General Somatic Pathology Research Articles

On the issue of the effect of bronchial asthma on the condition of the oral cavity

Relevance
 
 High-quality dental rehabilitation of patients suffering from bronchial asthma is one of the priority tasks of an integrated approach to the treatment of general somatic pathology. To date, it is believed that changes in the oral cavity are of a polyetiological nature and can be associated with xerostomia, nutrition, the nature of the treatment, and poor hygiene. Thus, the microbial factor may render an important role in the development of pathological changes in the oral cavity.
 
 Purpose 
 
 Using a review of the literature, to study typical and atypical types of microbial colonies developing in the oral cavity of patients with bronchial asthma, as well as to study ways to correct the pathogenic microflora of the oral cavity.
 
 Material and methods
 
 An analysis was made of information sources in the international databases of Google Scholar and Pubmed from 2000 to 2023. The keywords of the query were «oral cavity, bronchial asthma, microbes, antimicrobial therapy». As a result of the search, 118 sources were found, of which 34 were relevant.
 
 Results
 
 The search resulted in 118 sources, of which 34 were relevant. Based on the origin of the literature data, patients diagnosed with bronchial asthma were found to have dental problems associated with the possible occurrence of bacterial flora, among them: caries, periodontal disease, candidiasis. The above ways of spreading inflammatory and autoimmune processes, activating the action of pathogenic microflora.
 
 Conclusion
 
 Changes in the microbial balance have an impact on the development of pathologies of the oral cavity. Correction of hygiene and the use of antibacterial, antifungal agents, as well as a decrease in concentrations or the absence of drugs that stimulate the increase in pathogenic microbes, contribute to a decrease in the microbial pathological potential in the oral cavity.

Исходы интравитреальных кровоизлияний у новорожденных детей

Intravitreal hemorrhages are observed in 0.1–0.4 % of newborns, depending on the degree of maturity. Risk factors for intravitreal hemorrhages are rapid childbirth, obstetric benefits, general somatic and syndromic pathology. The article describes three cases of congenital hemophthalmos outcomes. In the long term, myopia, astigmatism, strabismus, retinal underdevelopment, the formation of epiretinal fibrosis, progressive vitreoretinal proliferation and traction retinal detachment were observed in children. Traditional therapy of hemophthalmos in newborn is ineffective. In severe cases, early vitrectomy is recommended. Children with a history of intravitreal hemorrhages are subject to longterm observation by an ophthalmologist. Keywords: intravitreal hemorrhages, newborns, hemophthalmos outcomes

Особливості клінічного перебігу генералізованого пародонтиту у пацієнтів з первинним гіпотиреозом

Actuality. Various pathogenetic relationships of general somatic pathology and diseases of the mucous membrane of the oral cavity, periodontium, and teeth dictate the need for a differentiated, personalized approach to their diagnosis and the choice of prevention and treatment tactics. The aim of the study. To study the peculiarities of periodontal status against the background of primary hypothyroidism. Materials and methods. The object of the study was 82 peopl eaged 28-47 years who applied to the Dental Medical Center of NMU. O.O. Bogomolets for the purpose of examination and remediation and had periodontal complaints. Of them, 51 had a confirmed diagnosis of primary hypothyroidism (manifest). The examination was carried out by standard clinical methods. Research results. It was established that the patients of the main group had a more severe degree of periodontal tissue damage and more often required a comprehensive periodontal examination and treatment. The fact of the rapid progression of the inflammatory process in the gums with the destruction of the clinical attachment and its rapid transformation into the inflammatory-destructive one has been established. Also characteristic are clearly pronounced signs of dystrophic processes, which are expressed in the generalized recession of the gums and their thinning. Conclusions. It has been established that the course of periodontitis against the background of primary hypothyroidism has a number of features caused both by the direct effect of insufficient thyroid hormones and by the specific effect of replacement therapy on the condition of periodontal tissues. Key words: рeriodontitis, gingivitis, hypothyroidism, periodontal status, gum recession, gum biotype.

