Chronic Foci Of Infection Research Articles

TANNERELLA FORSYTHIA AS ONE OF THE PREDICTORS OF THE SEVERITY OF CHRONIC GENERALIZED PERIODONTITIS

Chronic generalized periodontitis ranks second in prevalence among diseases of the maxillofacial region in the world. The high importance of the problem of the incidence of chronic generalized periodontitis among modern society is determined by early tooth loss, decreased chewing efficiency, and the formation of chronic foci of infection. It is known that the main factor in the etiology of chronic periodontitis is microbial. One of the representatives of this flora is Tannerella Forsythia, which is a gram-negative, anaerobic bacterium. The aim: to verify T. Forsythia in chronic generalized periodontitis, depending on the severity of the disease. Materials and methods: the total number of patients with chronic generalized periodontitis for scientific research was 126 patients. The patients of all the studied groups were taken from the periodontal pocket, and the control group had the contents of the gingival furrow. All samples were examined by PCR with the detection of results in real time on the DT-96 detecting amplifier of NPO DNA Technology LLC with the Periodontoscreen kit. The results of the study: the value of the correlation coefficient was 0.997 p(0.05), which indicates a direct strong relationship between the occurrence of this microorganism and the severity of the disease. Based on the conducted study, a direct strong relationship (0.948 p(0.05)) was revealed between the concentration of the genomic equivalent of Tannerella Forsythia and the severity of chronic periodontitis. Conclusion: as a result of the study, a direct correlation was found between an increase in the genomic equivalent and an increase in the degree of destructive changes in periodontal tissues. Thus, the results obtained confirm that the concentration of Tannerella Forsythia is a predictor of the severity of chronic periodontitis.

Placental alkaline phosphatase is a biocatalyst of metabolic dysfunctions of the placenta

The parameters of the enzyme involved in biologically important reactions occurring in an open thermodynamic system — the body of a pregnant woman during the gestational period — were studied. The role of an unfavorable premorbid back ground has been established: infectious diseases, repeated exacerbations of chronic inflammatory processes during prolongation of pregnancy, risk factors for perinatal complications, which causes certain morphofunctional changes in the placenta, form ing placental insufficiency. Pregnant women associated with diseases of the genitouri nary system are more often susceptible to infection. Ultrasound examinations made as part of screening the physiology of the system: mother — placenta — fetus, revealed changes in the structure of the placenta, which indicated a disruption in the relationship between the nascent embryo and the mother’s body, and ultimately manifested itself as violations of compensatory and adaptive mechanisms in the placenta, more pronounced in the sample, burdened by the presence of chronic foci of infection. The dependence of disturbances in the functional ability of the placenta on the level of the enzyme — thermostable alkaline phosphatase specific for it — was revealed. At the same time, a change in the activity of this enzyme was observed, which determined the compensatory capabilities of the provisional organ. In patients with an increased infectious index and placental dysfunction, unstable values of a specific placental enzyme are observed, as evidenced by an unfavorable course of pregnancy, accompanied by the threat of miscar riage and premature birth. These disorders occurred during prolongation of pregnancy and during the process of delivery. A significant decrease in the activity of placental alkaline phosphatase and a decrease in its relationship to alkaline phosphatase were es tablished. The worst indicators reflecting the intrauterine development of the fetus were observed in the sample with placental dysfunction and the risk of infectious complica tions, which was associated with delayed fetal development, and the birth of children with a combination of signs of intrauterine suf fering and hypoxia.

