Moscow State Medical University Research Articles

Design and multidimensional analysis of dental orthopedic prosthetics quality

The purpose of the research is a multidimensional analysis of the "quality of life" of patients before and after dental prosthetics. It is necessary to assess the quality of life of patients after prosthetics, depending on the type of prostheses, gender, and age of patients and give recommendations on the choice of prosthetics method. Methods. Dental prosthetics was performed at the clinic of the Moscow State Medical University named after A. I. Evdokimov, four types of prostheses were tested - the classic traditional prosthesis (TR) and three types of digital prostheses (D1, D2, D3). Based on the developed OHIP-20 DG questionnaire, the quality of life of patients was assessed before prosthetics, immediately after prosthetics and six months later. The quality of life of patients after prosthetics was determined within the framework of the theory of latent variables. Using a four-factor analysis of variance, the impact on the quality of life of the type of prostheses, the duration of adaptation after prosthetics, gender and age of patients was assessed. Results. Within the framework of the theory of latent variables, it is shown that the developed questionnaire can be used as a measuring tool to analyze the influence of the studied factors on the quality of life of patients after prosthetics. Due to the use of four-factor analysis of variance, the accuracy of statistical analysis has been improved and the statistical significance of four sources of variance has been revealed. Based on the results of statistical analysis, recommendations on the choice of prosthetics method have been developed. Conclusion. A multidimensional analysis of the studied factors affecting the quality of life of patients after dental prosthetics was carried out. The quality of life of patients increases statistically significantly after prosthetics. Due to the use of a four-factor model of variance analysis, the precision of assessments of the quality of life of patients has been improved. The prosthetics method (D1) is recommended for women, the prosthetics method (D3) is recommended for men. The obtained results are recommended to be used in practice.

The necessity and demand of machine learning in treatment and diagnostics in dentistry

Aim: to justify the necessity of machine learning technology in treatment and diagnostics in dentistry.Material and methods: the research was taken using the method of anonymous questionnaire to estimate the demand and necessity of machine learning technology in diagnostics and treatment in dentistry on the basis of the E.V Borovsky Institute of Dentistry I.M Sechenov First Moscow State Medical University (Sechenov University). 100 participants from different dental specialities aged 20 to 54 took part in the questionnaire. Wilson score interval and Student’s T Critical Values were used for the statistical analysis of the Results.Results: during the study, it was found that the majority of dentists who participated in the questionnaire (54%) have challenges in diagnosing oral mucosal diseases. Herewith dentists with work experience more than 5 years diagnose this kind of disease more frequently than specialists with less work experience (p<0.05). Surgical dentists (46,6%) and prosthetic specialists (50%) diagnose this pathology most often. Clinicians attribute diagnostic challenges to the lack of experience (85%) and low occurrence of patients with this group of diseases. During treatment and diagnostics 84% of residents mentioned that they compare their patients’ clinical cases with clinical cases from the Internet and other resources, 78% of residents believe that machine learning will help to increase the efficiency of diagnosing oral mucosal diseases in clinical work. During the held research, it was found that 85% of participating dentists would definitely use digital programs with machine learning in their clinical work for treatment and diagnostics.Conclusions: the presence of problems in treatment and diagnostics of oral mucosal diseases was confirmed, and to solve it, the demand and the need to develop and implement digital systems based on artificial intelligence using machine learning technology were substantiated.

Comparative analysis of the parameters of local immunity of oral fluid and the duration of the course in children with systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, juvenile idiopathic arthritis and systemic vasculitis