Factors in the development of refractory primary open-angle glaucoma (part 2)

Development of primary open-angle glaucoma (POAG) in older patients is associated with a high risk of its refractoriness, which contributes to the progression of the pathological process possibly leading to a severe disabling complication — blindness. Concomitant pathology also makes a significant contribution to the course of primary open-angle glaucoma and requires a careful approach to diagnosis and management. POAG is a multifactorial pathology, so the treatment plan should take into account both genetic predisposition and general somatic pathology, as well as the socio-economic background. Studying the interaction of these factors contributes to a better understanding of the causes and processes that result in the refractory form of POAG. Specifically, the most common pathologies of the cardiovascular system that affect the course of POAG are arterial hypertension (AH) or hypotension, coronary heart disease (CHD), dyscirculatory encephalopathy (DE). In addition, the course of the disease is significantly affected by diabetes mellitus (DM), neurodegenerative pathologies, and smoking. These findings have been confirmed in a number of international multicenter studies. Certain social factors, however, are of particular importance due to mutually exclusive published findings. Notably, the socioeconomic status of patients (for example, the presence or absence of higher education) also plays an important role in the diagnosis and progression of the disease. Detailed consideration of these factors is extremely important for a better understanding of the disease and, consequently, the improvement of the quality of life of patients.

ОСОБЕННОСТИ СОСТОЯНИЯ ОРГАНОВ И ТКАНЕЙ РТА У ЛИЦ С МЕТАБОЛИЧЕСКИМ СИНДРОМОМ В АСПЕКТЕ ОРТОПЕДИЧЕСКОЙ СТОМАТОЛОГИЧЕСКОЙ РЕАБИЛИТАЦИИ С ИСПОЛЬЗОВАНИЕМ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ (ОБЗОР ЛИТЕРАТУРЫ)

At a dental appointment, a large number of patients with general somatic pathology require a purely individual approach to orthopedic rehabilitation. The influence of general somatic changes in metabolic syndrome on the osseointegration of dental implants and the subsequent functioning of orthopedic structures is not in doubt, and is determined by the influence of its components: obesity, arterial hypertension, diabetes mellitus, and dyslipidemia.
 Objectives. To analyze possible changes in the condition of the organs and tissues of the mouth in people with metabolic syndrome and their impact on the functioning of orthopedic structures supported by dental implants.
 Methodology. An analysis was carried out of the scientific literature for the period from 2000 to the present, devoted to the influence of somatic pathology, in particular metabolic syndrome, on the condition of the mouth and the functioning of orthopedic structures based on dental implants.
 Results. Among dental changes in people with metabolic syndrome, in almost all cases there are changes in the organs and tissues of the mouth of varying degrees of severity. The pathogenesis of pathological processes is based on microcirculatory, metabolic, enzymatic and immunological disorders. It is obvious that in patients with metabolic disorders, the risk of development, severity and manifestation of pathological changes in the tissues of the jaws surrounding orthopedic structures supported by dental implants is much higher.
 Conclusions. An analysis of the literature has fully shown that issues of dental rehabilitation, and especially the use of orthopedic structures based on dental implants as support in people with metabolic syndrome, do not have proper justification and in-depth study. The issues of carrying out important clinical stages in the manufacture of orthopedic structures for people with metabolic syndrome are practically not covered.

VERIFICATION OF ANGIOPROTECTIVE AND ANTI–INFLAMMATORY PROPERTIES OF VACCINIUM MYTILLUS, VACCINIUM ARCTOSTAPHYLOS IN EXPERIMENT

The dental system is a complex mechanism that includes a number of connective tissue structures that have specific properties and perform a number of functions, in particular, protective. One of the main barrier elements of the oral cavity is the mucous membrane lining it, throughout its length, having a different morphological structure. The most frequently pathological process is the periodontal tissue, which consists of attached and non-attached gums, bone alveoli, cementum of the tooth root and periodontal ligament of the tooth. At present, all periodontal diseases are usually divided into inflammatory and primary dystrophic, while a number of authors have found that in its pure form, the dystrophic process is detected no more than 1–8% of all diseases and is characterized as a generalised process against the background of general somatic pathology. The frequency of occurrence of periodontal diseases varies from 60 to 85% in the working population, which determines the relevance of studying therapeutic measures aimed at their relief and is the purpose of this study.The aim of the study was to investigate the angioprotective and anti-inflammatory properties of Vaccinium mytillus, Vaccinium arctostaphylos in experiment.Materials and methods. In this experimental work, the authors developed a model of periodontal damage in experimental animals (Vistar rats, weight – 25–300 g) under the conditions of drug loading with chloral hydrate, in accordance with the Directive on the Protection of Vertebrate Animals of 2000 and extracts from the act of Local Ethical Committee. The model was created by inflicting a single injury with a sharp object in the projection of the interdental space in the frontal segment of the mandible. The proper pathological condition was recorded on the 5–7th day; the verification of the morphological changes in some of the animals was being made by fragmenting the frontal segment of the lower jaw, followed by a pathological and histological examination. Then, the control group of animals was treated applied gel, made of Vaccinium mytillus, Vaccinium arctostaphylos to stop the process for 2 weeks. For comparison, the main group was treated with a gel without the inclusion of a drug component. At the end of the course of conservative therapy, according to the design of the study, biopsy specimens were taken again in both groups to evaluate the results of the conservative therapy provided.Results. According to the patho-histological study in the biopsy specimens of the damaged periodontium, the animals, revealed morphological disorders corresponding to chronic periodontal disease. At the stage of treatment in the control group, positive dynamics was noted both according to the clinical examination and after the pathological and histological examination of biopsy specimens in the comparison groups.Conclusions. The obtained results indicate the presence of anti-inflammatory and angioprotective effect of medicament compositions based on Vaccinium mytillus, Vaccinium arctostaphylos, which will be further tested in clinical trials.

