Clinical Examination Of Patients Research Articles

Features of Inflammatory Response in Juvenile Depression with Attenuated Symptoms of Schizophrenic Spectrum

Background: early nosological qualification of juvenile depression and detection in its structure of specific phenomena of schizophrenic spectrum makes it possible to identify the onset of an endogenous process and to provide timely therapeutic intervention. This becomes possible using an integrated approach based on a psychopathological assessment of patients and the determination of individual immunological indicators of blood. The objective: to determine the inflammation markers in patients with juvenile depression with attenuated symptoms of schizophrenic spectrum (ASSS) in relation to features of their clinical manifestation and response to therapy. Patients and methods: 50 patients aged 16 to 25 years with fi rst depressive episode with ASSS (F32.1, F32.2, F32.28, F32.8), of which 26 patients with attenuated psychotic symptoms (APS) and 24 ones with attenuated negative symptoms (ANS). The control group consisted of 19 mentally healthy volunteers. The leukocyte elastase (LE) and D1-proteinase inhibitor (D1-PI) activity and the level of autoantibodies (AB) to S100E and MBP were measured in blood plasma. The ratio of LE to D1-PI activity was defined as a leukocyte-inhibitory index (LII). Clinical and psychometric assessment (HDRS, SOPS, SANS scales) as well as immunological examination were carried out at admission to the hospital and at discharge. Results: the differences revealed in profiles of immunological parameters in patients with juvenile depression with ASSS reflect the different variants of the inflammatory response to pathological process. Regardless of the identified clinical group, only 24% of patients were characterized by a balanced immune response. The inflammatory response in 76% of cases was accompanied by varying degrees of insufficiency of neutrophils functional activity and an increase in D1-PI activity, i.e. reduced LII. In 44% of cases, a decrease in LII was also accompanied by an increase in the level of AB to S100E. The relationship between immunological profiles and clinical severity of depression with APS and ANS was confirmed. The patients with balanced immune response without an autoimmune component have the best therapeutic response. Conclusions: the results extend the concepts of the pathogenetic mechanisms of juvenile depression with ASSS and indicate various variants of inflammatory response associated with this pathological condition. Immunological analysis complements the clinical examination of patients in terms of assessing the severity of condition, prediction of the disease course and response to therapy.

EFFECT OF DIETARY PATTERNS ON VITAL SIGNS (PULS RATE, RESPIRATORY RATE, RECTAL TEMPERATURE) AND BLOOD PRESSURE IN DOG POPULATION DURING WINTER PERIOD

Vital signs (puls rate, respiration rate and rectal temperature) and blood pressure play a major role in a general clinical examination of patients in veterinary medicine, with a final purpose to diagnose disease. The general condition of a dog's organism is affected by a number of factors and each organism has its own defense mechanism against the cause of a disease. Oscillations in body temperature (increased or decreased), number of breaths per minute, heart rate and increased or decreased pulse indicate the body's response to the harmful effects of pathogens. Therefore, these parameters are considered to be the first sign of a disease. The obtained study determined the importance of dietary patterns and living conditions of dogs on vital signs and blood pressure in dogs from the City of Tuzla and Lukavac area, based on the results and monitoring performed in 30 dogs during the winter period from November 2014 to January 2015. Many authors, in their professional and scientific publications, indicate that obesity is a possible contributing factor in the development of the diseases, and consequently "obesity epidemic" is involved as a term. A large number of studies conducted in the world point to the fact that hypertension and tachycardia in the human and increasingly in the animal population is serious health problem and a significant risk for occurrance of heart disease, kidney and blood vessels disorders. Although the cause of most cases is unknown, there are a number of possible influencing factors, including inadequate diet and consequent obesity, which significantly affect the occurrence of disease in humans and animals. The study was conducted on two different groups of dogs (30 in total), as group A (15 dogs) included dogs that were fed with a combination of ready to serve and prepared meals, and group B (15 dogs) included dogs that were irregularly fed and malnourished. The study was conducted in accordance with the data of the World Veterinary Association. During the routine examination, rectal temperature, systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, as well as gender, breed, body weight, and age of the dog were used as parameters.