Immunoglobulins are considered to be the main factor of specific antimicrobial protection of oral tissues.The study was conducted on the basis of the University Children’s Clinical Hospital of the I.M. Sechenov First Moscow State Medical University of the N.F. Filatov Clinical Institute of Child Health, in the Department of Rheumatology. The study involved 316 children, with diseases: systemic lupus erythematosus (SLE), juvenile dermatomyositis (YDM), juvenile limited scleroderma (YOSD), juvenile systemic scleroderma (YSSD), juvenile idiopathic arthritis (JIA), systemic vasculitis (SV) and Behcet’s disease (BB) and were divided into age groups according to the duration of the course of the underlying disease. The analysis of the results revealed a decrease in the content of IgG, IgA, sIgA in saliva in children with rheumatic diseases in all age groups compared with the control group (children without somatic diseases). With the duration of the course of the disease up to 2 years, the most pronounced decrease in the content of IgG, IgA, sIgA in saliva was revealed, more than 4–10 times (p<0.05), and with a duration of more than 2 years, a decrease of 2–3 times (p<0.01), compared with the control group. The deficiency of these immunoglobulins shows that in children with rheumatic diseases, regardless of the nosology, there is a violation of the local immunity of the oral cavity, especially at the onset of the underlying disease (in groups up to 2 years of the duration of the course of the underlying disease), with pronounced autoimmune inflammation of tissues and blood vessels, and this is also facilitated by the reception, during this period of shock doses of glucocorticosteroids, cytostatics, immunosuppressors, which leads to severe inflammatory processes of the oral mucosa, periodontal and hard tissues of the teeth.

Pre-vocational education as a factor in the development of human resources in the healthcare system

Pre-professional medical education in high school provides not only a more in-depth study of individual subjects of general education programs, but also expands the opportunities for self-determination of students, ensures continuity of the educational process, allows boys and girls to adapt more successfully mastering higher medical professional education programs and is the basis for a successful career.Aim. To evaluate the results of the introduction and implementation of the model of pre-professional medical and pharmaceutical education using the example of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) (hereinafter referred to as the Pre-University) as a means of developing the human resources potential of the healthcare system on the territory of the Russian Federation.Materials and methods. During the work, a theoretical analysis of domestic and foreign literature on the problem of developing the human resources potential of the healthcare system was carried out. A study was conducted in the comparative aspect of the basic readiness of students in grades 8-11 at the Pre-University and specialized medical and biological classes of regional educational institutions to the choice of medical specialties using a test questionnaire with the identification of three key aspects: readiness to master medical specialties; self-assessment of capabilities and erudition in the field of modern medicine. 1465 people took part in the survey. The reliability of the results was carried using the Mann-Whitney U test. Assessment of the statistical significance of differences between the means was carried out at a critical level of p = 0.05.Results. Studying at the Pre-University of Sechenov University allowed the majority of adolescents to achieve higher levels of formation of the main indicators of basic readiness to choose medical specialties. The share of students with a high level of readiness to master medical specialties at the Pre-University is 13.8 % higher compared to students of specialized medical and biological classes, with high erudition – 13.8 % and 6.7 % higher those who highly assess their prospects for entering a medical university.Conclusion. Pre-professional education based on close interaction between the Pre-University and Sechenov University allows students to develop motivation to choose a medical profession, as well as a clear understanding of the learning process in the chosen profession and is an important link in the system of continuous educational trajectory «pre-university–university–clinic».

Analysis of the impact of pre-professional education on the health of medical students

BACKGROUND: Education in a higher educational institution is critical for students due to the vulnerability of the young body and the exposure of young men and women to the impact of adverse factors that contribute to health disorders. The solution to the problem of the observed deterioration of the health of students of medical higher educational institutions is currently very acute, since this problem is directly related to the health of future health workers and determines the future of the country. AIM: To assess the health status of students of the Institute of Clinical Medicine named after N.V. Sklifosovsky of Sechenov University on the example of graduates of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) in a comparative aspect with graduates of other educational institutions. METHODS: A single-stage selective comparative study of the morbidity rate of students of the N.V. Sklifosovsky Institute of Clinical Medicine of Sechenov University was carried out. The data of the registration form «No 025/у» 1–6-year students for the period from 2018 to 2024 (n=2229, including 414 graduates of the Pre-University) were used. Data analysis was performed using Pearson's χ2 test with Yates correction. The significance level was set as p 0.05. Numerical data are presented with absolute and relative values. RESULTS: It was shown that the number of students assigned to the first and second health groups among Pre-University graduates was higher overall, and the number of those assigned to the third health group was lower compared to their peers who were not Pre-University graduates (p 0.01). An increase in the overall morbidity of students by the sixth year was noted, but to a lesser extent among Pre-University graduates (p 0.001). All students have more frequent eye and apparatus diseases. The second and third places were occupied by diseases of the nervous system and diseases of the respiratory organs. Diseases of the musculoskeletal system and connective tissue were less common. CONCLUSION: The lower morbidity rate among the graduates of the Pre-University is presumably due to the promotion of a healthy lifestyle and rejection of harmful habits during the pre-professional education phase. The data obtained show the need to strengthen work on the identification and prevention of factors of educational environment, reducing the effectiveness of medical and educational measures for the formation of health status of students at the stage of pre-specific education.