Orthodontic treatment practical considerations during general somatic pathology correction with drugs that slow down bone resorption

According to the literature, more than 60% of orthodontic patients take certain medications and/or nutritional supplements on regular basis. To improve the efficiency and quality of treatment, based on systematic reviews and meta-analyses, an orthodontic treatment algorithm has been developed for patients taking bisphosphonates, drugs for the treatment of diabetes (except thiazolidinediones and SGLT-2 inhibitors), antihypertensives, antihistamines, statins, NSAIDs, estrogen-containing drugs, tetracycline, interferon- (deposit certificate No. 2080699). Algorithm helps orthodontist to make correct treatment plan, select appropriate orthodontic appliance activation regime, choose additional diagnostic procedures and consultations with doctors of other medical specialities.

RELATIONSHIP BETWEEN DISEASES OF ORAL MUCOSA AND GASTROINTESTINAL TRACT

A large number of scientific publications are devoted to diseases of the oral mucosa. This is due to their significant variety, prevalence, complexity of diagnosis and treatment, and medical and social significance as a determinant of precancerous diseases with subsequent malignant transformation. The data of professional studies show that most lesions of the oral mucosa are multifactorial and arise along with pathologies of various organs and systems, in particular, immune, cardiovascular, nervous, endocrine, and quite often, with diseases of the gastrointestinal tract. The purpose of this study was a retrospective analysis of professional literary sources devoted to a medically and socially relevant issue, the relationship between diseases of the oral mucosa and pathologies of the gastrointestinal tract. Bibliosemantic and analytical methods were used in the study. The analysis of data from the specialized literature shows the variety of diseases of the mucous membrane of the oral cavity and their close relationship with general somatic pathology. Clinical observations have revealed a significant correlation between chronic diseases such as gastritis, peptic ulcer disease (in the stomach and duodenum), chronic colitis, and enterocolitis, and various lesions of the oral mucous membrane. The severity of these lesions is dependent on the specific form and duration of the underlying gastrointestinal condition. Scientists attribute this relationship to the similarities in morphological structure, shared functions, common blood supply, and innervation. Professional sources substantiate the role of Helicobacter pylori infection and dysbiosis in the development and progression of oral mucosal lesions. The treatment of oral mucous membrane diseases places a significant emphasis on etiotropic therapy. However, when this approach is not feasible, pathogenetic or symptomatic treatment options are utilized.

Dynamics of index scores after complex treatment of periodontal diseases in persons with general somatic pathology