Ways to improve outpatient phlebological care with “one day” technology

Introduction.Chronic venous insufficiency is one of the most common diseases, so finding the best treatment options is one of the most urgent tasks of surgery. One of the methods of implementing this direction is to apply a personalized approach. The aim of the study is to improve surgical care for patients with VVPC by introducing a personalized approach.Materials and methods.The study was based on clinical observations and special studies in 428 patients with uBVNC in outpatient settings. All of those surveyed were women. The average age of the patients was 42.3 ± 15.5 years. All patients were operated on — endovasal laser coagulation (EVLk) was performed in the traditional way. Clinical examination of patients, as well as special methods of research was carried out. A questionnaire was used to assess the quality of life of patients. The peculiarity of the study was the use of social and hygienic methods: survey, psychological testing, expert. Statistical analysis and mathematical processing of results were carried out with the help of modern computer technologies based on the Statisticala 6 application package.Results.It has been established that over the past five years in the Ivanovo region there has been an increase in the incidence of vessels of the lower extremities. The frequency of varicose veins exceeds 47 per 100 patients examined. The desire to perform surgery in the nonstate health sector is observed in 9.8 cases. In 85.0% of patients with VBNC, received for surgical treatment, have a lack of preparedness. Their information, clinical and psychological level is 65.0–89.0% of the due and direct influence on the formation of an unfavorable result.Conclusion.Thus, the implementation of a personalized approach to the surgical treatment of patients with chronic venous insufficiency by laser coagulation provides on a par with the reliable obliteration of altered veins the fastest clinical recovery of patients, improvement of their quality of life, satisfaction with results, good hemodynamic and cosmetic effects.

Coenzyme Q10 phospholipidic vesicular formulations for treatment of androgenic alopecia: ex vivo permeation and clinical appraisal

ABSTRACT Introduction Coenzyme Q10 (CoQ10) is an antioxidant molecule with anti-aging activity on human hair, and because of its pharmaceutical limitations such as large molecular weight, high lipophilicity and poor water solubility, its therapeutic effectiveness has been hampered. Therefore, different vesicular nanocarriers were developed in the current work, for enhancement of the skin penetration of CoQ10 for treatment of androgenic alopecia. Areas covered In order to overcome the poor skin penetration of CoQ10, it was formulated in liposomes, transfersomes, ethosomes, cerosomes and transethosomes using the thin-film hydration method. Results revealed that transethosomes were the carrier of choice for CoQ10, in which it displayed a particle size of 146 nm, zeta potential −55 mV and entrapment efficiency of 97.63%. Transethosomes also achieved the highest deposition percentage for CoQ10, exceeding 95% in the different skin layers. Upon clinical examination in patients suffering from androgenic alopecia, CoQ10 transethosomes displayed better clinical response than the administration of CoQ10 solution, which was further confirmed by dermoscopic examination. Expert opinion Findings of this study further prove that loading antioxidants such as CoQ10 in nanocarriers maximizes their therapeutic efficiency, and opens many opportunities for their application in treatment of several other topical diseases.

Stroke in atrial fibrillation: inflammation as additional risk (retrospective study)

