Subgroups 1A Research Articles

Microstructure and mechanical properties of zirconia stabilized with increasing Y2O3, for use in dental restorations

AbstractThe present in vitro study aims at characterizing dental zirconia ceramics, which are stabilized with a high amount of Y2O3. Two groups of specimens were fabricated by computer‐aided design/computer‐aided manufacturing technique. The specimens of each group were divided into two subgroups (SGs): SGs 1a and 2a contained a relatively low amount of Y2O3 (6–8 wt.%), whereas SGs 1b and 2b contained a higher amount of Y2O3 (8–10 wt.%). The influence of yttria content on their microstructure and mechanical properties was experimentally determined. The statistical significance of the differences in the mechanical properties between the SGs was evaluated by the t‐test (p < 5% was considered statistically significant). Homogeneous and dense ceramics with fine nanostructure, comprising grains of yttria‐stabilized tetragonal and cubic zirconia, sized between ∼160 and ∼800 nm, were produced. The increase of yttria content, which causes an increase in grain size, favors the formation of cubic zirconia, resulting in mechanical properties’ slight reduction; yet, the differences were not statistically significant. Consequently, the mechanical properties (HV 11.74–12.91 GPa, and KIC 2.66–4.25 MPa m0.5) and the good esthetics of the investigated zirconia ceramics stabilized with high yttria content qualify these zirconia materials for fabricating dental restorations, because they can approach the properties and the esthetics of dental hard tissues as well as the tooth structure.

The effectiveness of post-prosthetic rehabilitation measures with the use of platelet autoplasm in patients with periodontal diseases and disorders of carbohydrate metabolism

Periodontal diseases and disorders of carbohydrate metabolism are comorbid conditions that aggravate each other. There are a number of practical recommendations aimed at preserving the positive results achieved by a dentist as a result of oral sanitation, periodontal and prosthetic treatment. However, they do not fully take into account the features of examination, treatment and rehabilitation of patients suffering from periodontal diseases for a long time, but denying the presence of somatic diseases.The purpose of the study. To evaluate the effectiveness of a complex of post-prosthetic rehabilitation measures using PRP therapy in patients with periodontal diseases and disorders of carbohydrate metabolism.Material and methods. In the period from 2016 to 2021, 441 patients aged 35-55 years who applied to a dental clinic were examined. All patients suffered from chronic generalized periodontitis (CGP), but denied the presence of somatic pathology. As a result of an additional examination in somatic medical organizations (CFOs), 205 patients suffering from CGP were found to have cardiometabolic disorders (impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension). Prosthetic treatment was performed in 195 patients who were stratified into two groups. Group 1 (120 people) included patients who underwent correction of identified metabolic disorders, group 2 (75 people) – persons who refused further observation by a clinician. By randomization, subgroups were formed in each group: patients of subgroups 1a and 2a received standard post-prosthetic rehabilitation (professional oral hygiene, periodontal treatment), patients of subgroups 1b and 2b additionally underwent local immunocorrection with platelet-enriched autoplasm – PRP (Platelet-rich plasma) therapy. The article presents the results of post-prosthetic rehabilitation of patients with CGP according to clinical (PMA, PI, BOP, OHI-S indices) and immunological (IL-10, IL-8, IL-1ß, TNF-α, sIg A, LDH in oral fluid) indicators obtained after oral sanitation, rehabilitation course, after 3 and 6 months of follow-up.Conclusions. The team approach of dentists and clinicians and the use of periodontal PRP therapy can improve the effectiveness of post-prosthetic rehabilitation measures in periodontal patients with identified comorbid somatic pathology.

Effect of soft tissue noise on trabecular bone score in postmenopausal women with diabetes: A cross sectional study.

Type 2 diabetes (T2D) is associated with increased fracture risk, despite similar or greater BMD compared to nondiabetics. TBS predicts fracture risk in T2D and nondiabetics. However, increased abdominal thickness, a common feature in T2D, may reduce TBS values. To study the relationship among glycemic status, BMD and TBS, considering abdominal soft tissue thickness (STT) interference. Cross-sectional analysis of 493 women ≥65years, with simultaneous DXA scans and HbA1c measures. STT and TBS (iNsight Software, v3.0) were derived from lumbar spine (LS) scans. Subjects were divided according to HbA1c levels: 1 (≥6.5%; n=116), 2 (5.7-6.4%; n=217) and 3 (≤5.6%; n=160). Group 1 was further divided based on HbA1c and/or disease duration: 1a (HbA1c≥7.5%; n=42), 1b (HbA1c≥6.5% and disease duration ≥5years; n=63) and 1c (HbA1c≥7.5% and disease duration ≥5years; n=30). For the entire cohort, mean age, TBS, BMI and STT were 71.8±6.0years, 1.299±0.101, 26.9±4.1kg/m2, and 21.4±2.9cm, respectively. LS-BMD was similar among groups. BMD in hip sites and STT were higher in group 1. TBS was lower in patients with higher HbA1c (P=0.020), with a mean TBS in groups 1, 2, and 3 of 1.280, 1.299 and 1.314, respectively. This difference remained after adjusting for age, LS-BMD and BMI (P=0.010). After replacing BMI with STT, TBS differences were no longer significant (P=0.270). The same was observed when subgroups 1a and 1b were compared to group 3. However, for subgroup 1c, TBS remained lower compared to group 3, even after adjusting for age, LS-BMD and STT, with a borderline P-value (1.275 vs. 1.308; P=0.047). Higher HbA1c levels were associated with greater BMD in hip sites, higher abdominal STT and lower TBS values. However, after including the STT in the adjustment, TBS differences among groups disappeared, except in women with higher HbA1c levels and longer disease duration.

Новые возможности терапии экссудативного среднего отита у детей

Anti-inflammatory therapy for otitis media with effusion (OME) in patients with chronic diseases of the Waldeyer's tonsillar ring is a key stage of treatment. Patients and methods. This observational study included 85 patients. Group 1 comprised 50 OME patients with grade I–II pharyngeal tonsil hypertrophy who were further divided into two subgroups: 1A (n = 30) and 1B (n = 20). Group 2 involved 35 OME patients on the second day after adenectomy; they were divided into subgroups 2A (n = 20) and 2B (n = 15). Children in subgroups 1A and 2A received standard OME therapy plus ammonium glycyrrhizinate (AG) for 30 days, whereas children in subgroups 1B and 2B received standard OME therapy alone. Results. Patients from the experimental subgroups (1A and 2A) who received AG demonstrated significantly lower VAS scores of both auditory symptoms (hearing loss and congestion/noise in the ear) and initial manifestations (rhinorrhea and nasal congestion) already by first follow-up visits compared to controls (subgroups 1B and 2B). Maximum differences were observed on day 30: the severity of symptoms in children from group 1A was 2.5 times lower than in children from subgroup 1B; patients from subgroup 2A also demonstrated a 2-fold reduction in symptom severity compared to children from subgroup 2B (p < 0.05). Tympanometry showed that 90% of patients in the experimental subgroups (1A and 2A) had complete restoration of auditory tube function by day 30, while in control subgroups 1B and 2B, the proportion of such patients was significantly lower (55% and 73%, respectively). Audiometry results suggest that complete hearing restoration by day 30 was more frequent in patients receiving AG than in controls (1A and 1B: 94% vs 70%; 2A and 2B: 100% vs 80%). Patients of the experimental subgroups were more satisfied with treatment results. Conclusion. The inclusion of AG into the treatment scheme for OME and auditory tube dysfunction after elective adenectomy increases treatment efficacy by normalizing drainage and ventilation functions of the middle ear, elimination of exudate, and ensuring hearing restoration. Key words: otitis media with effusion, children, auditory tube, Waldeyer's tonsillar ring, hearing loss, impedance audiometry, ammonium glycyrrhizinate

Vancouver Scar Scale for Assessing the Long-term Cosmetic results of surgical treatment of children with deep neck burns

BACKGROUND: Deep neck burns always result in cicatricial changes in the skin. Scars in this area can lead not only to functional disorders but also affect the psychoemotional status of the patient and family. Current studies have reported on the results of the treatment of deep neck burns in both adults and children. However, among foreign and Russian publications available, no studies have assessed the cosmetic results of treatment using validated scales.
 AIM: This study aimed to analyze the long-term cosmetic results of surgical treatment of deep neck burns in children using the Vancouver Scar Scale.
 MATERIALS AND METHODS: A non-interventional case control study was conducted. The article analyzes the long-term cosmetic results of treatment of 64 children with deep neck burns. All patients were divided into the main group 1 35 (29%) children who received early surgical treatment] and control group 2 29 (45%) children after staged treatment]. The main group was further divided into subgroups 1a, 1b, and 1c. Subgroup 1a included 13 (20%) children who underwent tangential necrectomy with simultaneous autodermoplasty, subgroup 1b included 12 (19%) children who underwent radical necrectomy with simultaneous autodermoplasty, and subgroup 1c included 10 (16%) children who underwent necrectomy with delayed autodermoplasty. The Vancouver Scar Scale was used to assess the vascularization, pigmentation, elasticity, and size of the scar mass. For statistical analysis, the results of different options for early surgical treatment were compared with a staged method.
 RESULTS: The best indicators for vascularization, elasticity, size of the formed cicatricial mass, and overall score were obtained in children who received surgical treatment of deep neck burns by early necrectomy (tangential or radical) with simultaneous autodermoplasty in comparison with staged surgical treatment. When analyzing the pigmentation indicator, the scores of patients who underwent all types of early surgical treatment were comparable with those in patients who received staged surgery.
 CONCLUSIONS: According to the analysis of the Vancouver Scar Scale, the best cosmetic results in children with deep neck burns can be achieved by performing tangential or radical necrectomy with simultaneous autodermoplasty.

Influence of the quality of viscoelastic removal on phacoemulsification results. Part 1. Type of the postoperative period course depending on the quality of viscoelastic removal in phacoemulsification

BACKGROUND: The reasons for the development of postoperative reactive inflammation under optimal conditions for the operation are errors in the surgical technique and the presence of viscoelastic residues. The likelihood of developing ophthalmic hypertension exists with the use of viscoelastic of any type. Its incomplete evacuation can be explained by the difficult visualization due to its transparency. Analysis of the dependence of the postoperative period course on the quality of viscoelastic removal at phacoemulsification can be considered to be relevant and expedient.
 AIM: The aim was to study the type of the postoperative period course depending on the quality of viscoelastics removal at phacoemulsification.
 MATERIALS AND METHODS: 104 eyes of randomly chosen patients who underwent femto-laser assisted phacoemulsification, divided into 2 groups according to ophthalmic viscoelastics characteristics (colored or transparent). Both groups were split into 2 subgroups each depending on method of viscoelastics removal. Tonometry and biomicroscopy were performed 3 hours after phacoemulsification and on the post-op Day 1. Patients with Tyndall effect were examined daily until its disappearance.
 RESULTS: At comparable preoperative IOP indices, its elevation 3 hours after surgery took place in subgroups 2a and 2b, the highest being in subgroup 2a. The greatest number of eyes with Tyndall effect, at all follow-up periods, was found in subgroup 2a, the lowest in subgroup 1b. The total number of eyes with keratopathy (as epitheliopathy) observed 3 hours after surgery was 7, four of them being from subgroup 2a.
 CONCLUSIONS: The conducted research showed that the type of early postoperative period course of phacoemulsification depends on visualization possibility of the viscoelastic and of the method of its removal. Minimal changes of hydrodynamics and maximal number of eyes with absence of inflammation took place when using colored viscoelastic and impulse irrigation method.

Уровень NT-рroBNP как предиктор развития фибрилляции предсердий у больных острым коронарным синдромом

Актуальность. Фибрилляция предсердий (ФП) отягощает течение инфаркта миокарда в 15,5 % случаев и ассоциирована с увеличением летальности на 40–50 %. Поэтому поиск маркеров риска развития ФП у больных острым коронарным синдромом (ОКС) является актуальным заданием. Целью исследования было определение предикторной ценности уровня NT-proBNP относительно риска развития ФП у больных ОКС. Материалы и методы. Обследованы 125 больных ОКС. Больные, у которых ФП впервые возникла во время госпитализации по поводу ОКС, составили подгруппу 1а (n = 41); больные, у которых ФП была в анамнезе, составили подгруппу 1б (n = 24). В группу 2 вошли больные без указаний на ФП (n = 60). Образцы крови для определения уровня NT-proBNP методом иммуноферментного анализа забирали в первые сутки заболевания. Результаты. Больные группы 2 были моложе больных подгрупп 1а (р = 0,019) и 1б (р = 0,002). В группе 2 было больше больных, чем в подгруппе 1б, которые курили (р = 0,029). У больных группы 2 уровень гемоглобина был выше, чем у больных подгруппы 1а (р = 0,014). Больные подгруппы 1б по сравнению с больными 2-й группы имели более высокий уровень гликемии при поступлении (р = 0,010). Уровень NT-proBNP оказался наивысшим в подгруппе 1а: 1592,00 (439,20; 3281,00) пг/мл. В подгруппе 1 б и группе 2 уровни NT-proBNP составили 1281,00 (844,45; 2012,50) пг/мл и 226,50 (54,40; 822,00) пг/мл соответственно (р1а–2 = 0,002; р1б–2 = 0,010). Выявлены корреляционные связи уровня NT-proBNP с возрастом больных (r = 0,500; р = 0,00006), женским полом (r = 0,286; р = 0,030), частотой сердечных сокращений и гликемией при поступлении (r = 0,363; р = 0,005 и r = = 0,482; р = 0,0001 соответственно), скоростью клубочковой фильтрации (r = –0,459; р = 0,0003), уровнем гемоглобина (r = –0,307; р = 0,019). Методом ROC-анализа, в который были включены больные подгруппы 1а и группы 2, установлена предикторная ценность уровня NT-proBNP относительно риска развития ФП у больных ОКС: при использовании пороговой точки > 1774 пг/мл чувствительность метода составляла 48 %, специфичность — 95,2 %, площадь под ROC-кривой составляла 0,77 (95% доверительный интервал 0,64–0,91). Выводы. В нашем исследовании уровень NT-proBNP был ассоциирован с клинико-анамнестическими показателями. Он был наивысшим в группе больных, у которых ФП развилась впервые на фоне ОКС; уровень NT-proBNP > 1774 пг/мл был ассоциирован с риском развития ФП.

The platelet-rich plasma lysate use in the treatment of persistent epithelial defects after keratoplasty

AIM:to evaluate the effectiveness of the platelet-rich plasma lysate (PRP lysate) use in the treatment of persistent epithelial defects (PED) after keratoplasty.
 MATERIALS AND METHODS:In the study, 60 patients with PED after keratoplasty were included. The 1st group (24 cases)included patients after keratoplasty with low risk of rejection, and the 2nd group 36 cases after keratoplasty with highrisk of rejection. Each group was divided into two subgroupscontrol subgroups 1a (cases 10) and 2a (cases 16), where patients received only standard postoperative therapy, and the main subgroups 1b (cases 14) and 2b (cases 20), in which PRP lysate was prescribed against the background of standard therapy, starting from the Day 15 post-op. As the criterion for effective treatment, complete persistent epithelialization after keratoplasty was considered.
 RESULTS:The effectiveness of the use of PRP lysate in the subgroup 1b was 85.7%, while complete epithelialization in the control subgroup 1a was recorded in 70%; in the subgroup 2b, complete epithelialization was observed in 55%, in the control subgroup 2ain 43.75%.
 CONCLUSION:The use of PRP lysate in the treatment of PED after corneal transplantation as an adjuvant therapy is effective and safe in both high and low risk keratoplasty. In the examined category of patients, treatment with blood derivatives increases the frequency and rate of complete epithelialization.

Динамика показателей психоэмоционального состояния женщин — внутренне перемещенных лиц с угрозой прерывания беременности на фоне комплексного лечения

Актуальность. Беременность является состоянием повышенной уязвимости для развития тревоги и депрессии, которые являются наиболее распространенными психическими расстройствами во время беременности и после родов. