Mucous Membrane Research Articles

Effects of Tongluo Jiedu prescription on immune function and oxidative stress in patients with oral cancer

BACKGROUND Oral cancer, which is caused by mucous membrane variation, represents a prevalent malignant tumor in the oral and maxillofacial region, posing a significant threat to patients’ lives and safety. While surgical intervention stands as a cornerstone treatment for oral cancer patients, it carries the risk of incomplete treatment or high rates of postoperative recurrence. Hence, a multifaceted approach incorporating diverse treatment modalities is essential to enhance patient prognosis. AIM To analyze the application effect of Tongluo Jiedu prescription as adjuvant therapy and its influence on patient prognosis in patients with oral cancer. METHODS Eighty oral cancer patients in our hospital were selected and divided into the observation group and control group by a random number table. The control group was treated with continuous arterial infusion chemotherapy of cisplatin and 5-fluorouracil. The observation group was additionally given Tongluo Jiadu prescription. The inflammatory stress level, peripheral blood T-cell subsets, and immune function of the two groups were subsequently observed. SPSS 21.0 was used for data analysis. RESULTS The observation group demonstrated lower levels of interleukin-6 and C-reactive protein, and a higher level of tumor necrosis factor in comparison to the control group. After treatment, the immune function in the observation group was significantly better than in the control group. CONCLUSION Tongluo Jiedu prescription can improve the immune function and oxidative stress level of patients with oral cancer and accelerate the recovery process.

Determining the dispersion time in Staphylococcus epidermidis biofilm using physical and molecular approaches

Despite being an innocuous commensal of human skin and mucous membranes, Staphylococcus epidermidis, infects surgical wounds and causes infections through biofilm formation. This study evaluates, in a time-dependent experiment, the self-dispersion of S. epidermidis CIP 444 biofilm when formed on borosilicate glass (hydrophilic) and polystyrene (hydrophobic) surfaces, using physical and molecular approaches. During a seven-day period of incubation, absorbance measurement revealed a drop in biofilm optical density on both studied surfaces on day 4 (0.043–0.035 nm/cm2, polystyrene), (0.06–0.053 nm/cm2, borosilicate glass). Absorbance results were correlated with crystal violet staining that showed a clear detachment from day 4. The blue color increases again on day 7, with an increase in biofilm optical density indicating the regeneration of the biofilm. Changes in gene expression in the S. epidermidis biofilm were assessed using a real-time reverse transcription-polymerase chain reaction. High expression of agr genes was detected on days 4 and 5, confirming our supposition of dispersion in this period, autolysin genes like atlE1 and aae were upregulated from day 3 until day 6 and the genes responsible for slime production and biofilm accumulation, were upregulated on days 4, 5, and 6 (ica ADBC) and on days 5, 6 and 7 (aap), indicating a dual process taking place. These findings suggest that S. epidermidis CIP 444 biofilms disperse at day 4 and reform at day 7. Over the course of the seven-day investigation, 2-ΔΔCt results showed that some genes in the biofilm were dramatically enhanced while others were significantly decreased as compared to planktonic ones.

GARLIC: Nature's potent antifungal and antibacterial ally - cream formulation and evaluation

In the pursuit of effective and safe treatments for infectious diseases, herbal remedies have garnered significant attention due to their diverse phytochemical composition and potential therapeutic properties. This study aimed to explore the phytochemical profile and evaluate the antibacterial and antifungal properties of herbal garlic extracts. Traditional natural products continue to be sought after for their bioactive compounds, which offer promising avenues for therapeutic intervention in both human and veterinary medicine. Our investigation not only sheds light on the regional variation of stomach disease occurrence, highlighting the role of dietary factors, but also underscores the importance of herbal preparations in medicinal practice. By combining various plant classes, herbal formulations can exert localized effects upon application, penetrating the skin or mucous membranes to target underlying conditions. The effectiveness of these combined medications may lie in their synergistic mechanisms, offering a comprehensive therapeutic approach. This research contributes valuable insights into the potential of herbal remedies as adjuncts or alternatives to conventional treatments, paving the way for further exploration in infectious disease management and prevention strategies.

The causal relationship between vitiligo and autoimmune thyroid diseases: A bidirectional two-sample Mendelian randomization analysis.

