Subgroup 1B Research Articles

Malignancy Rate and Malignancy Risk Assessment in Different Lesions of Uncertain Malignant Potential in the Breast (B3 Lesions): An Analysis of 192 Cases from a Single Institution

Background: The question of how to deal with B3 lesions is of emerging interest. Methods: In the breast diagnostics of 192 patients between 2009 and 2016, a minimally invasive biopsy revealed a B3 lesion with subsequent resection. This study investigates the malignancy rate of different B3 subgroups and the risk factors that play a role in obtaining a malignant finding. Results: The distribution of B3 lesions after minimally invasive biopsy was as follows: atypical ductal hyperplasia (ADH), 7.3%; flat epithelial atypia (FEA), 7.8%; lobular neoplasia (LN), 7.8%; papilloma (Pa), 49.5%; phylloidal tumour (PT), 8.9%; radial sclerosing scar (RS), 3.1%; mixed findings, 10.4%; and other B3 lesions, 5.2%. Most B3 lesions were detected by stereotactic vacuum-assisted biopsy (44.3%), 36.5% by ultrasound-assisted biopsy, and 19.3% by magnetic resonance imaging-assisted biopsy. Most B3 lesions (55.2%) were verified by surgical resection, whereas 30.7% were downgraded to a benign lesion. About 14.1% of the cases were upgraded to malignant lesions, 9.4% to ductal carcinoma in situ and 4.7% to invasive carcinoma. In relation to individual B3 lesions, the following malignancy rates were found: 28.6% (ADH), 13.3% (FEA), 33.3% (LN), 12.6% (Pa), 5.9% (PT), and 0% (RS). The most important risk factor was increasing age. Postmenopausal status was considered an increased risk for an upgrade (p = 0.015). A known malignancy in the ipsilateral breast was a significant risk factor for a malignant upgrade (p = 0.003). Conclusion: Increasing knowledge about B3 lesions allows us to develop a “lesion-specific” therapy approach in the heterogeneous group of B3 lesions, with follow-up imaging for some lesions with less malignant potential and concordance with imaging or further surgical resection in cases of disconcordance with imaging or higher malignant potential.

Immediate and long-term results of stenting of vertebral arteries in patients with asymptomatic chronic brain ischemia

Highlights. The efficiency of the endovascular treatment combined with medical therapy versus medical therapy has been proven to prevent strokes in patients with vertebral artery atherosclerotic lesions and asymptomatic chronic cerebral ischemia.Aim. To assess the efficiency of endovascular treatment in patients with asymptomatic vertebral artery atherosclerotic lesions as an approach for secondary prevention of strokes.Methods. Group 1 patients (n = 44) underwent stenting of the vertebral arteries combined with the medical therapy to prevent strokes, whereas group 2 patients (n = 56) received the medical therapy alone. Group 1 was then subdivided into two subgroups -subgroups 1a and 1b. Subgroup 1a patients underwent (n = 22) stenting using the embolic protection devices, while Subgroup 1b patients (n = 22) - embolic protection devices were not used. The follow-up was up to 36 months with regular visits at 12, 24, and 36 months. The inclusion criteria were as follows: asymptomatic vertebral artery stenosis of 50-95%; the diameter of the vertebral arteries of less than 3.0 and not more than 5 mm; the presence of cerebral and focal symptoms corresponding to asymptomatic chronic brain ischemia (according to E.V. Schmidt).Results. The overall incidence of spasm and dissection during endovascular intervention was 20% and 4.5% in Subgroup 1a and 1b, respectively (p = 0.0367). 2 (4.5%) patients had transient ischemic attack in Subgroup 1a. There were no perioperative strokes in Subgroup 1b. The overall rate of major cerebral complications over 36 months was 4.5% in Group 1 versus 37.5% in Group 2 (x2 = 15.101; p <0.0001). The rate of adverse cardiac events was 9.1% and 19.6%, in Groups 1 and 2, respectively (x2 = 14.784; p <0.0001). In-stent restenosis occurred in 38.67% of patients in Group I, who underwent stenting using various generations of stents. In-stent restenosis did not affect the incidence of major cerebral complications in the long-term period (x2 = 0.1643; p = 0.735).Conclusion. Endovascular treatment combined with medical therapy allowed preventing cerebral complications associated with the instability of atherosclerotic plaques in patients with asymptomatic vertebral artery stenosis. It has proved to be an effective method for the secondary prevention of strokes.