Comprehensive assessment of the effectiveness of diagnosis and treatment of patients with chronic apical periodontitis based on microbiological and joulemetric research methods

Background. An increase in the number of patients with chronic apical periodontitis is becoming a global trend, which is mediated by several factors: the formation of foci of chronic infection, an increase in the number of various odontogenic complications leading to the loss of a causal tooth, a decrease in general resistance and the development of persistent sensitization of the body.The aim of the study was to evaluate the effectiveness of diagnostic measures based on a complex of microbiological and joulemetric methods in patients with chronic apical periodontitis.Materials and methods. 25 patients with the established diagnosis of «chronic apical periodontitis» were examined. Microbiological and joulemetric analyses of the root canal system were performed before and at the stages of treatment using the delayed obturation method, which provides for intra-channel administration of a preparation of highly dispersed calcium hydroxide.Results. The comprehensive analysis of the results of bacteriological and joulemetric studies of the contents of the root canal system in the examined patients at the diagnostic and treatment stages fully corresponded to the clinical picture of the course of this nosological form and reflected the dynamics (negative and positive) of the inflammatory process in the studied periapical region.Conclusions. The combined use of microbiological and joulemetric techniques increases the effectiveness of therapeutic and diagnostic measures in patients with chronic apical periodontitis, which in turn reduces the risk of possible complications and improves the effectiveness of immediate and long-term therapy results.

Analysis Of Risk Factors For Hypoxic Damages Of Newborn`S Central Nervous System

Currently, perinatal damage to the central nervous system of newborns occupies an important place in the structure of pathology of young children, which is associated with high prevalence, severity of clinical manifestations and the risk of disability formation. The purpose of our study was to determine the significance of risk factors for the development and to develop criteria for the severity of hypoxic-ischemic CNS damage in newborns. We examined 120 newborns with moderate to severe perinatal CNS damage. The examination consisted of the collection of maternal history, which included information on somatic and gynecological diseases, the course of this pregnancy, childbirth, general clinical examination methods, examination of a newborn with an assessment of somatic and neurological status. The results of the study showed that modifying risk factors for the development of moderate perinatal encephalopathy are the threat of miscarriage, toxicosis, the age of the mother over 35 years old, moderate anemia, acute upper respiratory tract infections, gynecological pathology, taking antifungal drugs, rapid and protracted childbirth, weak birth activity. We also found that the modifying risk factors for the development of severe perinatal encephalopathy are stillbirth, bad habits in the father, closely related marriage, obesity, chronic foci of infection, acute bacterial infectious diseases, urogenital infection, NSAIDs, rapid and protracted childbirth, chronic fetal hypoxia.

Peri-wound skin lesions of allergic nature

Peri-wound dermatoses are a fairly common occurrence in clinical practice. In general, they are all allergic in nature and occur on the skin around the surface area of both primary and postoperative wounds. Peri-wound skin lesions can develop as paratraumatic eczema, simple contact or allergic dermatitis. All these dermatoses can be complicated by a secondary bacterial or mycotic infection, both exogenous and endogenous, which significantly complicates the course of the dermatitis itself and wound healing. The patient is exposed to a fairly large number of potential allergens in the course of surgical care provided at all stages: both in the pre- and postoperative period, and during the surgical intervention. Among them may be drugs and antiseptics, surgical sutures, implants, and even latex gloves of healthcare practitioners in some cases. When it comes to potential allergens, foci of chronic infection in the patient’s body, as well as secondary wound infections should be noted as a separate matter. The presence of peri-wound dermatoses is the most common cause of delayed surgical debridement, and can also become an obstacle to surgical treatment and healing of the wound surface. In addition, pre-existing paratraumatic eczema can progress to a chronic course and contribute to the further spread of the inflammatory process. Thus, peri-wound dermatoses are a pressing interdisciplinary issue. Patients with peri-wound dermatoses require a personalized selection of combination therapy and additional consultative assistance from highly specialized doctors. Fixed-dose topical glucocorticoids combined with antibiotics and antimycotics may be the drugs of choice for patients with peri-wound eczematous process, with due account for complex pathogenetic effects and ease of use. The article describes clinical cases of dermatoses developed in surgical patients.