Vitiligo is an acquired autoimmune depigmented disorder characterized by the presence of white and well-defined patches on the skin, mucous membrane, or both. It is associated with a significant disease burden and has a profoundly impacts patients' quality of life. Autoimmune thyroid diseases (AITDs) result from an autoimmune system dysregulation, leading to an erroneous immune attack on the thyroid gland. Previous observational and epidemiological studies have suggested the association between vitiligo and AITDs. However, the bidirectional cause-effect relationship between vitiligo and AITDs has not been formally assessed. Two-sample bidirectional Mendelian randomization (MR) analysis was conducted to explore potential causal relationships between genetically increased risk of vitiligo and AITDs, using summary statistics from genome-wide association studies in European populations. Causal effects were primarily estimated using the inverse variance weighted method, and additional quality control was performed using the MR-Egger, weighted median, simple mode, and weight mode methods. Sensitivity analysis was conducted to assess the robustness of the results. The forward MR analysis showed a positive causal relationship between vitiligo and autoimmune thyroiditis (AIT), autoimmune hyperthyroidism (AIH), and Graves' disease (GD). The odds ratio (OR) were 1.17 (95% CI, 1.01-1.35; p=0.04), 1.12 (95% CI, 1.03-1.22; p=0.01), and 1.13 (95% CI, 1.06-1.20; p<0.01), respectively. In the reverse MR analysis, a positive causal relationship was found between AIT and vitiligo, with an OR of 1.10 (95% CI, 1.01-1.35; p=0.04). However, no causal relationship was observed between AIH (p=0.10) or GD (p=0.61) and vitiligo. Sensitivity analysis revealed no evidence of horizontal pleiotropy or heterogeneity. The genetic-level investigation provides evidence of a genetic causal association between susceptibility to vitiligo and an increased risk of AITDs. Additionally, the results demonstrate a genetic causal association between susceptibility to AIT and an increased risk of vitiligo, while not indicating a similar association with susceptibility to AIH or GD.

Modern approaches to restoring vaginal microbiocenosis

The article presents literary data on the morphology and types of vaginal lactobacilli, pathological changes in the vaginal environment, as well as modern possibilities of restoring the vaginal microflora of a woman’s organism. Certain regularities regarding the connection of bacterial vaginosis with intestinal dysbiosis have been observed, which indicates a single dysbiotic process in the organism with a dominant manifestation either in the sexual or digestive system.A review of scientific publications of recent years shows the significant influence of intestinal dysbiosis, infectious and inflammatory diseases of the stomach and intestines, as well as the oral use of antibacterial drugs on the quantitative and qualitative composition of the vaginal microflora in women. It was found that an increased number of opportunistic microorganisms (85%) and a decreased number of lactobacilli and bifidobacteria (less than 70%) in the intestine are associated with a rise in the content of opportunistic microorganisms in the vaginal biota in women with infectious and inflammatory diseases of the reproductive system. This is explained by the ability of saprophytes and opportunistic microorganisms to penetrate into the reproductive organs of women by increasing the permeability of the mucous membrane of the intestinal wall, as well as into the vascular bed, which can be observed, for example, on the background of antibiotic use. The antibiotic use in a number of cases leads to a closed circle, when the need for antibacterial therapy to eliminate one infection leads to a deepening of dysbiosis and an increased number of other pathogens.Numerous studies have demonstrated the effectiveness of selective decontamination (selective elimination of pathogens) in combination with a probiotic, prebiotic or synbiotic to restore vaginal microbiocenosis.Our experience of using an oral synbiotic (1 capsule contains 5 billion colony-forming units of Lactobacillus plantarum lyophilizate pcs. 8Р-AZ, Lactobacillus fermentum pcs. 90Т-С4 and prebiotic inulin, once a day 30 minutes before meal for 7–10 days) in a complex therapy of bacterial vaginosis in non-pregnant women of reproductive age indicates faster elimination of systemic dysbiosis and restoration of normal intravaginal flora. Thus, regression of complaintsand normalization of objective data was determined on average for 2.9 days versus 4.7 days in women who were not administered the drug.The obtained data show that a systemic synbiotic containing a lyophilized microbial mass of probiotic lactobacteria, products of their metabolism and inulin (prebiotic) creates an additional effect in restoring normal biocenosis and the immune mechanism of ensuring colonization resistance of the body’s mucous membranes.