ЗНАЧИМОСТЬ ИММОБИЛИЗАЦИИ ПРОТИВОВОСПАЛИТЕЛЬНЫХ ПРЕПАРАТОВ ДЛЯ ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ ИХ ПРИМЕНЕНИЯ ПРИ ЛЕЧЕНИИ ХРОНИЧЕСКОГО ПАРОДОНТИТА ЛЕГКОЙ СТЕПЕНИ ТЯЖЕСТИ

Chronic generalized periodontitis of mild severity is characterized, along with inflammation, by minor radiological manifestations of destructive processes in the periodontal tissues. This determines the importance of choosing an algorithm for complex treatment of patients using immobilized anti-inflammatory drugs to achieve stable remission.
 The aim of the study was to study the effect of immobilization on the effectiveness of nonsteroidal anti-inflammatory drugs in the treatment of mild chronic generalized periodontitis.
 Research materials and methods. The study included the results of treatment of 180 patients with mild chronic periodontitis, who were divided into three groups depending on the drug used: in the first — based on benzidamine hydrochloride; in the second — based on etoricoxib, in the third — based on naphthylpropionic acid. In each group, two subgroups were identified "a" and "b": in subgroups 1a, 2a, 3a, a non-steroidal anti-inflammatory drug was used without immobilization. In subgroups 1b, 2b, 3b was immobilized. To assess the effect of immobilization on the effectiveness of the drugs, the results of therapy between subgroups were compared six months after the course of treatment. The periodontal index, PMA, and laser Doppler flowmetry parameters were used to study the clinical results.
 The results of the study. When analyzing the totality of indicators obtained after six months, it was found that in subgroups 1a, 2a, 3a, the effectiveness of treatment was 78.9%. A comparison of the studied index and functional indicators obtained after six months allowed us to state that in subgroups 1b, 2b, 3b, periodontitis was in the stabilization phase, that is, the effectiveness of treatment using immobilized drugs was 93.3%.
 Conclusion. The immobilization of nonsteroidal anti-inflammatory drugs on sorbents increases the effectiveness of their use in the treatment of chronic generalized periodontitis of mild severity from 78.9% to 93.3%.

Comparative efficacy оf non-surgical correction of early-onset genital prolapse based on differentiated approach

The paper presents the results of the comparative efficacy of non-surgical correction of early-onset genital prolapse (GP) in women of perimenopausal and menopausal age using differentiated approach. The objective: to study morphological traits of the vaginal walls and to compare the effectiveness of non-surgical techniques of GP correction. Materials and methods. The study involved 120 patients with early-onset GP. The treatment group (Group 1) consisted of 90 women with GP who were divided into three subgroups depending on the non-surgical correction technique chosen (utility model patent No.145380 from 10.12.2020): 1a (n=30) – GP correction by platelet-rich autoplasma, 1b (n=30) – GP correction by hyaluronic acid-based agent, 1c (n=30) GP correction using СО2 laser radiation. The experimental group (Group 2) consisted of 30 patients who underwent GP correction by training the pelvic floor muscles individually according to the standard method.Results. Three months after the treatment according to the patented method, the number of patients with GP of grade 2 decreased by 16.7% in group 1a, by 31.3% in group 1b and by 41.2% in group 1c. In patients of 1c subgroup, where the presence of the combined type (cystorectocele) of GP prevailed, in 19 women (63.3%) after the treatment there was an improvement in the morphological structure of the vaginal wall, which was manifested by a pronounced diffuse improvement in angiogenesis (in all layers) due to neoangiogenesis, preserved structure of collagen fibers with increasing density of the latter in the absence of signs of edema and mild degenerative changes. It should be noted that in subgroup 1b, three months after the treatment 17 (56.6%) women had no complaints which was associated with a significant improvement in the indicator of the size of elastin and collagen fibers, and only in 9 patients (30%) this indicator remained without changes. In subgroup 1a, the evaluation of the effectiveness of the non-surgical technique showed that only 10 (33.3%) women had a slight improvement in quality of life compared to baseline before treatment. In the experimental group, there was no positive dynamics, and in 9 women (30%) three months after the treatment there was an increase in manifestations of GP and symptoms associated with it, which was confirmed by such morphological changes as minimal focal signs of neoangiogenesis, thinned, significantly swollen collagen fibers, surrounded by interlayers of connective tissue.Conclusions. This algorithmic approach in non-surgical correction of GP contributes not only to the effective treatment of early-onset GP, prevention of further progression, but also to a significant improvement in quality of life.

Immediate and Delayed Bond Strength of a Multimode Adhesive to Deep Coronal Dentin Following Different Root Canal Irrigation Regimens.

To investigate the effects of root canal irrigants, dentin surface treatment, and timing of the restoration on the microtensile bond strength (μTBS) of a universal adhesive to deep coronal dentin. Ninety (90) intact molars were grouped according to the irrigation protocol: group 0 (saline, control group); group 1: 5.25% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) followed by 5.25% NaOCl; group 2: 18% etidronic acid (HEDP) + 5.25% NaOCl in a single mixture. Groups 1 and 2 were divided into 2 subgroups (n = = 10) according to the time of restoration: immediate (subgroup A) and after 7 days (subgroup B). Four other groups (n = 10) were created according to the dentin surface pretreatment and received an immediate restoration: group 3: 5.25% NaOCl - 17% EDTA and AH Plus Cleaner; group 4: 5.25% NaOCl - 17% EDTA and 100% ethanol; group 5: 5.25% NaOCl + 18% HEDP and AH Plus Cleaner; group 6: 5.25% NaOCl + 18% HEDP and 100% ethanol. μTBS testing was carried out for each subgroup and interfaces were analyzed through SEM. The μTBS was analyzed with Welch statistics and the post-hoc Games-Howell test for multiple comparisons (p < 0.05). Statistically significant differences were observed between test groups and control groups (p < 0.001), except for group 3 (p = 0.349). No significant differences were recorded between groups 1A (27.5 ± 8.7 MPa), 2A (32.6 ± 14.5 MPa) and 3 (27.3 ± 14.3 MPa). Group 6 (48.6 ± 11.6 MPa) exhibited the highest μTBS among all tested groups. For groups 1 and 2, significantly higher values were recorded for subgroups 1B (39.3 ± 7.6 MPa) and 2B (43.8 ± 8.3 MPa) compared to subgroups 1A (27.5 ± 8.7 MPa) and 2A (32.6 ± 14.5 MPa). When using NaOCl as root canal irrigant, it is advisable to delay the placement of a post-endodontic-treatment restoration.