КОМОРБИДНОСТЬ ЗАБОЛЕВАНИЙ ПОЛОСТИ РТА И ВНУТРЕННИХ ОРГАНОВ

Abstract. Introduction. Literature analysis is presented showing the existence of both phylogenetic and functional interrelation of internal diseases and oral-cavity diseases. Comorbidities contribute to the patients’ longer stay in hospital, reduce the quality of measures taken to prevent disabilities, and increase the number of post-surgical complications. Aim of the study is a review of the current information on the functional relationship between internal diseases and oral-cavity diseases. Material and Methods. Published topical studies were studied that deal with investigating the mechanisms of the relationship between oral infections and secondary systemic manifestations. Results and Discussion. Data are presented on the pathogenetic unity of the occurrences of somatic and dental diseases. Causal relationships are substantiated between them, arising from the impaired immunologic balance, interleukin regulation, and nonspecific resistance in human body. We noticed the negative comorbidity of internal and oral-cavity diseases, namely, the dependence of dental diseases on the general body condition and the influence of chronic infection foci in the oral cavity on the development of common diseases. Odontogenic transient bacteremia was proven at the dentist’s office, and conditions are shown for its transformation into any infectious disease. We identified the need for unified systemic approaches to the treatment of polymorbid pathology. Conclusions. Influence of comorbid pathology on clinical manifestations, diagnoses, prognoses, and treatment of many diseases is multifaceted and individual.

Risk factors of recurrent respiratory infections in early school-age children

Acute respiratory infections (ARIs) annually rank first in the structure of infectious diseases both in Ukraine and worldwide. ARIs are the leading cause of disability and death in preschool children, and with recurrent episodes, they can impact the physical and psychological aspects of children's health, imposing a significant medical burden on families, healthcare systems, and society as a whole. Preventing recurrent respiratory infections (RRIs) can only be achieved through timely intervention in risk factors.Aim: to determine the influence of risk factors on the development of recurrent episodes of acute respiratory infections in children aged 5 to 7 years and to develop preventive measures for their control in primary healthcare settings.Materials and Methods. The authors retrospectively analyzed medical records of 342 children aged 5 to 7 years. The main group included children with RRIs (264), and the control group consisted of children with sporadic illness episodes (78). Results: the incidence of RRIs in children has two peaks at ages 3 and 6, which is likely associated with the commencement of attendance in childcare settings (kindergarten and school). Key prenatal and postnatal, clinical-anamnestic, and social risk factors that increase the likelihood of recurrent respiratory infections in younger school-age children were identified.Conclusions. factors significantly increasing the likelihood of developing RRIs in a child include: ARI episode within the first 6 months of life (OR = 22, 95% CI 11.6 - 41.7), previous pneumonia (OR = 12, 95% CI 3.7 - 40), and the presence of chronic infection foci in the form of tonsillitis (OR = 8.2, 95% CI 4.3 - 15.6), p=0.0001. Primary healthcare practitioners should follow strategies to modify these risk factors and not wait for further depletion of the child's adaptive potential (sanitation of chronic infection foci, promotion of breastfeeding, and tobacco cessation).

Concomitant infections in children with allergic pathology in the Kaliningrad region

