatment and subsequent follow up of a patient with pulmonary arterial hypertension, who was suspected at the stage of initial treatment in the PAH office, diagnosed with echocardiography, verified according to catheterization of the right heart during hospitalization, are presented. Results. Specific echocardiographic signs of pulmonary hypertension (PH) and methods for calculating pulmonary artery pressure (PA) made it possible to identify the disease in a timely manner and prescribe appropriate therapy. At the stage of dispensary observation, special attention was paid to the function of the right ventricle (RV) as a   control of the treatment. Conclusion. The complex application of medical history, laboratory data, echocardiography and catheterization of the right heart is important in the diagnosis of pulmonary hypertension. Echocardiography is an integral part of further dynamic follow-up against the background of ongoing treatment of PAH patients.