Modern Methods of Treating Erectile Dysfunction in Young Men

Traditionally, the incidence of erectile dysfunction (ED) increases with the age of a man, evolutionarily protecting him from passing on old, defective genes to his offspring by limiting his participation in sexual activity. Nevertheless, in the modern world, only 1 % of sexual contacts are carried out for the purpose of reproduction, the rest – with a recreational and social purpose. In addition, there has been an increasing number of cases of ED in young men lately. The problem of treating ED in young patients (up to 45 years old) requires an etiological approach.&#x0D; The objective: to determine the effectiveness of etiological non-surgical (treatment of prostatitis, psychotherapy) or minimally invasive (Marmara operation, veno-occlusive surgery, PRP-therapy) treatment of young men with ED.&#x0D; Materials and methods. On the basis of the Kharkiv Regional Medical Clinical Center for Urology and Nephrology named after V.I. Shapoval and on the basis of the P. Mogila Black Sea National University (Nikolaev) during 2014–2020. a comprehensive examination and treatment of 563 patients was carried out, which were divided into three supergroups (A, B and C) according to the prevailing factor: 156 patients with venoocclusive erectile dysfunction – supergroup A, 353 patients with chronic prostatitis – supergroup B and 54 patients with predominant psychoneurological disorders and the absence of organic pathology - supergroup C.&#x0D; Results. The effectiveness of surgical treatment in supergroup A according to subjective data after 2 months was almost equal in groups and subgroups, but after 18 months it was significantly higher in subgroups 1b and 2b (65.4 % and 83.7 %) according to ICEF results, and according to objective data after 18 months – 73.4 % and 91.4 %, respectively. After 1 and 7 months, the effectiveness of treatment in supergroup B was determined by the indices of satisfaction with sexual intercourse on the IIEF scale, the number of patients satisfied with the results of treatment, the absence of prostatic complaints and the eradication of infectious agents. Convincing results were obtained when assessing the quality of life of patients in supergroup C.&#x0D; Conclusion. Chronic prostatitis is the most common cause of erectile dysfunction ED in young men. Three-week antibacterial etiological treatment demonstrates the highest rates of infection eradication and ICEF recovery in patients with prostatitis. Operation Marmara reduces venous hyperemia of the prostate, lowers the IPSS score, and improves erectile function in patients with comorbid pathology. The use of an etiological approach allows to improve the sexual function of young patients, returning them to a normal sexual life, creating an alternative to falloprosthetics.

Method of surgical treatment of chronic dacryocystitis and its effectiveness in monitoring patients in the early postoperative period

The aim. To develop a method for endonasal endoscopic dacryocystorhinostomy (EEDCR) and evaluate its effectiveness in monitoring patients in the early postoperative period.&#x0D; Materials and methods. The study group (1st group) consisted of 45 patients with chronic dacryocystitis (CD), who underwent EEDCR according to the developed method, the comparison group (2nd group) included 36 patients who, after performing the developed EEDCR, an implant was installed in the dacryorhinostoma zone. The control group (3rd group) included 28 patients who underwent EEDCR according to the generally accepted method. Patients of groups 1 and 2 were divided into 2 subgroups: 1A and 2A included patients who underwent computed tomography of the lacrimal ducts in the preoperative period according to the developed method, and patients of subgroups 1B and 2B – according to the traditional algorithm. Reliably the best results of restoring lacrimation function were in subgroups 1A and 1B already from the 3rd day of observation after surgery, as well as in the subsequent periods of observation. The worst values of lacrimation function were recorded in the control clinical group with a statistically significant difference from other groups (p&lt;0.05). When comparing the results of treatment of subgroups 1A with 1B and 2A with 2B, the best indicators were observed in subgroups 1A and 2A, but due to the small sample of patients, statistical significance in the differences could not be achieved (p&gt;0.05).&#x0D; Results. A method of EEDCR has been developed, a comparative analysis of groups of patients according to the above indicators has been performed when observing patients in the early postoperative period. On the first day after surgery, the mean score of the severity of lacrimation according to the Munk scale significantly decreased in all groups and gradually decreased on the 7th day and after 2 weeks (p&lt;0.05). Significantly better indicators were in subgroups 1A and 1B in the entire early postoperative period (p&lt;0.05). The degree of edema of the mucosa of the dacryorhinostoma zone and the middle nasal meatus at all periods of observation was the lowest in subgroup 1A from 3rd day and in each subsequent period of observation with a statistically significant difference from other groups (p&lt;0.05). On the 7th day, significantly more patients with mucous discharge in the area of dacryorhinostoma and middle nasal meatus were observed in subgroup 2B and in 3rd group (p&lt;0.05), and significantly better results were noted in subgroup 1A, where more than 2/3 patients had no mucous discharge. Reliably the best results of restoring lacrimation function were in subgroups 1A and 1B already from the 3rd day of observation after surgery, as well as in the subsequent periods of observation. The worst values of lacrimation function were recorded in the control clinical group with a statistically significant difference from other groups (p&lt;0.05). When comparing the results of treatment of subgroups 1A with 1B and 2A with 2B, the best indicators were observed in subgroups 1A and 2A, but due to the small sample of patients, statistical significance in the differences could not be achieved (p&gt;0.05).&#x0D; Conclusions. The developed EEDCR method complies with the principles of sparing surgery, is effective in the treatment of patients with CD, while there is a faster rate of recovery of the lacrimal function and mucosa, improves the quality of life of patients