Spread of Covid-19 in Dental Setting

In the marine sector of the city of Wuhan in China and spread quickly through other cities of China and other nations, extreme (2019-nCoV) even fetal pneumonia has occurred. The Covid-19 was distinct from SARS-CoV, but the human angiotensin converting enzyme 2 (ACE2) expressed the same host receptor. The 2019-nCoV person-to - person routes involved active touch, such as cough, sneezing, inhalation droplet delivery and interaction delivery, such as gastrointestinal, nasal and visual mucous membranes. In addition, 2019-nCoV can be distributed through the saliva. Participants in dental work face-to - face contact and proximity to sweat, blood and other bodily fluids and the treatment of urgent equipment subject them to immense 2019-nCoV contamination. Dentists have an excellent position to perform in stopping 2019-nCoV transmission. The key method of spreading this disease is through inhalation of respiratory gout, for instance while the patients chat, sneeze, etc. Here we prescribe the management of infections during dental practice through obstructive transmission routes in dental clinical areas, as human-to-human transmission appears to occur mainly through closing up with symptoms involving Covid-19. The virus is often known for its potential to live outside living species, in aerosols or in infected equipment. Dentists are especially susceptible to Covid-19, since they cannot usually be more than one meter long and are exposed during surgical operations to spit, blood and other body fluids. In addition, a number of dental operations may produce aerosol, which is a greater source of airborne infection.

Lid-wiper keratopathy and mucous membrane grafting.

A healthy lid-wiper is an important component of a healthy ocular surface. Any abnormality or irregularity of the lid wiper can potentially damage a relatively healthy ocular surface. Stevens-Johnson syndrome, toxic epidermal necrolysis, and ocular cicatricial pemphigoid are some of the examples that can result in lid-margin keratinization during the course of the disease. These permanent changes at the lid margin mechanically abrade the corneal surface and facilitate corneal neovascularization. The corneal clarity is lost over time, and the patients have corneal blindness. This video discusses the role of a healthy lid-wiper, conditions causing lid-margin keratinization and subsequent lid-wiper keratopathy, and surgical technique in mucous membrane grafting. The video demonstrates the technique of restoration of a healthy lid margin by doing a mucous membrane graft for lid-margin keratinization and its role in the prevention of corneal blindness. Lid-margin keratinization is essentially a chronic sequela and is often ignored till irreversible corneal changes develop. Early intervention in the form of mucous membrane grafting can prevent corneal vascularization and loss of corneal clarity. https://youtu.be/NGMlqUp_qLU.

#1925 A rare cause of hyponatremia due to adrenal insufficiency in a patient with small cell lung cancer