The aim of our work was to study the structure and prevalence of the infectious syndrome in children from Kaliningrad Region with moderate-to-severe allergic pathology, with a complex manifestations of allergic reactions, both on skin and on the mucous membranes of the digestive and respiratory tract.
 Ninety children from 0 to 18 years old with various symptoms of allergic pathology were examined and included in the study group using standard clinical, objective and laboratory criteria. The severity of clinical course was associated with the severe and long-lasting symptoms, as well as with frequent bacterial and bacterial-fungal complications, with impaired quality of life and night sleep. The children were consulted by the specialists in otorhinolaryngology, hematology, pulmonology, surgery, ophthalmology, infectology, endocrinology, cardiology. Diagnoses according to nosological forms were made in accordance with the current clinical recommendations of Russian Ministry of Health. Our article presents data on concomitant infectious diseases and their impact on general condition and severity of hypersensitive responses. The average age of allergic manifestations in the group of children was 3.12±2.72 years. The average duration of the disease in the observed group was 7.5±0.88 years. The number of boys in our group prevailed (n = 56) by 1.6 times. Complicated heredity factors were reported by 15% of the patients’ parents. However, with careful collection of medical history taking, upon dynamic observation, the aggravated heredity on the mother’s side was detected in 45.56% (n = 41), and on the father’s side, in 31.1% of cases (n = 28). In eight families, both parents suffered from allergic pathology, in siblings, 21.1% (n = 19) of the examined children had allergies. In the families, including grandparents, allergic pathology was reported in 56 cases (62.2%).
 Almost all patients had problems with nasal breathing, 77 (85.6%) children with adenoid hypertrophy had a habit of breathing through the mouth. Postnasal drip syndrome was found in 78 cases. Allergic rhinitis with adenoid hypertrophy is, generally, accompanied by postnasal leakage, which can provoke aspiration bronchitis and pneumonia, especially if pathogenic or opportunistic flora is transferred to the nasal cavity and/or to the pharynx.
 Conclusions: 1. Identification and rehabilitation of chronic foci of infection, bacterial, fungal, should be a necessary component of the personalized therapy of allergic pathology in children. 2. In cases of recurrent sowing or finding of pathogenic flora (iodophilic flora, fungi, coccal flora) in the coprogram, one should exclude not only transient lactase deficiency, but also congenital lactase deficiency, thus preventing development of enterocolitis in the future like as worsening of skin status and respiratory manifestations. 3. In case of severe respiratory viral infections in children during the period of adaptation for pre-school institutions, one should exclude sensitization to allergens of house dust mites and epidermal allergens of domestic animals. 4. A comprehensive and personalized approach to the diagnosis of allergic disorders and comorbid conditions enables us to create conditions for stable remission, making it possible to conduct allergen-specific immunotherapy, which may provide a disease-modifying effect upon the hyperreactive states in our patients.

SPESEFIC CHANGES IN SALIVA CONTENT IN ORAL SOFT TISSUE LESIONS IN YOUNG SCHOOL-AGED CHILDREN

The high level of dental morbidity of the child population remains an urgent general medical and social problem. It is known that dental caries and its complications, being chronic foci of oral infection, can lead to premature tooth loss, as well as contribute to the development of focal-conditioned diseases. At the same time, despite the active development of therapeutic measures for patients with dental caries, some problems of its prevention remain unresolved. It should be noted that knowledge of the quantitative and qualitative characteristics of the composition and properties of mixed saliva in school-age children is important in improving the effectiveness of preventive measures. It should be noted that dental caries has a polyfactorial genesis, which is associated with the aggressive effects of exogenous and endogenous factors.

MEDICAL AND STATISTICAL CHARACTERISTICS OF PATIENTS WITH ODONTOGENIC PHLEGMONS (BASED ON THE MATERIALS OF THE REPUBLIC OF UZBEKISTAN)

In the clinic of purulent maxillofacial surgery, one of the most acute problems is odontogenic phlegmons arising from the spread of pathogenic origin from the focus of chronic infection of the so-called "causal" tooth, which is associated with the severity of the purulent process itself, the rapidity of its spread to neighboring cellular spaces, a high risk of severe complications and frequent death]. The problem under consideration has not only medical, but also important socio-economic significance. The aim of the work was to study the prevalence of odontogenic phlegmon in the Republic of Uzbekistan to identify the main trends in the development and course of this pathology. Materials and methods. 845 case histories of patients with odontogenic phlegmon hospitalized in the hospital of maxillofacial surgery of the Department of adult maxillofacial surgery of the Tashkent State Dental Institute in the period from 2019 to 2021 were studied. Statistical processing of the research results was carried out using Microsoft Excel 10 application programs and the STATISTICA for Windows 6.0 statistical package (Statsoft, USA) by the method of variational statistics using the Student's parametric criterion. We also used a statistical research method – Pearson Chi-squared. Results of the study. There was an increase in the number of patients with odontogenic phlegmon, among whom residents of the districts of the Republic of Uzbekistan prevailed and were most often found among people of working age. The odontogenic "cause" in most cases were the molars of the lower jaw. The structure of morbidity was dominated by odontogenic phlegmons of one cellular space. Most of the hospitalized patients, bypassing the pre-hospital stage, went to the hospital on their own. Findings. Given the increase in the number of patients with odontogenic phlegmon, the issues of their prevention and effective treatment remain relevant.

THE ROLE OF ENDODONTICS IN THE TREATMENT OF CHRONIC ODONTOGENIC DISEASES IN PREPARATION FOR PROSTHETICS

Background. When planning orthopedic restoration of significantly destroyed teeth with signs of apical periodontitis, it is necessary to assess the complexity of root canal anatomy as one of the factors influencing successful endodontic dental treatment. Modern approaches in endodontics allow in most cases to achieve the restoration of bone tissue, as well as the elimination of the focus of chronic infection, which allows for subsequent orthopedic dental treatment in order to restore their function and increase the percentage of survival in the oral cavity.
 Purpose. Improving the efficiency of orthopedic restoration of teeth with chronic odontogenic infection.
 Materials and methods. 64 patients aged 18 to 45 were examined. All had clinical signs of failed endodontic treatment of the incisors in the upper and lower jaws with a dark, radiolucent focus in the apex region, as well as significant destruction of the crown requiring orthopedic restoration. The assessment of radiographic parameters was based on CBCT, and mobility was assessed clinically. The results were evaluated after 6, 12, and 24 months.
 Results. All patients showed different signs of restoration of the bone tissue after 6 and 12 months and complete restoration of the bone tissue 24 months after the treatment. No pathological tooth mobility was found 24 months after the end of treatment in 100% (primary endodontic treatment) and 97.5% (repeated endodontic treatment) of patients.
 Conclusion. The analysis of the anatomy of the root canals, and, accordingly, the complexity in biomechanical cleaning and washing of the root canals affects the decision to carry out treatment in one or two visits.

EFFECTIVENESS OF СOMBINED REHABILITATION THERAPY IN KIDS WITH METABOLIC SYNDROME

Abstract The work carried out a multivariate study of the mechanisms of metabolic disorders, closely related to an increase in blood pressure in children with arterial hypertension from 10 to 17 years. For this purpose, 60 children with arterial hypertension and metabolic disorders were examined. 20 children made up the control group. Before and after spa treatment, all children underwent a set of clinical and laboratory examinations, which included daily monitoring of blood pressure, biochemical studies of lipid and carbohydrate profiles, insulin, insulin resistance indices HOMO and CARO, leptin, adiponectin. Besides the individual hypocaloric diet, the rehabilitation included proper physical activity, school of arterial hypertension, not allowing for a child to sit at the computer or watch TV for a long time (or at all), treatment of foci of chronic infection (including pelotherapy and inhalations), sedative aero-phytotherapy, aero-ionotherapy, exercise therapy in either arterial hypertension or obesity group, classical hand massage of the neck and shoulders, electrosleep therapy. Depending on the treatment received the children with arterial hypertension (n=60) were divided into three groups (using the method of simple randomisation). The use of balneotherapy and electrosleep therapy in complex spa treatment contributes to the normalization of initially disturbed biochemical carbohydrate and lipid metabolic markers, a decrease in high levels of leptin and insulin, and an increase in initially reduced adiponectin. This allows us to conclude that the combined sanatorium-resort rehabilitation of patients is highly effective, which is expressed in a decrease in blood pressure, body weight, indicators of fat and carbohydrate metabolism. Intensive spa treatment has a beneficial effect on changing the criteria for the development of MS in children with obesity and hypertension. Of course, to achieve the optimal effect in the correction of disorders of carbohydrate and lipid metabolism, a long period of therapeutic measures and observation of patients is required, at least 3-6 months.

EFFICACY OF PRIMARY REHABILITATION MEASURES ASSOCIATED WITH THE DEVELOPMENT OF RECURRENT BRONCHIAL OBSTRUCTION SYNDROME IN YOUNG CHILDREN WITH RESPIRATORY DISORDERS IN NEONATAL PERIOD.

The aim: To improve primary prophylactic measures associated with the development and progression of recurrent bronchial obstruction syndrome in young children, who had suffered respiratory disorders in neonatal period. Materials and methods: Algorithm of primary prophylactic measures implied adequate balanced nutrition, sanation of living conditions, restriction of contact with infectious agents, sanation of chronic foci of infection, systematic training and general fitness. The investigation included 160 young children (1 day - 3 years of age). The basic group (n=80) involved children, who had experienced respiratory disorders in neonatal period and received appropriate respiratory therapy (artificial ventilation and / or spontaneous breathing with continuous positive airway pressure and supply of free oxygen), control group - children, who did not have respiratory disorders and respiratory therapy (n=80). Results: Conducted investigation throughout 12-month monitoring enabled to record the development of recurrent bronchial obstruction syndrome in 43 children (respectively, 30 - 37.50% patients of the basic group versus 13 - 16.25% of control group; p 0.05), could not be obtained. Conclusions: Comparative analysis within groups did not show a reliable difference in the development of recurrent bronchial obstruction syndrome in children (р>0.05), which can be explained by partial following of doctor's recommendations. There is the need in further study of the issue involving more patients for a longer period of monitoring.

Experience in the phytotherapy use for rehabilitation of adolescents with recurrent respiratory diseases

Introduction. The state of modern Russian adolescents health is characterized by negative trends such as high level of morbidity, largely due to recurrent acute respiratory diseases (ARI). Recurrent acute respiratory infections negatively affect the health of adolescents, contributing to the development of chronic infection foci, having a negative impact on their physical development and psychoemotional status. Many approaches have been proposed for the rehabilitation of adolescents with recurrent acute respiratory infections, but in recent years phytotherapy has attracted the attention of researchers.Aim. The study is to analyze the experience of using phytotherapy in the rehabilitation of adolescents with recurrent respiratory diseases.Materials and methods. 124 adolescents aged 13–18 years with recurrent acute respiratory infections were examined. The control group consisted of 50 conditionally healthy adolescents. The artificial colonization of buccal epithelial cells, anti-adhesive activity of saliva and level of psychic adaptation were determined. In addition to the generally accepted measures, the herbal medicine was included in the rehabilitation complex for 51 adolescents. Statistical processing of the obtained data was carried out using the SPSS 12.0 program.Results. A decrease in oral mucosa adaptive stability in adolescents with recurrent respiratory diseases during the period of clinical well-being was found – such as decrease of anti-adhesive activity of saliva, increase artificial colonization of buccal epithelial cells index. The prevalence of persons with psychic desadaptation among adolescents with recurrent acute respiratory infections was revealed. The positive clinical effect of the herbal medicine in improving the health of adolescents with recurrent respiratory infections, manifested by the end of the course of therapy by an increase in the adaptive resistance of the oral mucosa in the most of patients, and at the follow-up period of 6 months – an increase in the immune resistance and psychic adaptation.Conclusions. The use of herbal medicine effectively restores the reserves of oral cavity mucosal protection, psychic adaptation and reduces the number of acute respiratory infections. The drug has good tolerability and can be recommended for use in a complex of recreational activities for adolescents with recurrent respiratory diseases.