Features of Preoperative Preparation of Patients with Burns and Chronic Ulcers of Various Etiology for Autodermoplasty

The influence of various schemes of preoperative preparation for autodermoplasty on the rates of skin graft survival and the duration of hospitalization in patients with burns and wounds of various etiologies was analyzed. Patients were divided into groups and subgroups depending on the preparation scheme. Group I (22 patients) received negative pressure wound therapy (NPWT) during the preoperative period for 5 days in combination with reamberin — intravenous drip at a rate of 40-60 drops/min, 500 ml, once a day for 5 days. Those patients were divided into subgroups: subgroup 1A (17 people) received complex treatment without antibiotic therapy, subgroup 1B (5 people) received antibiotic therapy. Group II consisted of 30 patients, who received vacuum therapy during the preparatory period. Group II patients were also divided into subgroups: 2A (16 people) received NPWT without antibiotics, 2B (14 people) — vacuum therapy together with antibiotic therapy. Group III (comparison, n=52) included patients who were treated using traditional methods, including antibiotic therapy and topical use of various dressings and ointments. Follow-up morphohistological study of wound biopsies was carried out in order to determine the area of fibroblasts, the area of fibroblast nucleus, and the number of vessels. After skin autografting, skin flap survival rate was determined, taking the time of hospitalization into account. Upon comparison of preoperative preparation schemes used for patients with burns and chronic ulcers of various etiologies with a surface area of 1–5% appropriate for skin autografting, the scheme that included NPWT and reamberin for 5 days proved to be the most effective: an improvement in fibroblastogenesis and blood flow to the wound was noted in this group of patients, which was accompanied by an improvement in the skin flap survival rate up to 90.0±9.9%, which, in turn, reduced the duration of patient’s hospital stay — the average duration of the preoperative period was 2.5 times shorter, postoperative — 1.9 times shorter than in the comparison group (p&lt;0.05). The results obtained make it possible to recommend the use of this scheme in the preoperative preparation for skin autografting for patients with burns and chronic ulcers of various etiologies with the surface area of 1–5%.

Bone turnover markers in patients with isolated femoral shaft fracture undergoing systemic ozone therapy

Efferent physical therapy holds promise as an adjunct to the combination treatment of femoral fractures in young, working-age individuals. The aim of the study was to investigate the dynamics of bone turnover markers at different stages of femoral fracture consolidation in patients undergoing ozone therapy. The study enrolled 20 men (group 2, 47.8 ± 3.5 years) with a femoral shaft fracture (AO/ASIF 32А, 32В). The control group (group 1, 46.8 ± 3.7 years) comprised 10 healthy males. Subgroup 2a (n = 10) was assigned to receive standard therapy; subgroup 2b (n = 10) was assigned to receive standard therapy complemented by minor autohemotherapy (MAHT) at 20 mg/L ozone concentrations. On days 7, 30 and 90, fracture consolidation was assessed on the RUST scale and blood levels of С-terminal telopeptides of type I collagen (bCTx, pg/ml) and procollagen type I carboxy-terminal propeptide (PICP, ng/ml) were measured. On day 7, the total RUST score in subgroups 2a and 2b was 4 points; on day 30, it was 6.5 and 8.7 points, respectively, and on day 90, it reached 10 and 11.5 points, respectively. Bone mineral density was as high as 90% in the MAHT subgroup vs. 78% in subgroup 2а, indicating faster bone healing. On day 30, bCTx levels in subgroup 2b were higher than in subgroup 2a (2289.4 [2145.3; 2365.4] vs. 1894.6 [1745.3; 2098.2], respectively. On day 7, PICP was significantly elevated in subgroup 2b in comparison with subgroup 2a; its levels peaked on days 30 and 90 (day 30: 268.3 [231.2; 286.3] vs. 183.2 [174.6; 195.6]; day 90: 584.6 [512.3; 589.3] vs. 351.2 [312.3; 369.4]. Thus, MAHT produces a positive effect on the quality and intensity of bone healing in men with isolated closed femoral shaft fractures.