Abstract Background and Aims Hyponatremia is the most frequent electrolyte disorder. Small Cell Lung Cancer (SCLC) release often antidiuretic hormone paraneoplastically. But Adrenal insufficiency is a rare cause of hyponatremia in SCLC. Prior one can cause euvolemic hyponatremia, latter one can cause hypovolemic hyponatremia. Opposite treatments should be applied for each one. So They should be investigated carefully before starting the treatment. Method A male patient who had metastatic SCLC was admitted to the emergency. After physical examination blood and urine tests were provided. Results A 52-year-old male patient who had metastatic SCLC was admitted to the emergency unit because of fatigue, weakness and confusion. On physical examination the patient's face was darkened but his conjunctiva was pale, his tongue and mucous membranes were dry. The blood pressure was 90/60 mm Hg. The test results provided were as follows: Glucose 106 mg/dL, creatinine 0.42 mg/dL, urea 38.1 mg/dL, sodium 109 mmol/L, potassium 3.3 mmol/L, white blood cells 9760 /mm3, hemoglobin: 9 g/dL, platelets: 176000/mm3. The patient had no chemotherapy during the last three months. He also did not have a history of antihypertensive treatment. The echocardiographic examination revealed that the ejection fraction was 60%. The abdominal computerized tomography scan showed multiple metastasis of the tumor, but adrenal glands were free of metastasis. The sodium deficit was calculated targeting to 120 mmol/L and therapy was started. The patient's weight was 70 kg. The calculated sodium deficit was 420 mmol. Since the hyponatremia was chronic, the deficit was planned to be given in 24 hours. Potassium was also given. During hospitalization, on day 2nd the patient's blood and urine tests were as follows: Creatinine 0.58 mg/dL, urine creatinine 22.8 mg/dL, 24-hour urine volume 2200 mL, 24-hour creatinine clearance 60 ml/min. Urine sodium concentration 105.6 mmol/L, serum sodium 114 mmol/L, sodium clearance: 1.41 ml/min. Fractional sodium excretion was 2.3%. Although the treatment was continued for 6 days, with the same dose of 420 mEq sodium given for each day, the serum sodium concentration reached to 115 mmol/L on day 6. (Totally, 2520 mEq of sodium was given for 6 days). Therefore, hyponatremia was thought to be due to urinary loss of sodium. The fractional sodium excretion of 2.3% supported this. All these findings suggested the diagnosis of renal salt wasting in this patient. We decided to give the patient fludrocortisone (Astonin H 0.1 mg) twice a day orally in addition to sodium chloride tablets (approximately 1.5 gram = 25-30 mmol). During the follow-up of the patient, the both fludrocortisone pills and salt tablets increased to 2 × 2, finally, when reached the level of sodium is above 130 mmol/L, salt tablets were stopped. One thing need to be noted here; hyponatremia did not improve unless giving fludrocortisone. But after this, although more sodium was given during sodium replacement, there was no increase in fractionated sodium excretion, on the contrary, it decreased. On day 14th, Fractional sodium elimination was 1.7%. Serum Na: 133 mmol/L. The patient was advised to take fludrocortisone tablets twice a day orally and was discharged from hospital on day 15th when serum sodium concentration was 138 mmol/L. If a patient with serum cortisol level below 4 mcg/dl have been evaluated as adrenal insufficiency regardless of ACTH level in sera.; additionally, hyperpigmentation and hyponatremia due to salt wasting through the kidneys led us to diagnose. The hyponatremia resolved only after added fludrocortisone. Conclusion However SCLC can give rise euvolemic hyponatremia producing ADH generally, besides, SCLC can cause adrenal insufficiency leading to serious hypovolemic hyponatremia. Diagnose is of crucial importance for correct treatment which can be only achieved by replacing the both sodium and fludrocortisone.

#2989 Superposition of atypical hemolytic syndrome and tubulointerstitial nephritis, a case report

Abstract Background and Aims Hemolytic uremic syndrome is a heterogeneous group of diseases that have in common the development of thrombotic microangiopathy with diffuse endothelial damage, resulting in the classic triad composed of microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury, on the other hand, tubulointerstitial nephritis is characterized by the presence of inflammatory infiltrates and edema and of the interstitial compartment that causes deterioration of renal function. Method The following is the case of a patient with acute kidney injury of etiology composed of thrombotic microangiopathy and tubulointerstitial nephritis. Results 27-year-old female patient without significant history, began 3 weeks prior to admission with fever, chills, asthenia, nausea and vomiting of food content, approximately 5 episodes per day for 3 days, presenting intermittent episodes of jaundice of the mucous membranes and conjunctivae, with progressive increase of the symptoms to the point of preventing daily activities, she was admitted for study, detecting hemolytic anemia, thrombocytopenia and severe acute kidney injury, so she was referred to our center was decided for evaluation by Nephrology and Hematology. In our institution, urinary sediment with dysmorphic erythrocytes was documented, peripheral blood smear without the presence of schistocytes, positive Coombs 4 crosses, renal ultrasound with data compatible with acute kidney injury, and supportive management with hemodialysis was initiated. Due to suspicion of autoimmune glomerulopathy, an autoantibody panel was indicated with negative antinuclear antibodies, anti-double-stranded DNA, anti-Sm, anti-B2 glycoproteins, and lupus anticoagulant, with normal complement values, stool culture, and negative stool Shiga protein assay, angiotomography of the abdomen where the integrity of renal circulation is verified, so renal biopsy with immunohistochemical study is performed, finding data compatible with thrombotic microangiopathy and acute tubulointerstitial nephritis. The patient is maintained with supportive care, steroids and hemodialysis as required with progressive recovery of renal function until renal replacement therapy is weaned, she is discharged with a steroid regimen and clinical nephrology and hematology follow-up. Conclusion Acute kidney injury is a complex and multifactorial entity, which requires a comprehensive approach in order to identify the best therapeutic option and to offer a better outcome in the renal function of these patients. The case of our patient presented a sudden deterioration of renal injury composed of two entities with different pathophysiology, demonstrating that, although the approach to these two entities converge in certain etiologies, it is imperative that the clinician does not forget the wide variety of factors that contribute to the development of renal injury.