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial fibrillation (AF) is a highly prevalent problem that is becoming more common with population aging and has many complication. The most significant complication of AF is thromboembolism, particularly stroke, because AF produces a hypercoagulable state and provokes pro-fibrotic, pro-hypertrophic, and pro-inflammatory responses in a variety of tissues. Various inflammation markers such as interleukin-6 (IL-6) and high sensitivy C-reactive protein (hsCRP) have been linked with AF. Several prothrombotic factors have been found to be elevated in AF, which contributed to an increased risk for stroke.The tissue factor (TF) as a principal initiator of the coagulation cascade. The aim of this study is to investigate the relationship between inflammation markers and risk of dynamic cerebrovascular accident or stroke, including the impact of this interaction on the outcome in patients with AF Methods. We observed 441 patients with nonvalvular AF during 5 years (2010-2016). Clinical examination of patients included a study of complaints (especially HF, dynamic cerebrovascular accident and stroke), physical, laboratory and instrumental examination, also additional biochemical blood tests , such as TF, hsCRP and IL-6. The blood tests were determined by ELISA on the analyzer "Stat Fax 303 Plus". Treatment regimens carried out in all patients included standard therapy, which is held in the hospital for the treatment of AF. Studies were conducted on the basis of simple randomized open-label protocols, using the universal statistical packages SPSS 13.0 Results Obtained results have shown that among 441 patients with AF within 5 years, heart failure was detected in 257 patients, 116 had either a cerebral circulation disorder or a stroke. It was found that in patients undergoing dynamic cerebrovascular accident or stroke there was a significant increase in levels of inflammatory markers compared with other patients with AF. So, the significant differences between the levels of hsCRP are 6, 7± 1.8 vs. 3.2 ± 0.6 p = 0.002 and level of IL-6 is 4.2± 0.8 vs. 2.6± 1.1 p = 0.043 accordingly. We revealed also that in patients with dynamic cerebrovascular accident or stroke the level of TF is improved as compared the other patients with AF (1200± 50.vs 850 ± 31.9 p = 0.026). Moreover plasma levels of hsCRP were higher among AF patients at high risk of stroke (=3 or more) by CHA2DS2-VASc (p = 0.003). Besides the levels of hsCRP and IL-6 are markedly elevated in patients with dilated left atrium, poorly functioning left atrial appendage and ventricular dysfunction .The similar tendency of hsCRP, IL-6 and TF was also observed in patients with AF and heart failure. Conclusion we have demonstrated that inflammation markers such as hsCRP and IL-6, together with coagulation cascade markers, are additional prognostic criteria that contribute to the development of dynamic cerebral circulation disorders or stroke in patients with AF

IMPORTANCE OF ASHTAVIDHA PARIKSHA – AS A DIAGNOSTIC TOOL

For effective management of disease, diagnosis and prognosis are two important aspects. Clinical examination is an important tool for assessment of disease as well as condition of patient. Different types of examination depicted in Ayurveda among that Ashtavidha Pariksha viz. Nadi (Pulse), Mootra (Urine), Mala (Faeces), Jihwa (Tongue), Shabda (Speech), Sparsha (Touch), Drika (Eyes) and Akriti (Posture) an effective tool for clinical examination of patient, which was routinely used by traditional Ayurvedic practitioner, but is missing in present era. In this paper, the clinical utility of Ashtavidha Pariksha is discussed which will be helpful for scholars to use it as a diagnostic and therapeutic tool in their clinical practice. Keywords: Ashtasthana Pariksha, Ayurveda, Examination, Diagnosis, Prognosis.

THE EFFECT OF SMOKING STEAM COCKTAILS ON THE HARD TISSUES OF THE ORAL CAVITY

The aim of the study was the current problem of studying the impact of smoking steam cocktails on human health, as well as the development of methods for the prevention of diseases that were caused by the action of this habit is one of the main directions of the development of health protection, both in Russia and around the world. The study of dental status was carried out by means of a questionnaire, a detailed survey and a clinical examination of patients. The questionnaire was used to determine the level of evaluation of motivation to quit smoking. During the survey of patients, the subjective state of the oral cavity was determined, namely, the presence of dryness of the oral cavity, unpleasant smell, burning sensation, pain in the tongue, impaired taste sensations, and whether there was a metallic taste. Then an external examination was carried out, an examination of the vestibule of the oral cavity, an examination of the dentition itself. The intensity of dental caries was determined. According to the results of the survey, it is clear that the motivation to quit smoking is low. Data from the study in patients who use and do not use smoking mixtures showed that the intensity of caries sharply worsens depending on the length of smoking. The obtained data indicate an increase in inflammatory and destructive changes in the hard tissues of the teeth.