МИКРОСПОРИДИИ ИЛИ КЛЕТКИ ПАНЕТА? ОСОБЕННОСТИ ДИАГНОСТИКИ МИКРОСПОРИДИОЗА ЧЕЛОВЕКА ПО ГИСТОСРЕЗАМ КИШЕЧНИКА

The Clinical Diagnostic Laboratory of Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, I.M. Sechenov First Moscow State Medical University continues to share its experience in diagnosing rare, unusual and/or ambiguous cases of parasitosis in publications. The article describes two cases of suspected intestinal microsporidiosis. The difficulties and the probability of error of the microscopic method in the identification of intracellular protozoa on histosections are discussed.

Intermittent hypoxic preconditioning reduces the risk of peri- and postoperative complications during on-pump cardiac surgery

Aim. To assess the effect of intermittent hypoxic-hyperoxic exposures (IHHE) on the outcomes of on-pump cardiac surgery.Material and methods. This prospective, single-center, randomized, controlled study was conducted in 110 patients with heart valve defects and/or aortic pathology from the cardiac surgery clinic of the I. M. Sechenov First Moscow State Medical University. The total sample was randomly divided into a group of patients who underwent IHHE (n=66) and a control group of patients who underwent placebo procedures with ambient air (n=44). The frequency and structure of intra-and postoperative complications were analyzed within 30 days after surgery. The presence of cognitive impairment, as well as serum troponin I and lactate concentrations were analyzed before and after surgery.Results. Peri- and early postoperative complications such as cardiac death, non-fatal infarction and acute heart failure occurred significantly less frequently in patients treated with IHHE compared with placebo group (1,6% vs 16,7%, p=0,009; 1,6% vs 16,7%, p=0,009; 6,3% vs 33,3%, p<0,001, respectively). The median troponin I values 24 hours after surgery were 1,068 ng/ml (0,388-1,397 ng/ml) in the IHHE group and were significantly lower compared to the control group (1,980 ng/ml (1,068-3,239 ng/ml)). The serum lactate level after surgery was 1,8±0,7 mmol/l in the IHHE group and was significantly lower compared to the control group — 2,4±1,2 (p=0,05). Cognitive function, assessed by MOCA and MMSE tests, turned out to be significantly higher in patients who underwent a preoperative IHHE. No significant complications or serious adverse events were observed during the IHHE procedures.Conclusion. The use of individually adapted hypoxic preconditioning procedures reduces the incidence of peri- and postoperative complications, which is accompanied by a lower ischemia-reperfusion myocardial injury during artificial circulation with preservation of cognitive functions. IHHE procedures ramp up prehabilitation of patients referred for on-pump surgery of heart defects and aortic pathology.

Hygienic assessment of dietary intake of saturated fatty acids and trans isomers of fatty acids