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Efferent physical therapy holds promise as an adjunct to the combination treatment of femoral fractures in young, working-age individuals. The aim of the study was to investigate the dynamics of bone turnover markers at different stages of femoral fracture consolidation in patients undergoing ozone therapy. The study enrolled 20 men (group 2, 47.8 ± 3.5 years) with a femoral shaft fracture (AO/ASIF 32А, 32В). The control group (group 1, 46.8 ± 3.7 years) comprised 10 healthy males. Subgroup 2a (n = 10) was assigned to receive standard therapy; subgroup 2b (n = 10) was assigned to receive standard therapy complemented by minor autohemotherapy (MAHT) at 20 mg/L ozone concentrations. On days 7, 30 and 90, fracture consolidation was assessed on the RUST scale and blood levels of С-terminal telopeptides of type I collagen (bCTx, pg/ml) and procollagen type I carboxy-terminal propeptide (PICP, ng/ml) were measured. On day 7, the total RUST score in subgroups 2a and 2b was 4 points; on day 30, it was 6.5 and 8.7 points, respectively, and on day 90, it reached 10 and 11.5 points, respectively. Bone mineral density was as high as 90% in the MAHT subgroup vs. 78% in subgroup 2а, indicating faster bone healing. On day 30, bCTx levels in subgroup 2b were higher than in subgroup 2a (2289.4 [2145.3; 2365.4] vs. 1894.6 [1745.3; 2098.2], respectively. On day 7, PICP was significantly elevated in subgroup 2b in comparison with subgroup 2a; its levels peaked on days 30 and 90 (day 30: 268.3 [231.2; 286.3] vs. 183.2 [174.6; 195.6]; day 90: 584.6 [512.3; 589.3] vs. 351.2 [312.3; 369.4]. Thus, MAHT produces a positive effect on the quality and intensity of bone healing in men with isolated closed femoral shaft fractures.

Comparative analysis of treatment of patients with chronic dacryocystitis in early and late postoperative periods

Chronic dacryocystitis (CD) is a common pathology of the lacrimal ducts. The search for the optimal method of endonasal endoscopic dacryocystorhinostomy (EEDCR), which would give a quick, high-quality and lasting effect, as well as a lower percentage of disease relapses, remains relevant. The aim: to analyze the effectiveness of treatment of patients with chronic dacryocystitis in the early and late postoperative periods with the use of various modifications of EEDCR. Materials and methods: The study group (1st group) consisted of 45 patients with CD, who underwent EED-CR according to the developed method, the comparison group (2nd group) included 36 patients who, after performing the developed EEDCRa polyvinyl chloride (PVC) conductor was installed in the area of the dacryorhinostoma. The control group (3rd group) included 28 patients who underwent EEDCR according to the generally accepted method: with preservation and plastic placement of mucous flaps and with the installation of a PVC conductor. Patients of 1stand 2nd groups were divided into 2 subgroups: 1A and 2A included patients who underwent computed tomography of the lacrimal ducts in the preoperative period according to the developed method, and patients of subgroups 1B and 2B – according to the traditional algorithm. In the postoperative period, the severity of lacrimation was assessed according to the Munk scale, the degree of visualization of the dacryorhinostoma was determined, and the lacrimal function was investigated by advanced West nasolacrimal test under endoscopic control. The final treatment efficacy was assessed 1 year after surgery. Results: The best results when tested according to the Munk scale were recorded in subgroups 1A and 1B with a statistically significant difference from subgroups 2A, 2B and 3rd group throughout the early postoperative period and 1 month after surgery (p&lt;0.05).During the observation period of 3, 6 and 12 months, that is, after the removal of the implant from the lacrimal ducts, there was an improvement in the results in patients of subgroups 2A, 2B and 3rd group, and the difference from subgroups 1A and 1B was statistically insignificant (p&gt;0.05).In the early postoperative period, visualization of the dacryorhinostoma was good in all patients. In the late postoperative period, the best results were in subgroup 1A, the worst in 3rd group, but without a statistically significant difference due to a small sample of patients (p&gt;0.05).Reliably better results of the lacrimal function were obtained in subgroups 1A and 1B already from the 3rd day after surgery, as well as in the subsequent periods of the early postoperative period and 1 month after surgery (p&lt;0.05).In subsequent periods of the late postoperative period, this indicator worsened in all clinical groups, the best results were in subgroup 1A, the worst in 3rd group, but due to a small sample of patients, there was no statistically significant difference (p&gt;0.05).The maximum paces of deterioration in visualization of dacryorhinostoma and lacrimal function were observed from the 3rd to 6th months after the operation. The proportion of positive treatment results in 1st group was 97.8%, in 2nd group – 94.4%, and in 3rd group – 85.7%, while the difference between groups 1 and 3 was statistically significant (p&lt;0,05). Conclusions: The developed technique of endonasal endoscopic dacryocystorhinostomy allows achieving stable remission in 97.8% of patients with chronic dacryocystitis, and the use of CT of the lacrimal ducts according to the developed technique allows to improve the results of surgical treatment.