HIV/AIDS and its marker diseases-manifestations

An objective confirmation of the seriousness of the human community’s understanding of the global significance of such a «relatively young» infection as HIV/AIDS is the extensive discussions — the discussion of this seemingly purely medical problem at several meetings of the UN General Assembly, as well as the creation of a specialized UNAIDS program (of the United Nations AIDS Program) which this year published a final report entitled «In danger». It assessed the current situation with this infectious disease as an absolute threat to the entire modern human society. Objective — to conduct an analysis of professional publications of recent years regarding the modern clinical and epidemiological features of the clinical course of HIV-infection/AIDS and to determine organizational measures to ensure at least partial well-being of the public health of the population of Ukraine in wartime conditions and the conduct of active hostilities. It is important to emphasize to primary care physicians not only the significant variety of clinical manifestations of various forms of this acutely contagious viral pathology, but also the real possibility of visually diagnosing it — suspecting it at a daily outpatient polyclinic appointment, based on the clinical manifestations of numerous marker diseases already present on the skin and mucous membranes. Materials and methods. Official documents and scientific publications related to public health policy, approaches to overcoming the HIV/AIDS epidemic, dynamics of morbidity and specific manifestations and clinical course of certain marker dermatological manifestations of this viral pathology in Ukraine were analyzed. Results and discusion. The content of the analyzed professional publications indisputably shows that the problem of HIV/AIDS has gone far beyond the scope of the purely medical field and has acquired the status of national significance. A modern approach to improving the state of public health requires constant coordination of the efforts of different people, who at the same time have a wide range of professional skills in many different disciplines, as well as the ability to collaborate fruitfully with others in joint multiprofessional teams to achieve the common goal of overcoming this viral epidemic. Conclusions. The analysis of scientific publications of recent years on the problem of HIV/AIDS indicates an urgent need to consider this disease in the state public health system as a socially significant infectious disease of the whole organism, in which early visual identification on the skin of clinical manifestations of a number of marker dermatoses allows prompt suspicion, and then and to quickly confirm both the fact of HIV infection and to start a course of ART. This requires an interdisciplinary approach and systematic methodological cooperation of primary care physicians, dermatovenerologists, infectious disease specialists, and pathologists in the aspect of timely (early) diagnosis and complex therapy of this viral infectious pathology.

Trichiasis in cicatricial ocular surface disease: a multi-center comparison of electroepilation versus eyelash resection outcomes

ABSTRACT Purpose To evaluate the outcomes of trichiasis (excluding entropion) management in non-trachomatous cicatricial ocular surface diseases. Methods This is a multicenter, retrospective study of 59 patients with trichiasis who were managed using two different techniques: electroepilation using radiofrequency (RF) cautery and eyelash resection. The assessed outcomes were residual trichiasis at 6 weeks, 6, and 12 months of follow-up and the number of procedures needed. Results 41 patients (90 eyelids) underwent electroepilation, and 18 (41 eyelids) were managed with eyelash resection. All patients belonged to either Indian or Japanese ethnicity. Most patients in both groups had Stevens-Johnson Syndrome (63.4% vs. 88.9%). The mean age (43.2 vs. 46 years), disease duration (122 vs. 192.4 months), median trichiasis grade (2 vs. 2), and involvement of upper eyelids (53/90 vs. 23/41) were similar in the two groups. At six weeks, 48.9% of eyelids that underwent electroepilation had no trichiasis, and recurrences were managed with repeat electroepilation (6 eyelids) and mucous membrane grafting (10 eyelids), and 35 eyelids opted for manual epilation, giving 67.8% success at a mean follow-up of 20 months. The eyelash resection group had 75.6% success at 6 months, and recurrences were managed using lid splitting and eyelash resection, resulting in 100% success at a mean follow-up of 79 months. More interventions were needed in the electroepilation group compared to eyelash resection. Conclusion Eyelash resection of the trichiatic eyelashes achieves a better success rate than electroepilation in cicatricial ocular surface disorders. Following electroepilation, one needs multiple interventions to resolve trichiasis.