Introduction. An imbalance of the fat component of the diet is one of the most common violations of the population nutrition in developed countries, leading to the risk of occurring nutrition-dependent pathologies due to hyperlipidemia and dyslipoproteinemia. A special role in the formation of risk is played by an excess of medium-chain saturated fatty acids (SFA) and trans isomers of unsaturated fatty acids (TFA). Materials and methods. Actual nutrition was studied by reproduction method with three times 24-hour recall. Based on the research results, the content of SFA and TFA was calculated, and their main sources were determined. Three hundred fourteen students of the I.M. Sechenov First Moscow State Medical University took part in the study. Gender and age groups of respondents were analyzed separately. Results. The intake of SFA at the level of normal physiological needs was registered in only 7.6% of students. At the same time, 80% of respondents had a significant excess of both total fat and SFA; an adequate level of TFA intake was noted in 80% of students, and a significant excess of this indicator was registered only in 13.3% of respondents. A significant quantitative increase in SFAs was noted with the additional inclusion of processed products in the diet, including those with hidden fat. Excessive consumption of TFA is associated with the inclusion of rich confectionery products containing hydrogenated fats in the diet. Limitations. The study has age and regional restrictions: young 18–29 years people living in the Moscow region, as well as restrictions on the analyzed indicators: SFA and TFA supplied with the diet. Conclusions. A significant risk of developing nutrition-dependent non-infectious diseases is observed in 52.9% of respondents with an SFA content in the diet of more than 150% of the norm, and the maximum risk is in 13.3% of students receiving a combined excess of SFA and TFA. The results of the study confirm the need to correct the diets of students in terms of the fat component.

Automation of manuscript typographic formatting using MS Word

The article describes the goals, methods, and results of developing a set of versatile requirements for formatting scientific manuscripts, the application of which can be automated. The experience and results of testing the developed requirements and methods of their automation are presented. The set of requirements for formatting scientific manuscripts in an editable format allow the document to be circulated between the authors, editors, reviewers, and layout designers, thus optimizing labor- and time resources. The developed requirements meet the text document standards adopted in the Russian Federation and are approved by typographic specialists. The requirements are supported by built-in MS Word automation tools (macros) and are executed automatically. The author’s time spent on mastering the requirements and automation tools is compensated by accelerating the formatting of lengthy documents in the future. The requirements can be customized according to individual preferences and specific publisher requirements. The developed tools were tested as part of the specialized course “Preparation of a Scientific Article for Publication” at Sechenov First Moscow State Medical University. It was found that students become to acknowledge the importance of using formatting styles when the text is initially aligned according to the IMRAD format. By that means, the text structure and formatting tasks are interrelated, complementing each other during the article preparation process. The presented set of requirements seems promising in terms of developing a generally accepted standard.

ПЕРЕВОД И МЕЖКУЛЬТУРНАЯ АДАПТАЦИЯ «ИНСТРУМЕНТА СКРИНИНГА ТРУДНОСТЕЙ С КОРМЛЕНИЕМ/ГЛОТАНИЕМ И НЕДОСТАТОЧНОСТИ ПИТАНИЯ У ДЕТЕЙ С ДЕТСКИМ ЦЕРЕБРАЛЬНЫМ ПАРАЛИЧОМ (FNST)»

Children with cerebral palsy (CP) often have feeding and swallowing difficulties, which can lead to malnutrition and low body weight gain and negatively affect growth and development. In order to identify feeding difficulties and malnutrition in children with CP and timely access to specialists, the FNST (Feeding Nutrition Screening Tool) English-language questionnaire has been developed and validated. The purpose of the research was to translate into Russian and carry out a cross-cultural adaptation of the FNST screening tool. Methods used: the translation and cross-cultural adaptation of the questionnaire content consisted of seven stages in accordance with the standards of the International Society for Pharmacoeconomics Research and Evaluation of Results (ISPOR). Preliminary testing of the pre-final version of the tool was conducted with the participation of 30 parents/caretakers of CP patients and 10 practitioners. The stages of the work were carried out at the National Medical Research Center for Children’s Health, I.M. Sechenov First Moscow State Medical University and Moscow State Linguistic University (all three are located in Moscow, Russia). The pre-final version was adopted with minor changes. Results: the final Russian-language adapted 4-point screening tool represents a short and simple questionnaire to identify feeding disorders and malnutrition in children with CP aged 2 to 19 y/o and to ensure the possibility of timely dietary intervention. The translation of the questionnaire into Russian and its cross-cultural adaptation have preserved functional, structural and operational equivalence. Conclusion: a Russian-language version of the FNST questionnaire has been created and adapted for screening for eating disorders in children with CP, which is the first necessary step for its further official validation and implementation.