The purpose of the study was to evaluate the effectiveness of the developed schemes of complex treatment and prevention of periodontal tissue diseases in patients with general somatic pathology according to the dynamics of periodontal and hygienic indices. Treatment was carried out in 134 patients with inflammatory and dystrophic-inflammatory diseases of the perio­dontium against the background of somatic pathologies: two developed schemes of complex treatment of periodontal diseases were used, taking into account the values of the CPITN index. All patients were divided into 2 groups: the main (73 (54.48 %) patients), whose treatment was carried out using the schemes developed by us, and the comparative (61 (45.52 %) patients), in whom the treatment of periodontal pathology was carried out according to generally accepted schemes. The dynamics of the values of PMA, OHI-S indices and the vacuum test of gingival capillary resistance were evaluated according to the method of Kulazhenko V.I. before the treatment of periodontal diseases, 3, 6 and 12 months after it. After 12 months of follow-up, the values of the PMA index remained significantly lower compared to the values before treatment, and the state of oral hygiene remained satisfactory in patients of both groups. In the examined main group, an increase in the time of formation of hematomas on the gums ((62.14±0.38) seconds) was observed by 1.15 times compared to the data before treatment, but in the patients of the comparison group, this indicator was lower than the initial data. Тhe patients of the main group showed an improvement in all index scores, while in the comparison group, the values of these indices were below the initial values. Treatment of periodontal disease with values of the CPITN index ≤ 2 and > 2 points against the background of general somatic pathology, with the use of schemes developed by us, contributed to the elimination of inflammation, improvement of oral hygiene and normalization of hemodynamics in the periodontal tissues, which was confirmed by the positive dynamics of index scores in the near and distant periods of observation. Keywords: treatment of periodontal diseases, somatic pathology, index assessment of periodontal status.

Антропометричні особливості обличчя у дітей з уродженими дефектами коміркового відростка верхньої щелепи до хірургічного втручання

The purpose of the study was to investigate the anthropometric parameters of the nasolabial complex in patients with different sizes of the congenital defect of the alveolar process before surgical intervention. Materials and methods. To achieve the goal, a clinical assessment of the nasolabial complex was carried out in 54 children with clefts of upper lip and palate (aged 10 to 19 years). The next indicators were included: the length of the nasal wing, the width of the bottom in the nostril, the vertical displacement of the nasal wing and their ratios. The children were divided into three subgroups, depending on the size of the bone defect, which involved the planning of a different type of surgical intervention: 1 (n=13) – recovery of the defect without osteoplasty, 2 (n=11) – osteoplasty using the mandibular symphysis tissue, 3 (n=30) – osteoplasty using an autograft from tibia. Results and discussion. Clefts of upper lip and palate are accompanied by numerous anatomical and functional disorders in the maxillofacial system. Reconstruction of the maxilla alveolar processes on the cleft side is a necessary stage of the complex rehabilitation of the patient. The degree of severity of functional disorders in cases of clefts of upper lip and palate depends on many factors and conditions – the form and size of the cleft, the patient's age, concomitant local and general somatic pathology, as well as the success of the performed complex treatment. Fixation of the patient's rehabilitation process by photography and analysis of clinical photos are important components of evaluation of treatment results. The volume of the congenital (residual) defect of the alveolar process on maxilla directly affects the level of facial asymmetry which is reflected in changes in the ratios on the affected and healthy side – the length of the nasal wing, the width of the nostril, the angles of the base of the nasal wing. Such anthropometric data may be crucial points in the selection of surgical intervention methods and the use of different autologous transplants. The obtained results are consistent with similar studies by Ajami S., 2020, which established pronounced differences in the structure of the nasolabial complex even under the conditions of full and timely rehabilitation of children with congenital cleft of the upper lip and palate, compared to the ethnic anthropometric norm of healthy patients. And the sooner the integrity of the upper lip is restored, the better the symmetry of the nasolabial complex is achieved. Alveolar process plasty significantly equalizes the symmetry of the nose and upper lip in patients with congenital cleft of the upper lip and palate, which was shown by three-dimensional anthropometric studies in a number of clinics around the world. Conclusion. Anthropometry (photogrammometry) of the nasolabial complex on the face is an additional method in diagnostic that is necessary to make the correct clinical decisions during the planning of reconstructive interventions on the maxilla in case of clefts of lip and palate

The role of magnesium deficiency correction in the rehabilitation of women with climacteric syndrome and surgical menopause: results of the MAGYN study