Захворюваність населення України запальними захворюваннями пародонта, прогнозування та профілактика патологій в сучасних умовах

The purpose of the study. The article reflects the issues of the incidence of inflammatory periodontal diseases in the population of Ukraine, methods for predicting exacerbations of diseases for the timely conduct of secondary prevention. It has been established that the high prevalence of periodontal diseases among different groups of the population makes this problem one of the most important problems of modern dentistry. According to WHO experts, 80% of schoolchildren in different countries have periodontal pathology, and among adults it occurs in almost 100% of cases. Modern periodontal prophylaxis should be carried out on the basis of clinical examination of patients. Periodontal prophylaxis should be based on taking into account the identified etiological factors of the disease. Predicting the incidence of periodontitis and predicting the course of the disease is one of the most important problems of periodontology today. Solving forecasting problems in clinical, experimental and preventive medicine is one of the most difficult areas of the activity of doctors of various profiles. Materials and methods. In order to form a risk group, the occurrence of an exacerbation of inflammatory periodontal diseases for the timely implementation of secondary prevention of pathology, an algorithm for the probability of diseases and a mathematical model for predicting the course of the disease were developed. The use of this method made it possible to select 9 signs out of 42 that most significantly affect the prognosis of exacerbation in inflammatory periodontal diseases. Results and discussion. Based on the curves of the dependence of the frequency of the occurrence of exacerbation of inflammatory periodontal diseases on the magnitude of the risk of exacerbation of this pathology, 3 degrees of prognosis probability were determined: low, medium, high. The use of the method of stepwise discriminant analysis made it possible to develop a system for predicting the possibility of an exacerbation of inflammatory periodontal disease and to scientifically substantiate the principles of identifying risk groups for the possibility of exacerbation of inflammatory periodontal diseases in this group of examination. For patients with a risk of exacerbation, dynamic observation was established for one year, before the beginning of which they were divided into 2 groups – the study and control. Patients in the study group underwent preventive treatment, which included the appointment of an appropriate diet, work and rest regimen, correction of the state of the immune system using immunomodulatory drugs, treatment of concomitant diseases and local treatment of inflammatory periodontal diseases. Patients in the control group underwent conventional prophylaxis, which included adherence to general rules: a rational regimen, a balanced diet, rational oral hygiene, and basic sanitary and educational work. Conclusion. As shown by the results of dynamic observation, among patients of the study group, exacerbation of the disease was observed in 14.3% of cases, in patients of the control group – in 42.5%, which corresponded to the likelihood of an exacerbation of the disease by 94.5%

Point-of-care ultrasound of the heart and lungs in patients with respiratory failure: a pragmatic randomized controlled multicenter trial

BackgroundPoint-of-care ultrasound is a focus oriented tool for differentiating among cardiopulmonary diseases. Its value in the hands of emergency physicians, with various ultrasound experience, remains uncertain. We tested the hypothesis that, in emergency department patients with signs of respiratory failure, a point-of-care cardiopulmonary ultrasound along with standard clinical examination, performed by emergency physicians with various ultrasound experience would increase the proportion of patients with presumptive diagnoses in agreement with final diagnoses at four hours after admission compared to standard clinical examination alone.MethodsIn this prospective multicenter superiority trial in Danish emergency departments we randomly assigned patients presenting with acute signs of respiratory failure to intervention or control in a 1:1 ratio by block randomization. Patients received point-of-care cardiopulmonary ultrasound examination within four hours from admission. Ultrasound results were unblinded for the treating emergency physician in the intervention group. Final diagnoses and treatment were determined by blinded review of the medical record after the patients´ discharge.ResultsFrom October 9, 2015 to April 5, 2017, we randomized 218 patients and included 211 in the final analyses. At four hours we found; no change in the proportion of patients with presumptive diagnoses in agreement with final diagnoses; intervention 79·25% (95% CI 70·3–86·0), control 77·1% (95% CI 68·0–84·3), an increased proportion of appropriate treatment prescribed; intervention 79·3% (95% CI 70·3–86·0), control 65·7% (95% CI 56·0–74·3) and of patients who spent less than 1 day in hospital; intervention n = 42 (39·6%, 25·8 38·4), control n = 25 (23·8%, 16·5–33·0). No adverse events were reported.ConclusionsFocused cardiopulmonary ultrasound added to standard clinical examination in patients with signs of respiratory failure had no impact on the diagnostic accuracy, but significantly increased the proportion of appropriate treatment prescribed and the proportion of patients who spent less than 1 day in hospital.Trial registrationhttps://clinicaltrials.gov/, number NCT 02550184.