Drug-related exanthema under immunotherapy and targeted oncological therapy

Oncological therapies can cause avariety of mucocutaneous adverse events. Exanthematous adverse events can be challenging in the context of the urgent need for cancer treatment due to their spread, sometimes rapid progression, and mucous membrane or organ involvement. This article provides an overview of the most important exanthematic dermatoses as side effects of modern drug-based tumor therapies with diagnostic and therapeutic information for clinicians, taking into account the current literature and guidelines. Exanthematous adverse events of immune checkpoint inhibitors, EGFR antagonists, kinase inhibitors, bispecific T‑cell engagers, and the CCR4 inhibitor mogamulizumab are reviewed in detail. Cutaneous side effects are common across all drug classes and cover abroad spectrum. While some adverse events are specific to one drug class, many exanthemas can occur with both oncological immunotherapies and various targeted therapies. Areliable diagnosis, dose adjustment or discontinuation of the offending agent in consultation with the treating oncologists and appropriate symptomatic therapy are important for correct management. In the case of severe, life-threatening drug reactions, however, permanent discontinuation of the drug is essential.

Pyogenic granuloma of maxillary median gingiva in a pediatric patient: A case report and literature review

Pyogenic granuloma (PG) is a painless pedunculated granulomatous lesion that develops on the skin and mucous membranes. PG in children is relatively rare. We herein report a case of PG of the maxillary median gingiva in a pediatric patient. The patient was a 6-year-old Japanese boy who presented with a painless mass with bleeding after exfoliation of the left upper deciduous central incisor. The lesion had undergone continuous, rapid growth for approximately 10 days. Intraoral findings revealed a painless, elastic, soft, and non-pedunculated mass, measuring 15 &amp;times; 10 mm, in the left upper deciduous central incisor area. To differentiate it from malignancy, an excisional biopsy was performed on the patient under general anesthesia. Histological findings confirmed that the patient suffered from PG. At the time of writing this paper, the patient had been clinically followed up for the 18th month after the surgery, showing no signs of tumor recurrence.

A rare case of classic Kaposi’s sarcoma with a lesion of the oral mucosa

Kaposi’s sarcoma is a systemic tumor multifocal disease of vascular genesis. In the classic Kaposi’s sarcoma, lesions are most often localized on the skin of the lower extremities, lesions of the mucous membranes are extremely rare. The article presents a rare clinical case of the classic Kaposi’s sarcoma in a 56 years old man with lesions of the oral mucosa. This clinical case is of particular interest due to the difficulties of differential diagnosis of Kaposi’s sarcoma and lichen planus when mucous membranes are involved in the pathological process. The presented case emphasizes the importance of a histological examination of the biopsy in differential diagnosis of Kaposi’s sarcoma. In case when the rash is widespread and the mucous membranes are involved, it is recommended to collect the material from the skin, because the histological picture will be more characteristic. It is important to pay attention to the duration of the elements’ existence, as morphological diagnosis in the early stages of Kaposi’s sarcoma can imitate the pattern of chronic dermatosis.

MYCOLOGICAL ANALYSIS OF CYSTIC CONTENT IN PATIENTS WITH POLYMICROCYSTIC CHANGES OF THE MAXILLARY SINUS MUCOSA

The prevalence of mycotic infections of the paranasal sinuses is constantly increasing worldwide. Pathogens can enter the sinuses through the respiratory tract that leads to the colonization of microorganisms in both the lungs and paranasal sinuses as part of the normal microflora. The presence of filamentous fungi in the maxillary sinus may result from endodontic treatment of molars directly adjacent to the sinus, increasing the risk of fungal foci development. Fungal paranasal sinusitis manifests in invasive or non-invasive forms. While mycological culture remains the traditional gold standard for mycosis diagnosis, its sensitivity is reportedly low. Paranasal sinus cysts comprise 4-8% of general ENT pathologies and approximately 4-16% of chronic paranasal sinus diseases, with a predominant presence in the maxillary sinus. Factors that contribute to the development of sinusitis and create favorable conditions for fungal spore adhesion and growth include impaired ventilation and transport function of the sinus mucosa, inadequate use of broad-spectrum antibacterial drugs and steroid therapy, as well as household factors. Recently, there has been an increase in the number of cases of multiple small cysts in maxillary sinuses. Clinical manifestations range from asymptomatic incidental findings to varying degrees of discomfort and/or pain localized in the maxillary sinus area. The aim of this study is to identify the involvement of a fungal agent and to develop a set of therapeutic and prophylactic measures for polymicrocystic changes in the mucous membrane of the maxillary sinuses. The study enrolled 37 patients aged 18 to 65 years. Atypical cystic content was collected and cultured in Sabouraud's nutrient broth and Amies transport medium at 35-37°C for 5-7 days, with final measurements on day 21. Treatment involved a 14-day regimen of itraconazole (100 mg once daily) alongside topical miramistin (0.01% solution, 2 ml) sinus injections. The findings obtained demonstrate the following: positive fungal growth was observed in 26 cases (70.3%), predominantly Penicillium (48.6%) and Aspergillus (21.6%). Absence of growth was noted in 11 cases (29.7%). Follow-up examinations in 6 months and in a year revealed no crusts in the nasal cavity, moderate mucous discharge in the sinuses, and no polymicrocystic changes. Conclusion. The analysis has demonstrated the involvement of fungal flora in the development and recurrence of cystic changes in the maxillary sinus mucosa, advocating for mycological examination alongside bacteriological analysis. Itraconazole for systemic therapy and miramistin for topical therapy demonstrate efficacy in treatment and recurrence prevention.