The use of an innovative technique for perforations of the mucous membrane of the maxillary sinus during the sinus lift operation

Introduction. To date, according to WHO, the number of people with a complete absence of teeth is greater than 8% of all the people worldwide. Loss of teeth due to complications of caries treatment, chronic periodontitis and trauma leads to atrophy of the alveolar ridge and that of soft tissues in this area, which in turn complicates the rehabilitation of the patients. According to the literature, in the first year after tooth extraction, the volume of the bone tissue of the alveolar ridge decreases by 40–60%, which greatly complicates the subsequent orthopedic rehabilitation of the patients. Currently, the «gold standard» for increasing the volume of the bone tissue of the alveolar ridge of the upper jaw in the distal section is the sinus lift operation. However, according to the literature, when sinus lift operation is performed, Schneider’s membrane perforation occurs in 7–23% of cases, which in terms, leads to the inability to complete the operation and complications in cases with total perforations of membrane.Purpose of the study. To evaluate the complex rehabilitation of patients with partial secondary absence of teeth and severe atrophy in the lateral sections of upper jaw using the «envelope technique» during open sinus lifting.Materials and methods. In 2020–2022, during a clinical study at the clinic of the Department of maxillofacial and plastic surgery of the Moscow State Medical University named after A.I. Evdokimov, 54 patients who had a history of PPI interventions in the ENT department were treated. All patients underwent bilateral open sinus lifting using enamel matrix proteins or the «envelope technique» for perforation of the Schneider membrane. After 9–12 months, a comprehensive rehabilitation of patients based on dental implants was carried out.Results. The number of extensive (total) perforations of the Schneider membrane in the study group of patients was 50%. As a result of the use of the patented «envelope technique» with the use of enamel matrix proteins, no postoperative complications were observed in patients with total perforation of the Schneider membrane. Taking into account the planned orthopedic design, 292 dental implants were installed in all patients.Conclusion. The method is effective and safe, allowing to rehabilitate patients with missing teeth and severe atrophy in the lateral part of the upper jaw, in case of intraoperative total perforation of the Schneiderian membrane.

Levels of cardiac biomarkers and three-year survival rate in hospitalized patients with heart failure and community-acquired pneumonia

Aim. To evaluate the impact of community-acquired pneumonia (CAP) on the levels of cardiac biomarkers and long-term survival rate in patients with heart failure (HF).Material and methods. The prospective observational single-center study included 132 patients (73 men, 59 women); mean age — 72,3±12,1 years, consecutively hospitalized at Clinical Hospital № 4 of the I. M. Sechenov First Moscow State Medical University with decompensated heart failure in the period from March 2018 to December 2019. The main (n=40) and comparison group (n=92) included patients with and without clinical and CT signs of CAP, respectively.Results. Patients with HF and CAP and HF without CAP were comparable in sex, age, and severity of HF. CAP in most patients met the criteria for non-severe pneumonia (average CURB-65 score — 1,55±0,73). The levels of N-terminal probrain natriuretic peptide (NT-proBNP) in patients with HF with CAP (1188,9 [439; 2493] pg/ml) were insignificantly higher than in patients with HF without CAP (839,6 [413; 1900]) pg/ml (p>0,05). A similar pattern was noted for the soluble growth stimulation expressed gene 2 (sST2) (30,85 [12,8; 59,6] ng/ml vs 22,8 [15,2; 44,7] ng/ml, p>0,05). The haptoglobin level in patients with CAP was significantly lower (732 [315; 1312] ng/l), compared to the group without CAP (1270 [902; 2022] ng/l, p=0,0022). No differences in the concentrations of galectin-3, copeptin and hepcidin were detected. The one-year mortality rate of patients who underwent CAP was 27,3%, and without CAP — 7,2% (p<0,001), while the three-year mortality rate was 44,9% and 21,4%, respectively (p=0,0004). Elevated levels of NT-proBNP and sST2, along with age over 75 years and left ventricular ejection fraction <40%, are additional factors of poor prognosis in patients with HF and CAP.Conclusion. CAP in patients with HF does not have a significant effect on most cardiac biomarkers, but significantly worsens the prognosis. Independent factors of unfavorable prognosis in patients with HF and CAP are age over 75 years, left ventricular ejection fraction <40%, increased NT-proBNP and sST2 levels.