A study profile and incidence of organophosphate poisoning at Gandhi hospital, Hyderabad, and Telangana- A three year study

Introduction: Nowadays, organophosphate (OP) compounds are widely used in agricultural field as an insecticide. Toxicity with these compounds is owing to inhibition of acetylcholinesterase enzyme. Patients are presented with muscarinic and nicotinic side effects. Objective: To study the clinical aspect of OP poisoning in detail with hospital stay, clinical course, complication, and recovery and mortality in OP poisoning. Materials and Methods: This study was done at Gandhi Medical College and in association with ayan Institute of Medical Sciences, Hyderabad India, comprising 271 cases of OP poisoning. After taking written consent, personal history of the patients was taken. Then, a detailed history regarding poison and clinical symptoms was taken. Then, general and systematic examinations of patients were carried out, and blood samples were sent for investigations. We followed up the patients till discharge or death. Result: In our study, maximum incidence of OP poisoning was in between 21-30 years age group (40%), and male to female ratio was 4:1. Clinical symptoms such as unconsciousness, stupor (90.47%), vomiting (9.42%), convulsions (66.00%) are froth at mouth and nostrils (62.00%) and the common symptoms whereas constricted pupils (85.71%), pulmonary oedema (88.00%), Tachycardia (76.17%), hypotension (28.57%)are the common signs noted in this series of cases who were treated in the hospital and where the hospital records were available. Post-mortem appearances no specific anatomic changes are found in acute poisoning the changes are suggestive os asphyxia. The appearances are external or internal. The histopathological findings are not significant. Histopathological examination of tissue revealed usually congestion of brain, oedema and congestion of lungs and fatty degeneration in liver and in some cases cloudy swelling and tubular necrosis in kidneys. Conclusion: Detailed history and thorough clinical examination of patients are helpful in diagnosin

A case report on Meigs’ syndrome and elevated serum CA-125: A rare case report

Meigs syndrome is an uncommon presentation, where a benign ovarian neoplasia presents along with ascites and pleural effusion. About 1% of ovarian neoplasia can present as Meigs syndrome. Patients with Meigs’ syndrome and elevated serum CA-125 are not frequently reported. We report a case of a 50-year-old women who presented with shortness of breath, cough, weight loss of one and half month duration. Chest radiograph of the patient with clinical examination of patient confirms pleural effusion as cause of progressive shortness of breath. The presence of a pelvic mass and elevated serum CA-125, which raised the possibility of malignancy. After complete resection of tumor, the pathologic reports confirmed a benign ovarian neoplasia. We highlight the importance of suspicion, careful general examination, radiological assessment and histological tests to confirm the diagnosis of Meigs’ syndrome.

Persistent phosphaturic mesenchymal tumor causing tumor-induced osteomalacia treated with image-guided ablation

Phosphaturic mesenchymal tumors (PMTs) can present with vague symptoms of diffuse bone pain with pathologic fractures that often lead to a delayed diagnosis. We present a 60-year-old patient with a PMT that was persistently hypophosphatemic after resection, who was then successfully treated with cryoablation of the tumor. Tumor-induced osteomalacia (TIO) is a rare cause of hypophosphatemia characterized by vague symptoms of gradual muscle weakness and diffuse bone pain with pathologic fractures that often lead to a delayed diagnosis. This condition is usually caused by benign phosphaturic mesenchymal tumors (PMTs). Here, we present a case of persistent PMT after surgical resection treated with image-guided ablation. We present the patient's clinical examinations and laboratory findings (phosphorus, 1,25 (OH)2D, FGF-23, Intact PTH). Representative histologic images of a PMT are also presented. A 61-year-old male was evaluated for persistent hypophosphatemia and presumed osteomalacia. Six years earlier, he underwent surgical excision of a left ischial mass after presenting with TIO. The pathology was consistent with a PMT; however, hypophosphatemia persisted suggesting incomplete resection. He was treated with calcitriol and phosphate salts. A PET Ga68 dotatate scan of the patient revealed an avid left ischial mixed lytic and sclerotic lesions with marked amount of radiotracer uptake, suggesting persistent tumor. The patient was resistant to re-excision of the tumor due to the extended recovery period from his prior surgery and was treated instead with cryoablation of the tumor. His biochemical findings of hypophosphatemia and elevated FGF23 resolved after the ablation and have remained normal for 5months after surgery. In patients with TIO, wide surgical excision is the treatment of choice. When this is not possible, image-guided ablation is an alternative therapeutic option.