The Influence of Cement Spacer Thickness on Retentive Strength of Monolithic Zirconia Crowns Cemented with Different Luting Agents (A Comparative in-vitro Study)

Aims of Study: to evaluate and compare the retentive strength and the failure-modes of monolithic zirconiacrowns with different cement spacer thickness, cemented with two different types of luting agents.Materials and Methods: Forty sound maxillary first premolar teeth were divided into two main groups(n=20): Group A: cement spacer thickness of 80?m; Group B: cement spacer thickness of 120?m. Thegroups were further subdivided into two subgroups (n=10): (A1, B1) cemented with Panavia F2.0 resincement; (A2, B2) cemented with Riva luting plus RMGIC. All the teeth were prepared to receive monolithiczirconia crowns with the following features: (6º convergence angle, 0.8mm deep chamfer finishing line,4mm axial wall height with planar occlusal reduction). Afterwards, the teeth were scanned and the crownswere fabricated and cemented. Zirconia crowns were pulled-out along its path of insertion using universaltesting machine. Failure stresses were calculated in MPa. Failure-modes was assessed using magnifyinglens (2.5X).Results: The highest mean retentive values (in Mpa) was recorded by subgroup B1 (8.651); followed bysubgroup B2 (7.765); subgroup A1 (7.309) and subgroup A2 (6.875). Independent t-test showed a statisticallysignificant difference between A1 and B1 subgroups. Concerning the failure-mode, the majority of samplesrevealed adhesive failure between teeth and cement.Conclusion: All the tested crowns have mean retentive values within the clinically acceptable limit,increasing cement space resulted in a significant increase in the retention when Panavia F2.0 used as a lutingagent, while, it has no significant effect on the retention when RIVA luting plus was used.

Single-stage Orbital Decompression, Strabismus and Eyelid Surgery in Moderate to Severe Thyroid Associated Orbitopathy

ABSTRACT Purpose To evaluate the outcome of orbital decompression, strabismus and/or eyelid surgery in patients with moderate to severe thyroid-associated orbitopathy, when combined approach is preferred. Methods Retrospective, comparative, non-randomized review of 45 patients operated on from 2015 to 2018. Simultaneous decompression, eyelid and/or strabismus surgery was performed in 34 eyes of 20 subjects (group 1). Patients with multi-step procedures were used as control groups: group 2 included patients with staged decompression and eyelid retraction surgery (15 cases, 19 eyes); group 3 included patients with staged decompression and vertical strabismus surgery (10 cases, 13 eyes). Mean follow-up was 2.9 ± 1.8 years. Mann Whitney two-tailed test was used for paired data, and Fisher’s exact test for categorical data; p <.05 were considered statistically significant. Results Changes in margin reflex distance were not significantly different among patients of subgroup 1A (11 patients, one-step decompression/eyelid surgery) and group 2 (p >.05). Improvement in postoperative diplopia were not significantly different among patients of subgroup 1B (9 cases, one-step decompression/strabismus/eyelid surgery) and group 3 (p >.05). One patient of group 1 had recurrent dysthyroid optic neuropathy that recovered with steroid treatment. No other complications occurred in the one-step surgery group. Conclusions Simultaneous orbital decompression, strabismus and/or eyelid surgery resolved dysthyroid optic neuropathy, decreased proptosis, improved diplopia and eyelid position with a range comparable to that of a multi-step technique. If confirmed in prospective controlled studies, a one-stage approach might be advised to reduce the costs and time needed for rehabilitation in selected patients.

Clinical and radiographic evaluation of the effect of salvadora persica as a pulpotomy medicament versus formocresol and calcium hydroxide

Objective: The objective of this study was to compare between the clinical and radiographic effects of three medicaments (Salvadora Persica SP, Formocresol and Calcium hydroxide) on non-vital pulpotomy of primary and young permanent molars. Subjects and Methods: The present study was a randomized controlled study comprised of 24 children. These teeth were classified into two equal groups. The patients were with age from 4-8 years old. In (Group 1) the radicular pulp of the primary teeth was capped with formocresol in (subgroup 1A) and SP in (subgroup 1B) after pulpotomy procedures. In (Group 2) the radicular pulp of young permanenet molar was capped with calclium hydroxide in (subgroup 2A) and SP in (subgroup 2B) after pulpotomy procedures. The teeth were assessed clinically and radiographically after 3 months. Result: The present study revealed that, in (Group1) the clinical and radiographic success rate of salvadora persica was 83.3%, while the success rate of formocresol was 100% . In (Group2) SP showed no success as a pulpotomy medicament for vital pulpotomy of young permanenet molars. Conclusion: Based on the present finding, it may be concluded that, - Salvadora Persica proved good clinical and radiographic result as a pulp medicament for non-vital pulpotomy of primary molars. - Salvadora Persica showed no success as a pulpotomy medicament for vital pulpotomy of young permanenet molars.

Magnetic Fields of CP Stars in the Orion OB1 Association. IV. Stars of Subgroup 1b

The paper presents magnetic field measurements for 15 chemically peculiar (CP) stars of subgroup~1b in the OrionOB1 association. We have found that the proportion of stars with strong magnetic fields among these 15 CP stars is almost twice as large as in subgroup 1a. Along with this, the age of subgroup 1b is estimated as 2 Myr, and the age of subgroup~1a is in the order of 10 Myr. The average root-mean-square magnetic field Be for stars in subgroup 1b is 2.3 times higher than that for stars in subgroup 1a. The conclusions obtained fall within the concept of the fossil origin of large-scale magnetic fields in B and A stars, but the rate of field weakening with age appears anomalously high. We present our results as an important observational test for calibrating the theory of stellar magnetic field formation and evolution.