Introduction. It is believed to be relevant to assess a profile in patients not using menopausal hormone therapy (non-MHT) with climacteric syndrome (CS) and surgical menopause, because this cohort includes patients with malignant neoplasms of the reproductive system at the stage of rehabilitation after radical surgery, for whom few study data in real-world data are available.Aim: to describe a profile of non-MHT women with CS and surgical menopause included in the MAGYN study.Materials and Methods. A non-interventional epidemiological study screened for magnesium deficiency in 1528 non-MHT women with CS and surgical menopause; 29 patients were at recovery period after radical surgical treatment of reproductive system cancer (vulvar, cervical, endometrial, ovarian, and breast cancer). The number and proportion of women with magnesium deficiency was assessed using the Magnesium Deficiency Questionnaire (MDQ), and a biochemical blood test was performed to measure serum magnesium concentration. Quality of life (QoL) was assessed using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). There were analyzed general somatic pathology, complaints, symptoms of magnesium deficiency by using visual analog scale, as well as the data of drug therapy, including a combination of magnesium citrate + vitamin B6 (pyridoxine) applied for 4 weeks.Results. According to the MDQ, the prevalence of magnesium deficiency was 72.3 % (55.1 % with moderate and 15.2 % with severe deficiency). Of 469 women, serum magnesium concentration ≤ 0.80 mmol/L was found in 377 (80.38 %), ≤ 0.70 mmol/L – in 278 (59.28 %). Surgical menopause was significantly more common in patients with magnesium deficiency (13.0 %). Among the symptoms of CS in patients with magnesium deficiency, neuropsychiatric symptoms were significantly more common: 47.3 % vs. 43.2 % (p = 0.035). After 4 weeks of therapy, the MDQ score decreased from 46.0 ± 12.7 to 29.2 ± 15.1 points (p < 0.001), serum magnesium level increased to 0.79 ± 0.23 mmol/L. The WHOQOL-BREF demonstrated a significantly improved QoL compared to pre-therapy, including physical and psychological well-being (21.1 ± 4.5 vs. 26.2 ± 3.5 score; p < 0.001), selfperception (18,2 ± 3.7 vs. 22.2 ± 3.6 score; p < 0.001), social well-being (24.8 ± 4.9 vs. 28.1 ± 4.4 score; p < 0.001) and satisfaction with microsocial support (9.3 ± 2.7 vs. 11.0 ± 2.8 score; p < 0.001).Conclusion. The high prevalence of magnesium deficiency and its close relationship with symptoms decreasing QoL (neuropsychic symptoms, hot flashes, irritability, sleep disturbances, fatigue, chronic stress, frequent headaches, etc.) have been confirmed. Further research is needed to assess an effect of magnesium deficiency correction as part of complex medical rehabilitation on the QoL of women with malignant neoplasms of the reproductive system after radical surgery.

СОСТОЯНИЕ ЗДОРОВЬЯ РАБОТНИКОВ РАЗЛИЧНЫХ ВИДОВ ПРОФЕССИОНАЛЬНОЙ ДЕЯТЕЛЬНОСТИ В УСЛОВИЯХ СЕВЕРНОГО РЕГИОНА

An analysis of the structure of the identified professional and general somatic pathology allows us to conclude that there is an increase in the detected somatic pathology among workers employed both in the oil and gas industry and in other industries. The leading diseases in men are metabolic disorders, pathology of the digestive system, dental diseases and eye diseases; in the group of women - gynecological diseases, metabolic disorders and eye diseases.

STUDY OF IMMUNE-INFLAMMATORY RESPONSE CHANGES IN ORAL FLUID IN PATIENTS WITH DISEASES OF PERIODONTAL TISSUES IN COMBINATION WITH GENERAL SOMATIC PATHOLOGY.

The aim: To determine the concentration of markers of the immune-inflammatory response (IL-1β, IL-10, IL-1β / IL-10, hsCRP) in oral fluid in patients with diseases of periodontal tissues in combination with general somatic pathology. Materials and methods: The study was conducted at Danylo Halytsky Lviv National Medical University, Department of therapeutic dentistry FPGE, Lviv, Ukraine. The patients were divided into two groups: the main group - 144 patients (with periodontal tissue diseases on the background of general somatic pathology) and the control group - 30 somatically and dentally healthy persons, in whose oral fluid was determined the concentration of IL-1β, IL-10, hsCRP by the enzyme immunoassay method. Results: As a result of our research, it was found that in people with periodontal tissue diseases, against the background of general somatic pathology, there is an activation of the immune-inflammatory response, which aggravates the course of general somatic and dental diseases in this contingent of patients. Conclusions: Therefore, in patients with periodontal tissue diseases on the background of somatic diseases, a significant increase in the level of the pro-in-flammatory cytokine IL-1β and hsCRP was determined against the background of a decrease in the anti-inflammatory cytokine IL-10 in the oral fluid compared to the values in the control group.