ЮНОШЕСКИЙ АРТРИТ С СИСТЕМНЫМ НАЧАЛОМ: ЭПИДЕМИОЛОГИЯ, КЛИНИКА, ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА В РЕАЛЬНОЙ ПРАКТИКЕ (РЕЗУЛЬТАТЫ ДВУЦЕНТРОВОГО РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ)

Systemic-onset juvenile arthritis (sJIA) is an acute and severe disease characterized by systemic inflammation, arthritis and extra-articular manifestations. Until now, sJIA is considered to be a diagnosis of “exception” requiring careful differential diagnosis coupled with a number of other diseases. The purpose of this research was to evaluate the demographic features of sJIA, analyze clinical and laboratory data, patients’ compliance with diagnostic criteria according to the International League of Associations for Rheumatology's (ILAR) established criteria, and identify difficulties at the stage of differential diagnosis. Materials and methods used: a multicenter (two-center) retrospective cohort study was conducted among 65 pediatric patients aged 8 months to 17 y/o (27/41.5% girls and 38/58.5% boys) with an established diagnosis of sJIA in 2013-2022 in two clinical centers as follows: University Children’s Clinical Hospital of the N.F. Filatov Clinical Institute of Children’s Health with the I.M. Sechenov First Moscow State Medical University and Morozov Children’s City Clinical Hospital (both located in Moscow, Russia). Anamnesis of the disease, complaints upon admission, examination data upon admission, laboratory test results, including clinical and biochemical blood tests, immunological parameters (IgA, IgM and IgG), myelogram data, abdominal ultrasound, echocardiography, computed tomography of the chest and abdominal organs with intravenous bolus contrast and brain MRI were analyzed. Results: the disease onset occurs in the first 10 years of life (87.7% [73.6%; 94.8%]) in most cases with the age of onset in boys (6 [3; 9] years) and girls (5 [1.6; 8] years) did not differ statistically significantly (p=0.499). Characteristic for sJIA is the early age of onset of the disease, in 31 patients (47.7%) the diagnosis was made before the age of 6 years, from 6 to 10 y/o - in 26 (40.0%), from 11 to 16 y/o - in 8 (12.3%). According to the results of instrumental analysis, pericarditis prevailed among serositis, while a gender predisposition in the development of pericarditis in girls was identified (p=0.036). Conclusion: the difficulty of differential diagnosis lies in the absence of pathognomonic symptoms, biomarkers characteristic of sJIA, and therefore, to make a diagnosis, a number of diseases with similar symptoms should be excluded at first.

Salutogenic Design as Health Preservation Technology: Prospects for Implementation in Public Health

Introduction. The concept of salutogenic design, focused on creating a healthy environment, is based on the salutogenesis concept, developed back in the 1970s by Aaron Antonovsky. This approach is becoming increasingly popular in urban planning, development, and certification of buildings, offices, and medical fa-cilities. Due to ongoing national projects, there is an increasing demand for specialists in public health and salutogenic design in Russia, which has justified the creation of an interdisciplinary educational program. Objective. To present the implementation of the network master's program "Salutogenic Design" in the field of public health and the creation of a healthy urban environment.Materials and methods. We conducted literature review on existing practices for applying salutogenic de-sign in urban planning and described the implementation of the network master's program "Salutogenic De-sign" at the Institute of Leadership and Health Management of the I.M. Sechenov First Moscow State Medical University (Sechenov University) and Moscow institute of architecture (MIARCH).Results. The concept of salutogenic design is a prominent scientific and practical issue for researchers, pro-fessional community, and executive authorities worldwide, with particular interest in implementation studies of salutogenic design for designing and constructing environments, transport, medical organizations, and the urban landscape, as well as developing tools for urban environment assessment. The master's program "Salutogenic Design" is a unique educational experience that includes the development of professional skills in an interdisciplinary area of health sciences and urban planning, distinguishing it from other educational projects.

In honor of the 100th anniversary of the Department of Infectious Diseases at the I.M. Sechenov First Moscow State Medical University (Sechenov University)

This article is dedicated to the 100th anniversary of the Department of Infectious Diseases of the I.M. Sechenov First Moscow State Medical University (Sechenov University). This study examined key biographical information about department heads and achievements of teams at various historical stages. Currently, the department follows the educational policies of Sechenov University up to 2030. New educational programs in Russian and English are created for students. New teaching methodologies are implemented, talented students are engaged in student research on infectious diseases, interdisciplinary Olympiads are held, and conditions are formed to enhance student involvement in research and development activities to prepare competitive professionals with new professional competencies (research, interdisciplinary, and digital), capable of advancing science and new technologies.

Development and evaluation of the effectiveness of the educational and methodological complex of the module «Features of dental care for patients with concomitant diseases» of the Federal State Educational Standard of Higher Education in the specialty 31.05.03

Order No. 984 of August 20, 2020 of the Ministry of Science and Higher Education of the Russian Federation approved the Federal State Educational Standard of Higher Education – a specialty in the specialty 31.05.03 «Dentistry», programs are developed and approved by the organization independently with the formation of requirements for the results of its development in the form of universal, general professional and professional competencies of graduates. At the Department of Pain Management in Dentistry of Moscow State Medical University named after. A. I. Evdokimov developed the program «Features of providing dental care to patients with concomitant diseases» and an educational and methodological complex consisting of a textbook (monograph), a course of video lectures, an educational and methodological manual (workbook) for self-preparation of students for classes. In order to control the acquired knowledge, a bank of test tasks and situational tasks was created. An analysis of the performance of 1,306 students of the Faculty of Dentistry, who studied in the 9th semester, demonstrated the high efficiency of the developed program and educational and methodological complex.

ЭКСПЕРИМЕНТАЛЬНОЕ ОБОСНОВАНИЕ ПРИМЕНЕНИЯ БИОРЕЗОРБИРУЕМЫХ ПЕРСОНАЛИЗИРОВАННЫХ КОЛЛАГЕНОВЫХ МЕМБРАН ДЛЯ ЗАКРЫТИЯ ДЕФЕКТОВ СЛИЗИСТОЙ ОБОЛОЧКИ РТА

Subject. The subject of the study is the biomechanical properties of a personalized collagen membrane in the area of wound defects of the oral mucosa.
 Objectives. To increase the effectiveness of treatment of patients with extensive surgical wound defects of the oral mucosa by experimentally substantiating the use of developed collagen membranes from bovine Achilles tendon.
 Methodology. Based on the Central Vivarium of the First Moscow State Medical University named after I.M. Sechenov (Sechenov University) conducted an experimental study on laboratory animals (rabbits) (n = 12) to create a wound surface in the oral cavity (limited vestibuloplasty according to Clark on the upper jaw) and its closure with collagen membranes with an assessment of the course of the postoperative period and subsequent histological examination of biomaterials: 1st – using a personalized collagen membrane, 2nd – using a collagen membrane with lactoferrin, 3rd – using a Mucograft membrane, 4th group – control.
 Results. In the postoperative period, on the 3rd day, moderate swelling, and hyperemia in the area of vestibuloplasty were noted in the oral cavity of rabbits: the least pronounced swelling was in animals in the 2nd group of operations (1.5 ± 0.5 points) (p = 0.001), hyperemia – in the 3rd group (1.7 ± 0.4 points) (p = 0.001). On the 5th day in the oral cavity of experimental animals, hyperemia of the mucous membrane of the oral vestibule in the 2nd group was 0.8 ± 0.4 points (p = 0.001), and in the 3rd group – 1.8 ± 0.4 points (p = 0.001). According to the histological research method, a significant difference was noted in the quantity and quality of the formed soft tissues in the area of application of collagen matrices compared to healing by secondary intention (p < 0.05). The results of histological examination showed in group 2 epithelization with acanthosis and proliferation of the basal layer.
 Conclusion. The effectiveness of the developed collagen membranes from the Achilles tendon has been proven in eliminating extensive wound defects of the oral mucosa.