Цервицит: возможности альтернативной терапии

Aim: to assess the efficacy of the alternative treatment for cervicitis in women of reproductive age and premenopausal women. Patients and Methods: this pilot comparative study included 60 women of reproductive age and premenopausal women (25–45 years) with cervicitis who were divided into two groups. Group 1 women (n=30) received multi-component herbal preparation (Tukofitol cream) once daily for 20 days. Group 1 women were subdivided into two subgroups. In women of subgroup 1A (n=14), opportunistic flora in relevant titers was identified, and these women were prescribed systemic antibacterial treatment. In women of subgroup 1B, no opportunistic flora in relevant titers was identified, and these women were prescribed with multi-component herbal preparation only. Group 2 women (controls, n=30) were also subdivided into two subgroups. In subgroup 2A (n=16), women received systemic antibacterial treatment and Povidone Iodine vaginal to manage opportunistic flora. In subgroup 2B (n=14), no opportunistic flora in relevant titers was identified, and a watchand- wait approach was applied. Before treatment and 30 days, subjective symptoms typical for cervicitis were evaluated, laboratory tests and colposcopy were performed. Results: two women from each group have withdrawn from the study. In group 1, more rapid improvement of cervicitis symptoms vs. group 2 (p&lt;0.05) was reported. Moreover, no growth of opportunistic flora was more commonly seen in group 1 (100%) compared to group 2 (92.85%, p&gt;0.05). Conclusion: the improvement of subjective criteria and laboratory test results has demonstrated that treatment was effective in both groups. In the lack of opportunistic flora in relevant titers, multi-component herbal preparation as monotherapy can be prescribed to reduce symptoms of inflammation. KEYWORDS: cervicitis, inflammation of the cervix, Tukofitol, reproductive age, premenopausal age, treatment, diagnostics, colposcopy, opportunistic microbes, sexually transmitted infections, monotherapy. FOR CITATION: Saprykina L.V., Ibragimova D.M., Narimanova M.R. Cervicitis: potentialities of alternative treatment. Russian Journal of Woman and Child Health. 2021;4(3):225–228 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-225-228.

Effect of Bleaching with Strawberry Extract and Hydrogen Peroxide on Colour Change, Surface Morphology and Micro-Shear Bond Strength of Resin Composite to Enamel Surface

Introduction: The search to replace the chemical bleaching agent namely the Hydrogen Peroxide (HP) with a natural substance to whiten the discoloured tooth is a need of the hour, due to the severe roughing and compromised bonding of resin composite to enamel surface by this agent. Aim: To evaluate and compare the colour and surface changes in enamel surface, and the micro-shear bond strength of resin composite to enamel following bleaching with 35% HP and 2% Strawberry Extract (SE). Materials and Methods: In this in-vitro study, 30 bovine maxillary central incisors were decoronated and allocated randomly to two groups: group 1 (negative control) (n=15) and group 2 (experimental) (n=15). To evaluate the bleaching efficacy, group 2 specimens were experimentally stained with tea. Baseline colour coordinates (pre-bleach values) (L*, a*, b*) (∆E) were recorded. The crowns were sectioned to obtain four equal parts to obtain 60 specimens and these were allotted randomly to 4 subgroups a, b, c, d (n=15 each) based on the bleaching protocol. Subgroup a, Hydrogen Peroxide (HP). subgroup b, Strawberry Extract (SE); subgroup c, HP+SE (HPS); subgroup d, HP/P (HP/ Proanthocyanidin). Following bleaching, colour coordinates (post-bleach values) (L*, a*, b*) (∆E) were measured as mentioned before. Qualitative analysis of the surface (n=2) for each group was performed using scanning electron microscopy. Micro-shear bond strength of resin composite to the treated specimens (n=13) was determined using universal testing machine at a crosshead speed of 1 mm/min. Kruskal-Wallis one-way Analysis of Variance (ANOVA) was used to calculate the p-value and Post-Hoc Tukey Honest significant Test (HSD) was used to identify the significant groups, p-value (&lt;0.05). Results: All the post-bleach specimens showed significantly higher mean ∆E (more whiter) values compared to their respective pre-bleach specimens (baseline values) (p-value -&lt;0.05). Among the post-bleach groups, highest ∆E values (more whiter) were observed in subgroup 2c(HPS) (p-value=0.029). Similarly minimal morphological surface irregularities were observed in HPS. Group 1 (negative control) had the highest micro-shear bond strength compared to the experimental groups (group 2). Significantly, higher micro-shear bond strength was observed in subgroups 2b,c,d (SE, HPS, HPP) compared to subgroup 2a(HP) (p-value &lt;0.001). Conclusion: SE alone or in combination with HP is an efficient and effective dental bleaching agent.

The impact of the pelvicalyceal anatomy characteristics on the prediction of flexible ureteroscopy outcomes.