Comprehensive Assessment of the Knee Joint Structures in Young Men and Men of the First Period of Adulthood Using Sonography

The aim of the study was to comprehensively assess the structure of the knee joint in young men and men of the first period of adulthood with normosthenic constitution using the ultrasonography technique.Material and methods. V.V. Bunak anthropometry technique (1941), B.A. Nikityuk and V.P. Chtetsov somatotyping (1990) and clinical examination of patients were used to form study groups, 25 people each with Pignet index from 17 to 23 without chronic diseases and pathology of the knee joint. Complex ultrasound examination was performed using ultrasound scanners "Sonoline G-60", Siemens (Germany), and Aloka 5500 Pro-Sound (Japan) with a linear transducer, 10 MHz frequency, and a convex transducer, 3.5 MHz frequency, in Ortho, Carotid and Abdomen modes with the "ZOOM" function. Morphometry was carried out using reference points. The obtained data were statistically processed by methods of variation statistics with a significance level of P≤0.05.Results. There was detected a significant increase in the transverse and vertical dimensions of the condyles of the femur, and an increase in the thickness of the anterior and posterior cruciate ligaments in men of the first period of adulthood compared with the young men. The articular cartilage tended to restructure, this was manifested in thinning of its hypoechoic component and thickening of the hyperechoic component; the appearance of surface defects was more pronounced on the tibia. Ultrasound examination did not reveal age-related changes in the menisci of the knee joint, patellar ligaments and collateral ligaments.Conclusion. Ultrasound examination of the knee joint in young men and men of the first period of adulthood allowed establishing age-related transformations of the condyles of the femur, cruciate ligaments and articular cartilage.

Infection prevention and control for COVID-19 in healthcare settings

In healthcare facilities, the initial response to emerging and reemerging infectious diseases, including COVID-19, requires systematic management. The first step is to establish an initial risk assessment and subsequent response flow, using a combination of triage and clinical examination for patients. Screening tests are performed for the early diagnosis of asymptomatic patients who are judged to be at low risk in the initial assessment. However, regardless of the test results, subsequent patient care should be taken cautiously to avoid inadequate initial evaluation at the time of admission, follow-up of symptoms and infection control measures after admission. The basic principle is standard precautions, with particular emphasis on compliance with hand hygiene. Universal masking for preventing transmission from asymptomatic/pre-symptomatic patients and reducing droplet emission and inhalation become the new essential precaution. For suspected/confirmed patients with COVID-19, surgical mask or N95 mask, gloves, gown, eye protection, and cap are basically used. The policy for personal protective equipment is made based on the medical environment of each facility. A negative pressure room is not always required but should be considered in high-risk environments, if possible. While the risk of transmission from the surface environment in a standard healthcare delivery system is limited, a continuous review of the facility environment is expected, considering the importance of ventilation.

Assessment of Hearing in Children with Cerebral Palsy.

The objective of this study is to identify the prevalence and nature of auditory analyzer pathology in children with different forms of infant cerebral palsy by recording otoacoustic emission and recording short latency brainstem auditory evoked potentials. The subject group consisted of 75 children, 40 (53%) males and 35 (47%) were females, ranging from 3 to 14 years of age with a confirmed diagnosis of cerebral palsy on the basis of a psycho-neurological hospital in Tashkent. (Uzbekistan). The examination of children was carried out by the following methods: clinical examination of patients (general and otorhinolaryngological) and functional research methods of the auditory analyzer. All children underwent acoustic impedancemetry, including tympanometry with determination of the type of tympanogram and acoustic reflex. The data obtained revealed a bilateral lesion of the peripheral part of the auditory analyzer. Beilateral sensorineural hearing loss was detected in 21 - I - II degree, in 12 - III degree and in 15 - IV degree. Marked changes in the main parameters of BAEP were detected in the study of the stem structures of the auditory analyzer in children with cerebral palsy. Thus, disorganization, configuration disturbances of the component composition (I, III, V) were noted. Thus, the study revealed a disorder of auditory function by sound-detecting type and justified the need for hearing correction in these children. Evaluation of auditory function made it possible to determine the level of auditory analyzer injury and localization of the process from the results of a complex, objective examination.