English STUDY OF CYTOLOGICAL PROFILE OF MUCOUS MEMBRANE OF PROSTHETIC BED IN PATIENTS, USED BY DIFFERENT ADHESIVE AGENTS FOR FIXATION OF COMPLETE REMOVABLE PLATE PROSTHESES

In the dental market of adhesive agents for fixing removable prostheses there are different forms of release: pastes, creams, gels, films, powders of different composition and different manufacturers. In most cases, the choice of one or another means is determined by the patient's own opinion. However, there are researches that indicate a violation of the microflora and the deterioration of the hygienic condition of the oral cavity, the occurrence and development of prosthetic stomatitis in people who use adhesive agents to improve the fixation of removable prostheses. Therefore, in our opinion, it is important to develop recommendations for dentists on the choice of adhesives in accordance with the clinical, cytological and microbiological profiles of the tissues of the prosthetic bed of patients.
 Aim. Study the characteristic features of the prosthetic bed mucosa (PBM) according to the results of its cytological identification in persons using different adhesive agents, and on the basis of the obtained results to recommend the criteria for their selection.
 Materials and methods. In the clinic of the Department of Dentistry of Postgraduate Education of Ivano-Frankivsk National Medical University, 106 smear were obtained from 98 patients who used CRLD for 2-3 years. Among them, 72 people used adhesive pastes to improve fixation (group II): «Corega» adhesive paste was used by 30 people (ІІa); «Lakalut» 20 (ІІb) and «Protefix» 22 people (ІІc). The third group consisted of 26 patients who used complete removable laminar dentures (CRLD) without the use of adhesive agents. In addition, 15 people with intact dentitions without dental and general somatic pathology were examined, in which 30 smear-impressions from the mucous membrane of the upper and lower jaws (group I) were obtained.
 Cytological research was performed in the Educational and Scientific Laboratory of Morphological Analysis of IFNMU. Impression smear-impressions stained with «Leikodyf» reagent (manufactured by «Erba Lachema» (Czech Republic)) and hematoxylin and eosin were examined using a Micros Austria MC 300 light microscope at x200 and x400 magnification and photographed with a Toup Cam 5.1 M UHCCD C- Mount Sony with Toup Tek Photonics AMA075 adapter using Toup View 3.7 software.
 Results. In the examination of the PBM in patients of these groups it was found that in group II (22) 30.6% had first-made CRLD, and remade - 69.4% (50). In the third group, 30.8% (8) people used CRLD made for the first time, and 69.2% (18) repeatedly. The use of adhesive agents to improve the fixation of CRLD reduces the intensity of the processes of regenerative-plastic insufficiency and polymorphic cell infiltration. Revealed by the predominance of ortho- and parakeratosis in persons who did not use adhesive agents to improve the fixation of the first manufactured CRLD; the phenomenon of increased desquamation of epithelial cells, the presence of cells of other layers of the epithelium in persons who used CRLD made repeatedly. In the smears of patients using «Protefix» and «Lakalut» pastes, a decrease in the intensity of keratinization of epitheliocytes was observed, compared with groups I, IIa, III. In the smears of persons who used the adhesive agents «Corega» noted moderate intensity of keratinization of epitheliocytes, anisocytosis, anisocariasis, pyknosis of the nucleus.
 Conclusions. According to the results of cytological identification, adhesive agents «Protefix» and «Lakalut» can be recommended for primary orthopedic treatment and «Corega» for complex clinical conditions in repeated orthopedic treatment of CRLD.

“Long covid” (postcovid syndrome). Mechanism of occurrence, diagnosis and rehabilitation

Introduction. The article is devoted to the study of the mechanism of occurrence of postcovid syndrome, a new laboratory method for its diagnosis and issues of drug and non-drug rehabilitation of patients who have suffered COVID-19.The purpose of this work was to study the possibilities of using the method of monochrome analysis of nanoparticles for instrumental and laboratory diagnostics of postcovid syndrome and to substantiate the use of complex therapeutic approaches to the treatment of patients.Materials and methods. The biomaterial (saliva) of 250 patients who underwent COVID-19 in mild, moderate and severe forms, with a slight predominance of males, in the age range from 18 to 75 years, who were in the Center of Eastern and European Medicine (Moscow) on rehabilitation treatment in the period from June 2020 to September 2021, was studied by the method of monochrome analysis of nanoparticles. According to the results of the work carried out, it was found that the most typical saliva spectrum of patients diagnosed with “postcovid syndrome” was multimodal (three or more peaks) with the greatest contribution (45%) to light scattering on agglomerates of nanoparticles with a diameter of more than 1000 nm, with detectable nanoparticles of the middle sub-range of the spectrum from 119 to 122 nm with a 15% contribution to light scattering and an increased contribution to light scattering up to 41% on small nanoparticles with a diameter of 22 nm.Results. Analysis of the results of the study showed a statistically significant (p < 0.01) appearance of a peak of 119 nm on the histogram of patients, which was not observed either in the group of practically healthy individuals (control group) or in the group of patients with general somatic pathology (comparison group). Conclusions. An algorithm for non-invasive diagnosis of postcovid syndrome by saliva was developed. Also, special attention was paid during the study to the development of an integrated approach to the rehabilitation of patients who have undergone a new coronavirus infection, including medicinal and non-medicinal methods of treatment. >< 0.01) appearance of a peak of 119 nm on the histogram of patients, which was not observed either in the group of practically healthy individuals (control group) or in the group of patients with general somatic pathology (comparison group).Conclusions. An algorithm for non-invasive diagnosis of postcovid syndrome by saliva was developed. Also, special attention was paid during the study to the development of an integrated approach to the rehabilitation of patients who have undergone a new coronavirus infection, including medicinal and non-medicinal methods of treatment.