Background:The anatomical architecture is a prominent factor in the outcomes of flexible ureteroscopy (FURS).Aims and Objectives:The aim to regard the success of procedures based on Pelvicalyceal body that called Sampaio classification system.Materials and Methods:A total of 125 FURS procedures were reviewed between December 2012 and December 2016 in our department. Seven patients were excluded from the study due to the horseshoe kidney in two cases and recurrent cystine stone configuration in five patients. The patient's renal collecting system anatomy characteristics are regarded, and they are classified into four main groups based on the mid-renal-zone anatomy assessed according to Sampaio Classification.Results:Total stone-free rate (SFR) during the postoperative 1st-month evaluation was noncontrast computerized tomography 75 (63.6%). The evaluation of the SFR in all subgroup of cases based on Sampaio classification noticed easily, SFR was significantly lower in subgroup A2 (30.4%) (P = 0.00), significantly higher in subgroup B2 (P = 0.008). The comparative analysis of the operative duration defined that it was the shortest (75.3 ± 18.1 min) in Type B1 subgroup cases, and the longest (84.7 ± 25.7 min) in the Type A2 subgroup cases. Even though this duration was found to be relatively higher in Type A2 subgroup cases than the others, this difference was not statistically significant (P = 0.271). Fluoroscopy time was noted to be the shortest (11.9 ± 13.4 s) in B1 subgroup and the longest in A2 subgroup with a statistically significant different (median: 21.3 ± 30.4) (P = 0.04). While 6 (5.1%) cases had Clavien 2 and 3 (2.5%) cases, demonstrated Clavien 3a complications.Conclusion:The calyceal structure of the kidney affects the SFR; therefore, a detailed classification of pelvicalyceal could improve the outcomes, decrease the rate of auxiliary procedures and prevent the complications.

Winegrower’s Knives in the Mediaeval Crimea

This paper addresses the archaeological evidence of the development of viticulture in the mediaeval Crimea as a specialized branch of agriculture. Although the scholarship mentions the areas where vines were planted (Dimitraki hollow, the vicinity of the castle of Siuiren’, Mangup, etc.), these publications do not provide any appropriate descriptions or illustrations. Therefore, reliable archaeological sources include primarily the finds of special winegrower’s knives with a curved (crescent-shaped) blade. There are three zones of their distribution in the south-western (vicinity of Cherson, Eski-Kermen, Mangup, and the vicinity of the castle of Siuiren’), south-eastern (Tepsen’ and Kordon-Oba), and southern Crimea (Isar-Kaia and the vicinity of the castle of Funa). Their chronology covers the period from the eighth to thirteenth centuries. There are two main groups of winegrower’s knives determined according to their morphological features: group 1 comprises tanged knives and group 2 socketed knives. Each group is divided into two subgroups, depending on the presence or absence of a special trapezoidal protrusion, or “axe”, on the back of the blade. The iconographic materials demonstrate that winegrower`s knives of subgroup 1B occurred in the Late Byzantine Period (tanged winegrower’s knife with a sub-rectangular “axe” on the back of the blade). Western European Late Mediaeval miniatures demonstrate the functional use of winegrower`s knives of subgroup 1A (small tanged knives with no “axe”) intended for cutting bunches of grapes.

Аденомиоз и бесплодие. Подходы к лечению

Aim: to improve the rate of pregnancy in women with adenomyosis and infertility. Patients and Methods: this prospective comparative study included 150 women aged 24–38 years. Among them, 120 women were diagnosed with infertility and adenomyosis, and 30 healthy women planned pregnancy (control group). 60 women (study group 1) underwent surgery for adenomyosis, 30 women were followed up only (study subgroup 1A) and 30 women received Dienogest 2 mg for 6 months (study subgroup 1B). Women of study group 2 (n =60) underwent no surgery, 30 women were followed up only (study subgroup 2A) and 30 women received Dienogest 2 mg for 6 months (study subgroup 2B). After 3 and 6 months, blood levels of hormones, junctional zone thickness (measured by ultrasound), and the rate and time of pregnancy were assessed. Results: at baseline, women with adenomyosis were reported to have high levels of estradiol (p&lt;0.05 compared to the control group). After 3 and 6 months, the level of estradiol gradually reduced to 432.5±27.4 pmole/l and 364.3±16.2 pmole/l in study subgroup 2A and 314.3±22.7 pmole/l and 264.7±18.6 pmole/l in study subgroup 2B (p&lt;0.05). Pregnancy occurred, on average, after 6.1±1.6 (3–8) months in study subgroup 1A, 5.3±1.1 (4–7) months in study subgroup 2A, 4.1±1.4 (2–7) months in study subgroup 1B (p≤0.05 compared to study subgroup 1A and study group 2), and 5.1±1.2 (3–7) months in study subgroup 2B. In study groups 1 and 2, pregnancy occurred 1.5- and 1.4-times more commonly in women who received Dienogest. Conclusions: surgery and further hormone therapy is an optimal management strategy for adenomyosis and infertility. KEYWORDS: adenomyosis, infertility, Dienogest, junctional zone, pregnancy. FOR CITATION: Esedova A.E., Medzhidova A.M. Adenomyosis and infertility. Management strategies. Russian Journal of Woman and Child Health. 2021;4(2):110–114. DOI: 10.32364/2618-8430-2021-4-2-110-114.