Web 2.0 Technologies in Times of Pandemic COVID-19

This study substantiates the feasibility of implementing Web 2.0 services in practical educational activities and classifies the main types of Web 2.0 services adaptive to educational goals. A survey of 58 teachers from the First Moscow State Medical University, Kuban State Technological University, the Herzen State Pedagogical University of Russia, and Yelabuga Institute of Kazan (Volga Region) Federal University was conducted; their pedagogical experiences interacting with Web 2.0 services were considered in order to provide effective technological support for educational interactions in the context of distance learning in the era of COVID-19. The survey results showed that the most popular Web 2.0 services teachers use in distance learning include social networking services and virtual meeting and conference services. The study confirmed that using Web 2.0 services in educational processes can ensure high-quality digital pedagogy.

Comprehensive management of Pindborg tumor in childhood: a case report

Relevance. The calcifying epithelial odontogenic tumor, also known as Pindborg tumor, is a locally aggressive neoplasm characterized by strands and medullary formations of flat and clear cells, often accompanied by spherical calcifications and amyloid-stained hyaline deposits. The Pindborg tumor is rare, representing less than 1% of odontogenic tumors, and typically manifests in individuals aged 20 to 60 years. However, there is a growing incidence of neoplasms of diverse origins in childhood. This article presents a clinical case detailing the comprehensive multi-stage treatment of a pediatric patient with a Pindborg tumor, facilitating complete rehabilitation before reaching adulthood.Clinical case description. This article presents a clinical case detailing the comprehensive management of a patient with a Pindborg tumor. The individual initially sought treatment at the Department of Pediatric Maxillofacial Surgery of A.I. Evdokimov Moscow State Medical and Dental University in 2020, undergoing complete combined treatment until November 2023. Full rehabilitation was successfully achieved by the time of adulthood through a series of four consecutive surgeries, including dental implantation, followed by prosthetics utilizing a non-removable orthopedic structure in the final stage.Conclusion. Initiating comprehensive rehabilitation at an early stage, including dental implantation before reaching adulthood, facilitates complete social adaptation in society and contributes to the patient's harmonious development.

Effectiveness of topical antibiotic therapy in the prevention of infectious and inflammatory complications after rhinosurgical interventions

To assess the effectiveness and safety of the use of topical antibacterial medication in patients after rhinosurgery. 60 patients (38 were men and 22 women) aged 18 to 55 years were observed in the Clinic of Ear, Nose and Throat Diseases of the Sechenov First Moscow State Medical University, who underwent surgery under general anesthesia for non-purulent pathology of the nasal cavity and paranasal sinuses. In the postoperative period, all patients were randomly divided into two groups: the main group, which received Isofra (framecitin sulfate) intranasally, 1 dose 4 times a day for 5 days, and the control group, in which the antibiotic ceftriaxone was administered intramuscularly 1.0 g 2 times a day at the same time. In order to compare the indicators in the two groups on the 1st, 3rd and 5th days after surgery, the severity of subjective and objective symptoms was assessed using visual analogue scales (VAS). All observed patients were discharged from the hospital on the 5th day after surgery; on the 10th day, on an outpatient basis, material was collected from the mucous membrane of the nasal cavity for microbiological and cytological examination and the rate of mucociliary transport (MCT) was assessed using a saccharin test. For 3 months after discharge, all patients were called by a doctor monthly to identify episodes of acute respiratory viral infections, including the development of bacterial complications. Statistically significant differences were recorded on the 5th day after surgery in terms of the severity of nasal obstruction (p<0.05) - in the main group, the degree of difficulty in nasal breathing was lower than in the control group. There were no significant differences in the results of microbiological and cytological studies, or MCT indicators; the results of the main and control groups were comparable. No adverse events were observed in patients during topical antibiotic therapy; during systemic antibacterial treatment, 3 patients experienced dyspeptic symptoms for 3-7 days. Thus, the antibacterial nasal spray Isofra, when used in the postoperative period, is not inferior in effectiveness to preventive systemic antibacterial therapy, which allows, taking into account the risk of the formation of resistant strains of microorganisms and the development of adverse events against the background of systemic antibacterial therapy, to significantly limit the indications for the latter.