Результати стоматологічного обстеження пацієнтів з гастроезофагальною рефлюксною хворобою

Introduction. Dental syndrome in patients with gastroesophageal reflux disease is accompanied by damage to the soft tissues of the oral cavity, pathology of the periodontal tissues and hard tissues of the teeth with the development of tooth enamel erosion, caries and its complications, which lead to tooth loss and the appearance of dentition defects. A significant number of such patients require orthopedic treatment. The issue of studying the harmful effects of dental metal alloys of dental prostheses on the body of patients with general somatic pathology is still relevant and is extremely important in the medical and social spheres. Goal. Assessment of the dental status of 119 patients aged 25–65 with gastroesophageal reflux disease. Research methods. Survey, primary examination, evaluation of oral hygiene, condition of hard tissues of teeth and periodontal tissues, pH-metry of mixed saliva. The results. The hygienic status, the condition of the hard tissues of the teeth and periodontal tissues in patients with the erosive form of GERD was significantly worse compared to patients with the non-erosive form, and the available strain-soldered and metal structures, especially with a violation of their integrity, further worsened the oral hygiene of the patients both experimental groups. Conclusions. The study of the features of the lesions of the oral cavity in patients with GBD will allow us to identify certain patterns that will allow us to carry out correct diagnostic and treatment measures. Key words: gastroesophageal reflux disease, dental examination, defects of teeth and dental rows.

Features of formation somatic pathologies under chronic exposure to hydrofluoride in the manufacture of titanic alloys

Introduction. Most studies on the morbidity of workers with fluorine compounds are devoted to occupational medicine at aluminium industry enterprises. The aim of the study is to identify the exposure, gender and evolutionary features of the formation of general somatic morbidity associated with chronic occupational exposure to hydrofluoride in the production of titanium alloys. Materials and methods. The analysis of the prevalence of chronic pathology according to the medical examination of 562 workers in contact with hydrofluoride and the incidence of temporary disability according to 29949 disability sheets in comparison with non-exposed persons of the same enterprise is given. Results. With an increase in the degree of harmfulness of working conditions, there was an augmentation increase in the risk of developing pathology of the respiratory organs, eyes, musculoskeletal system, arterial hypertension and hypercholesterolemia. In the working conditions of Class 3.1, an increased prevalence of diseases of the nervous and genitourinary systems with a moderate degree of occupational conditionality was revealed (relative risks (RR) 1.6 and 2.0, respectively, р < 0.05), class 3.2 - a high degree of professional conditionality of respiratory diseases (RR = 2.8). When working in harmful working conditions, there was an average degree of occupational conditionality of nervous system diseases in women (RR = 1.9) and a small degree of arterial hypertension in men (RR = 1.2). The prevalence of general somatic pathology in all age groups was higher than in non-exposed persons of the same age. Conclusion. Hydrofluoride in the production of titanium alloys was proved to be a trigger contributing to the formation of the pathology of the respiratory, circulatory, digestive, ear, eyes, skin, blood, musculoskeletal, nervous, endocrine, and genitourinary systems.