Оптимізація лікування та профілактики захворювань тканин пародонта у працівників деревообробної галузі промисловості Чернівецької області

Goal. Improving the scheme of treatment and prevention of periodontal diseases in workers of the woodworking industry of Chernivtsi region, who in the process of professional activity have long-term contact with unfavorable factors of the production environment. Materials and methods. 70 workers of the woodworking industry with diagnosed chronic generalized periodontitis of the I degree were treated (35 people – the main group (A); 35 people – comparison group (B)), age – from 25 to 45 years. To compare the results of laboratory studies, an additional survey of 25 healthy individuals of the same age with an intact periodontium were conducted. They formed the control group (C). Clinical examination of patients was performed according to standart methods: subjective (complaints, medical history, life history) and objective (examination, periodontal indices, determination of the level of gingival attachment). Laboratory methods of research included determination of urease and lysozyme activity in saliva, degree of dysbiosis of oral cavity. As maintenance therapy, patients of the main group were prescribed the proposed composition DEPE. Results. After the treatment, a significant improvement in the hygienic status of patients in both groups was observed, but difference between groups A and B in the indicators of oral hygiene after treatment was no statistically significant (pA2–B2 > 0.05). There was a significant improvement in periodontal indices after treatment in patients of both groups (PMA index according to C. Parma, bleeding index according to Muhlemann in Cowell I. modification, Russell periodontal index, PSR-test), but the indicators in patients of the main group were significantly better – pA2–B2 < 0.05. In patients of the main group (A) the level of attachment loss decreased by 1.83 times, comparison group (B) – by 1.71 times. The difference in levels of attachment loss after treatment between groups A and B is statistically significant (pA2–B2 < 0.05). The activity of the enzyme urease in patients of the main group (A) and comparison group (B) after treatment was significantly reduced (pA1–A2 < 0.001, pB1–B2 < 0.001), but only in the main group it reached the level in the control group (C) (pA2–C > 0.05). The level of lysozyme after treatment was significantly increased in patients of both observation groups (pA1–A2 < 0.001, pB1–B2 < 0.001), and reached the level of lysozyme in patients of the control group (C) (pA2–C > 0.05, pB2–C > 0.05). The degree of oral dysbiosis in patients of the main group (A) was significantly reduced by 5.43 times (pA1–A2 < 0.001), and its difference from the degree of dysbiosis in patients of the control group (C) is statistically insignificant (pA2–C > 0.05 ). The degree of oral dysbiosis in patients of the comparison group (B) was significantly reduced by 3.04 times (pB1–B2 < 0.001), but still remained significantly different from oral dysbiosis in patients of the control group (C) (pB2–C < 0.05). Conclusion. The proposed pharmacological composition DEPE is an effective antiseptic solution and can be used in the phase of maintenance therapy to improve the treatment and prevention of periodontal disease in workers of woodworking industry. Key words: decamethoxine, propolis, ethonium, generalized periodontitis, woodworking industry.

SARS-CoV-2 Infection (COVID-19) Revealed by Persistent Hiccups: A Case Report

Hiccups are a ventilatory mechanism involuntarily involving the inspiratory muscles and the glottis, Its physiological interest has not been demonstrated until today. Acute or chronic hiccups have a wide variety of etiologies. We report the case of a 50-year-old patient with a history of iterative sinusitis, who consulted a gastroenterologist for persistent hiccups. The patient's clinical examination was normal. Chest x-ray showing an abnormal mediastinal image leads to a chest CT scan showing a typical picture of COVID-19 virus infection: bilateral and peripheral frosted glass opacities. A nasal swab RT-PCR test confirmed the diagnosis. Admitted to an isolation unit, the patient received treatment with clinical and biological monitoring. The hiccups disappeared around the 3rd day of hospitalization, the negativation of the RT-PCR occurring after 14 days with a favorable evolution of the symptoms. To our knowledge, this is the 2nd global case of persistent hiccups that has revealed infection with the COVID-19 virus.

Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis.

Intra-articular injections of platelet-rich plasma (PRP) and other novel blood-derived products developed specifically for osteoarthritis (OA) can provide pain relief and potential benefits in disease progression. Meta-analyses show the clinical superiority of PRP compared with other intra-articular injections, but results are modest and the effect sizes are small. PRP injections in knee OA are performed indiscriminately, but the clinical response varies enormously between patients because of an array of mixed OA phenotypes. Subgroup analyses are scarce; some studies stratify patients according to radiographic severity and found better results in early OA, without consensus for more advanced stages of the condition. Parallel identification of soluble and imaging biomarkers is essential to personalise and leverage PRP therapies. The inflammatory phenotype is most interesting from the PRP perspective because PRPs modulate inflammation by releasing a large pool of chemokines and cytokines, which interact with synovial fibroblasts and macrophages; in addition, they can modulate the innate immune response. No soluble biomarkers have been discovered that have implications for OA research and PRP interventions. Clinical examination of patients based on their inflammatory phenotype and imaging identification of pain sources and structural alterations could help discern who will respond to PRP. Synovial inflammation and bone marrow lesions are sources of pain, and intra-articular injections of PRP combined with subchondral bone injection can enhance clinical outcomes. Further refining ultrasound phenotypes may aid in personalising PRP therapies. Intra-articular delivery combined with injections in altered ligamentous structures, medial and coronal ligaments or premeniscal pes anserinus showed positive clinical outcomes. Although the evidence supporting these approaches are weak, they merit further consideration to refine PRP protocols and target the right OA phenotypes.

The quality of clinical examination of patients with nerological diseases in family polyclinics

The problem of the quality of medical examination in the new economic conditions is one of the most urgent in health care. In the Concept for the development of health care and medical science in the Republic of Uzbekistan, much attention is paid to the quality and efficiency of clinical examination. In recent years, a number of works [1-3] have been published on certain aspects of prophylactic medical examination of the population, but so far not enough research has been conducted to study its quality.

ДОСВІД ЗАСТОСУВАННЯ БРОНХИПРЕТУ-СИРОПУ У ДІТЕЙ ДОШКІЛЬНОГО ВІКУ З ГОСТРИМ БРОНХІТОМ І АТОПІЧНИМ ФОНОМ

Keywords: acutebronchitis, atopicdermatitis, children, Bronchipret. Acute bronchitisis a topical issue in pediatrics and one of the most common reasons for seeking medical attention. In children with anallergic background, special requirements are made for the treatment of acute bronchitis, as treatment should notincrease the allergy of the body. Objective: to study the effectiveness and safety of the drug Bronchipret syrup in children with acute bronchitis and atopic background. Materials and methods. The study in volved 30 children 3- 7 years old with acute bronchitis with a burdensome anamnesis of allergic diseases. Allergic background was assessed by serum IgE levels in blood serum. During treatment, all children received the drug Bronchipret syrup 3 times a day for 10 days. Repeated clinical examinations of patients were performed for 3, 5, 7 and 10 days from admission to the hospital. Results. Against the background of complex treatment with the inclusion of the drug Bronchipret, the intensity of fever and intoxication syndrome were significantly lower on the 3rd day of hospital treatment and on the 5th day in the vast majority of children disappeared. Improvement in the discharge of nasal and bronchial secretions was observed on the third day of therapy. Increase in eosiophil content wasn’t observed in any child during treatment. Within 10 day softreatment, significant changes in serum Ig E didn’t occur. Thus, at the beginning of the rapy it was in the range of 38.3 ± 1.3 kU / l, after 10 days – 36.8 ± 1.1 kU / l. Conclusions. Thedrug Bronchipret syrup has shown good efficacy and safety, no allergic complications in children with acute bronchitis and allergic background and can be recommended for useinpediatric practice.