The GERD-caused middle ear mucous membrane transformation features in chronic otitis media with effusion

Introduction. Chronic otitis media with effusion (COME) is a middle ear disease, characterized by mucous effusion accumulation in its structures. One of the important COME formation mechanism is gastric reflux. Gastric contents reflux into the tympanic cavity which contributes to the irreversible transformation of its mucous membrane.Aim. To substantiate the significance of the gastric reflux in the middle ear mucosa fibrous remodeling.Materials and methods. The study included 96 people diagnosed with COME and concomitant gastroesophageal reflux disease (GERD), 54 women and 42 men, in the age range from 18 to 65 years (mean age 51.4 years). All patients underwent tympanostomy tube installation and supervised by an otolaryngologist during 12 months. Patients were divided into 2 groups depending on their consent to GERD therapy. The conservative treatment of COME and GERD was carried out in accordance with established and current medical care standards and clinical guidelines for the relevant nosology.Results and discussion. 14 days after the tympanostomy, the otorrhea decrease was noted in 31 (75.6%) of the main group and 31 (56.6%) participants in the comparison group (n = 96).By the end of 12 months observation a positive disease outcome such as exudation reduction and complete tympanic membrane repair was recorded in 35 (83.3%) and 25 (62.5%) patients of both groups respectively (n = 82).Patients with a mixed 34 (35.4%) and non-acid 11 (11.5%) types of reflux showed worse disease outcome rates, just like in patients with COME who delayed GERD treatment 8 (8.3%).Conclusions. The combination of infectious agent exposure causes an active mucous membrane exudation in the disease early stages with mixed and non-acid gastric reflux leads to mucous membrane middle ear fibrous remodeling. It has also been established that an unsuccessful COME treatment duration aggravates the outcome of the disease in the absence of GERD therapy.

ANALYSIS OF SURFACE QUALITY IN BASE ACRYLIC PLASTIC USING FLAW DETECTION METHOD

Before scanning the surface of the base acrylic plastic, ten samples were selected with a surface that had undergone all stages of finishing according to the proper dental protocol and ten samples that had previously been artificially damaged with scratches using sandpaper. This study addresses the assessment of the quality of removable orthopedic appliances concerning surface polishing and detection of microdefects. The research employs a comparative analysis of reference samples of base plastic and artificially damaged samples using flaw detection analysis. Prior to scanning the surface of the base acrylic plastic, ten samples underwent all stages of finishing according to dental protocol, while another ten samples were intentionally damaged with scratches using sandpaper. The macrophotographs obtained were processed using the "Image J" program, allowing for quantitative analysis of images, enabling the evaluation of surface quality through various parameters. This included evaluating the total number of defects, as well as the average area and perimeter of the defects. Statistical analysis conducted in the JUSP program enabled comparison between the two groups of samples, identifying significant quantitative differences. Based on the prominent indicators available in the Image J program, conclusions were drawn regarding the quality of the acrylic plastic surface and the factors influencing its condition through specific mechanical defects. The proposed method of light-optical flaw detection expands the clinical assessment capabilities of removable orthopedic structures (base plastic), particularly concerning potential bacterial contamination, which can serve as a significant factor in the formation of inflammation foci on the mucous membrane of the denture-supporting oral tissues. Flaw detection analysis enables a comprehensive assessment of material surface polishing quality and the detection of surface defects that may arise during production or use, thus preventing biofilm accumulation. The experiment demonstrated the effectiveness of light-optical flaw detection and highlights the potential for its further improvement and broader implementation in clinical practice.

Lipomas of the oral cavity

INTRODUCTION. Lipomas are benign mesenchymal tumors consisting of mature adipocytes. They are classified according to their histological picture, localization in the oral cavity and the type of tissues involved in the pathological process.The OBJECTIVE was to present the clinical case and literature review.MATERIALS AND METHODS. We conducted the search in the PubMed database for the last 86 years (1937–2023) with keywords «oral lipoma» or «tongue lipoma».RESULTS. We reviewed 60 articles with 77 identified lipomas. The most publications were represented by the USA (n=10, 16.39%) and India (n=10, 16.39%). We found out that the average age was 51.38 years (51.38±15.57); and most of them occurred over 50 years old. Lipomas are mainly localized on the mucous membrane of the cheek (n=24, 31.17%), then on the tongue (n=17, 22.8%) and in other places. The most common histological picture was spindle cell lipomas (n=13, 27.66%), followed by fibrolipomas (n=8, 17.02%) and other types.CONCLUSIONS. Lipomas are relatively rare neoplasms of the oral cavity. chronic traumatization of the oral mucosa is the predisposing factor for lipoma development. Preventive examinations every six months is recommended, if a patient has dental constructions. Any formation removed from the oral cavity is subjected to histological verification.

Antibacterial therapy in patients with acute sinusitis

The prevalence of the acute sinusitis in ENT practice is very high. The current prevalence in Russian Federation is roughly estimated at 6 to 15%, and accounts for about 10 million cases a year. The incidence of acute sinusitis increases in autumn and early spring and decreases in the summer. Most cases of acute sinusitis are of a viral etiology, but it can also arise from bacterial infection, allergies, or injuries. The disease is characterized by swelling of the nasal mucous membrane, nasal blockage and discharge. Typically, the duration of acute inflammation of the paranasal sinuses averages about 4 weeks. In case of the inappropriate treatment, the inflammatory process can spread to adjacent anatomical structures – to the orbit, ear, or brain, resulting in serious, sometimes life-threatening complications. Over the last 10 years, the resistance of pathogenic flora to antimicrobial agents has greatly increased due to the unjustifiability and irrationality of their use. The purpose of this review was to analyze the effectiveness and safety of the antibiotic therapy for acute rhinosinusitis. The paper discusses the etiology, pathogenesis, and characteristics of the acute sinusitis. It presents the features of the most used drugs, with special attention to the comparative assessment of their therapeutic effectiveness compared to other antibiotics, as well as determining the optimal schemes for their use within the framework of modern clinical protocols. A description of a clinical case of acute sinusitis and a treatment regimen with Cefixime EXPRESS is presented.

Using of endoscopic band ligation for endoscopic removal of colonic polyps

BACKGROUND. Intraand postoperative colonic bleeding is the most frequent complication in endoscopic removal of large colonic polyps. In this article, one of the methods of preventing this complication is discussed – preliminary preventive ligation of the leg of the polyp, carried out by using an endoscopic loop ligation.METHODS AND MATERIALS. The prospective trial provided between March and September 2023. This trial included 38 patients with 39 colonic polyps with the feeding leg of the polyp non-less than 5 mm in diameter. All patients underwent endoscopic mucosal resection within the leg of the polyp with preliminary preventive ligation of the leg. The ligation provided by the device inserted through the instrumental channel of the endoscope, and allowing delivery and tightening of the non-dissolving Rцder’s loop on the leg of the polyp.RESULTS. All identified polyps were successfully removed. The radicality of the removal was confirmed by histological examination data. The occurrence of technical difficulties during removal was noted in one case when removing the polyp 4 cm in diameter. The appeared technical difficulties were associated with difficult visualization of the feeding leg of the polyp, which was due to the large size of the removed formation. Positive correlation between the forma tion size and surgery time was observed (Spearman p=0.52, P=0.034). There were no bleeding complications during operations and early postoperative period.CONCLUSION. Preliminary preventive ligation is a simple, effective and safe method to prevent bleeding when remov ing polyps of the mucous membranes of the gastrointestinal tract.