АССОЦИАТИВНЫЕ ПАРАЛЛЕЛИ ВЗАИМОСВЯЗИ И ВЗАИМООБУСЛОВЛЕННОСТИ КЛИНИЧЕСКИХ ОСОБЕННОСТЕЙ СТОМАТОЛОГИЧЕСКОЙ ПАТОЛОГИИ С СЕРДЕЧНО-СОСУДИСТЫМИ ЗАБОЛЕВАНИЯМИ

Subject. Diseases of the cardiovascular system are characterised by oral cavity manifestations which possible has inverse relationships. Prevalence and features of hard oral tissues, mucosa of the oral cavity and periodontium in cardiovascular patients is investigated. Aim — to form a list of main trends and scientific practical prospects related to cardiovascular diseases and dental pathology. Methods. In order to perform analysis of the studied topic, a review of 30 periodicals dated 2007-2019 was performed. Results. The analysis of Russian and foreign scientific literature resulted in formulation of three main groups of dental diseases with peculiarities in manifestations if IHD and HD: 1. Diseases of hard oral tissues; 2. Diseases of the mucous coat of the oral cavity; 3. Periodontium tissue diseases. Examination of oral cavity hygienic condition in CVD patients showed worse values in comparison with the control group. A major emphasis is placed on the role of C-reactive protein and the role of systemic inflammation in dental and cardiovascular pathology. Also, there is data regarding treatment of periodontium tissues and its influence on the cardiovascular system. Inverse interaction was noted: intake of medicines against the main pathology exerted influence on the oral cavity condition. Conclusion. The performed review of Russian and foreign literature makes it possible to conclude that the data presented is insufficient to draw any firm conclusion. Of principal interest are periodontium tissue diseases and their correlation with general somatic pathology, indicative of which is a significant number of practical researches devoted to this issue. However, the data analysed are of controversial character and do not make it possible to form a single trajectory for management of such patients and assessment of not only dental but also general somatic status of the patient.

Fast-track surgery and enhanced recovery after surgery concepts after their application in hernia repair

The growing number of surgical interventions that occur worldwide, along with the increasing prevalence of general somatic pathology, keeps current the problem of preventing complications during surgery and in the postoperative period. An efficient solution to this problem is to determine the risk of surgery, directed preoperative preparation, taking into account the comorbidity, optimization of surgery and postoperative rehabilitation. Fast-track surgery and enhanced recovery after surgery programs have significant potential for improving outcomes of surgery. These programs are widely used in various fields of surgery, but their effectiveness in herniology, especially in the performing simultaneous surgeries, there are very few reports, and the results of individual studies are contradictory. The review provides an analysis of holistic strategies of fast-track surgery and enhanced recovery and individual measures to assess the effectiveness of their impact on the immediate results of surgical interventions.

Effectiveness of the concept of fast-trak surgery for simultaneous laparoscopic hernioplastics and cholecistectomy

The aim of the research was to study the feasibility and effectiveness of simultaneous laparoscopic hernioplasty and cholecystectomy in patients with combined abdominal pathology. Material and methods. Simultaneous laparoscopic hernioplasty and cholecystectomy during 2015–2019 performed on 70 patients, including 49 (70 %) women, mean age 57.3 ± 6.5 g. In 37 patients the principles of Fast-track surgery were applied (group I), including thorough examination for diagnostics of combined abdominal pathology and clinically significant general somatic pathology; if necessary a course of therapy for full compensation of general somatic pathology was prescribed; during the operation of epidural prolonged anesthesia; choice in favor of laparoscopic technology; at the end of the operation – irrigation of the subdiaphragmatic space with local anesthetic; postoperatively: early drainage removal; withdrawal from opioids by prescribing parenteral paracetomol; activation of the patient 6-8 hours after surgery; on the day of surgery – use of chewing gum and fluid intake. In 33 patients the standard complex of perioperative management (group II) is applied. The immediate results of surgical interventions have been studied. Results. There were no significant complications during the operation and in the early postoperative period. In the first group, seroma (after open alloplasty) was detected in 2 (5 %) cases, and in the second group, small wound complications were detected in 4 (12 %) cases (p > 0.05 according to the χ2 criterion). The duration of inpatient treatment in patients of group I is 4.4 ± 1.2 months, in group II – 7.0 ± 1.3 days (р < 0.001 by Student’s test). Conclusion. Application of the principles of Fast-track surgery and accelerated recovery at all stages of simultaneous laparoscopic hernioplasty and cholecystectomy (preparation for surgery, during the operation and in the postoperative period) does not increase the number of postoperative complications and decreased duration of inpatient treatment from 7,0 ± 1,3 in patients with traditional postoperative management to 4,4 ± 1,2 days.