Risk factors for the development of retinopathy in premature infants

Background. Retinopathy of prematurity is one of the disabling conditions in premature babies. Despite the fact that the main predictors for the development of retinopathy of prematurity are known, the factors that can potentially cause it require further study. The purpose was to determine risk factors for the development of retinopathy in premature newborns for better control. Materials and methods. A retrospective analysis of 50 medical records of inpatient premature babies with a gestational age of 28–34 weeks and the medical charts of their mothers was carried out. Two groups were distinguished: the first one — 29 children with retinopathy, the second one — 21 patient without retinopathy. Results. The vast majority of children — 38 (76.0 %) were born at a gestational age of 28–31 weeks. Differences between groups were not significant. The analysis showed that 14 (48.3 %) premature children were diagnosed with stage I retinopathy, 6 (20.7 %) — with stage II, 5 (17.2 %) — with stage ІІІ and 4 (13.8 %) — with stage IV. The most influential risk factors for the development of retinopathy of prematurity were identified. The presence of retinopathy significantly correlated with gestational age of less than 34 weeks (ρ = 0.64, p < 0.001), need for oxygen subsidy ≥ 40 % (ρ = 0.59, р < 0.001), development of bronchopulmonary dysplasia (ρ = 0.34, р < 0.01), sepsis (ρ = 0.59, р < 0.001), intraventricular hemorrhages (ρ = 0.56, р < 0.001). It was also found that the presence of a burdened maternal history in the form of chronic foci of infection and chorioamnionitis is a significant risk factor for the development of retinopathy (ρ = 0.56, р < 0.001). Moreover, the presence of an infection in the mother increased the risk of retinopathy stage III–IV in a child by 3.8 times (p < 0.05), and stage I–II retinopathy — by 5 times. With a combination of chorioamnionitis and chronic foci of infection, the risk of developing severe retinopathy was almost 95 % (р < 0.007). Conclusions. Burdened maternal history in the form of chronic foci of infection and/or choriamnionitis is an important risk factor for the development of retinopathy in children. Chorioamnionitis is a predictor of severe retinopathy. Treatment of chronic foci of infection in pregnant women should be considered as a mandatory measure to prevent retinopathy in premature newborns.

Oral active matrix metalloproteinase-8 immunotest may be less accurate in haemato-oncologic patients.

This study examines the associations of active matrix metalloproteinase-8 (aMMP-8) point-of-care immunotest (Periosafe) outcomes with oral health of patients with haemato-oncologic diseases. Adult patients diagnosed with haematological diseases aimed to be treated with haematopoietic stem cell transplantation (HSCT) between 2018 and 2019 were included in the study. Clinical and radiological dental examination were taken immediately prior to transplantation. The presence of oral foci of infections, caries or periodontitis was examined and compared with the outcomes of aMMP-8 immunotest. Acute oral infection foci were present in 11.9%, chronic in 44.1% and periodontitis in 42.0% of the 143 subjects. aMMP-8 immunotest was positive in 13.3% of all the 143 subjects. Among subjects with periodontitis (n=60), the aMMP-8 immunotest was also positive in 13.3% of these subjects. However, the subjects with positive aMMP-8 immunotest (n=19) had more often acute or chronic infection foci and more than one of the examined dental treatment needs compared with subjects with negative immunotest (all p < 0.05). There were no differences in age, sex, hyposalivation, DMFT-index values nor with plasma levels of leukocytes, neutrophils or C-reactive protein between subjects with positive or negative aMMP-8 immunotest. aMMP-8 immunotest accuracy might be reduced, in relation to periodontitis, in haemato-oncologic patients.

ФИЗИОТЕРАПЕВТИЧЕСКИЕ МЕТОДЫ В КОМПЛЕКСНОМ ЛЕЧЕНИИ КРАСНОГО ПЛОСКОГО ЛИШАЯ СЛИЗИСТОЙ ОБОЛОЧКИ РТА

Abstract. Over the past five years, the number of patients has increased, especially after suffering a coronavirus infection COVID-19, with manifestations of lichen planus on the oral mucosa. Objective. Improving the effectiveness of complex therapy of lichen planus of the oral mucosa with the use of physiotherapeutic methods of treatment. Materials and methods. Under supervision in the clinic of the Department of General Dentistry of the Military Medical Academy n. a. SM Kirov, there were 26 patients, aged 35 to 62 years, 19 women and 7 men, with a diagnosis of Lichen planus, erosive-ulcerative form. All patients with lichen planus underwent a general clinical dental examination, and the dynamics of reparative processes was monitored. Treatment of all patients began with the sanitation of the oral cavity, which included filling carious cavities, extraction of teeth in order to eliminate foci of chronic infection, and the exclusion of traumatic factors. If necessary, patients were recommended rational prosthetics. Patients were divided into 2 groups, depending on the local treatment. By age, sex and forms of the disease, the control and working groups were comparable. The first group - 12 people (46.15%) were patients who received only drug treatment (general and local). In the second group - 14 people (53.85%), there were patients who were included in the treatment complex sessions with diode laser radiation of red light with a wavelength of 665 ± 15 nm, a frequency of 80 ± 5 Hz for 10 days, every other day (5 procedures). Also, every other day (5 procedures) sessions of ultraphonophoresis were performed on the elements of the lesion with 0.5% hydrocortisone ointment. Results and discussion. Papules epithelialization processes were monitored on the 7th, 10th and 20th days, pain sensations were assessed on a visual analogue scale. The effect of the treatment in the first group was significantly lower than in the second group. Conclusion. Treatment of lichen planus should be complex, including physical factors, and individual, with the involvement of specialists from other profiles.

Концептуальный подход к диагностике и лечению офтальморозацеа

The aim of the work is to study the variety of clinical manifesta-tions, the effectiveness of the treatment of ophthalmic rosacea with the use of anti-bacterial, antiparasitic, desensitizing drugs of general and local action, lubricants. An important aspect is the elimination of chronic foci of infection, the treatment of concomitant diseases, the restoration of the immune and endocrine status. Keywords: ophthalmic rosacea, clinical types, diagnostics and treatment.

Structural features of the roots and root canals of mandibular premolars and molars based on data of modern radiological methods of investigation used in dentistry

Objective. To determine the structural features of the root canals of mandibular premolars and molars, to assess the quality of endodontic treatment on the basis of cone-beam computed tomography (CBCT).Materials and methods. The structure of 50 teeth (premolars and molars of the mandible) after performed endodontic treatment was studied retrospectively on the basis of CBCT in 50 patients. The number of roots, as well as root canals and their angle of inclination, the presence of additional canals were taken into account. The obtained data were processed statistically.Results. No significant differences in the angle of inclination of the root canals and the number of roots were found. The ratio of unsatisfactory episodes of endodontic treatment was 82 %. Destructive processes in the periapical region were revealed in all the examined teeth.Conclusion. The results of the study prove the neсessity to develop the differentiated use of surgical methods for the treatment of foci of chronic odontogenic infections in the periapical region of mandibular molars and premolars.

Infectious complications of atopic dermatitis

Atopic dermatitis is a chronic inflammatory skin disease linked to a genetic predisposition and accompanied by acute inflammatory manifestations that develop due to abnormality of skin barrier properties and changes in both innate and adaptive immune responses. The high risk of developing complications of this disease caused by skin and systemic infections is one of the most urgent problems of modern health care. However, infectious complications of atopic dermatitis may include skin and soft tissue infections, herpetic eczema, bacteremia, osteoarthritis, myelitis, septic arthritis, and endocarditis. Skin barrier defects, type 2 immune-mediated inflammation, Staphylococcus aureus colonization, and skin dysbiosis are main predisposing factors for an increased incidence of infectious complications of atopic dermatitis. The development of infectious complications of atopic dermatitis may be prevented by comprehensive treatment of exacerbations of the underlying disease, sanitation of chronic infection foci, as well as restoration and maintenance of the skin barrier function. The use of special moisturizers and emollients for skin care during exacerbation and remission is an important and integral part of therapeutic and preventive measures.Emollients are medical cosmetic products that are close to the natural lipid skin barrier in composition. They not only effectively soften and moisturize the skin, but also restore damaged protective properties. Additional components of emollients with anti-inflammatory and antimicrobial activity are an optional, but desirable condition to prevent recurrence of the disease and reduce the risk of developing a secondary infection. Thus, not only special skin care drugs, but also products for patients with atopic dermatitis, can contribute to the development of antibacterial protection and prevent the development of infectious complications.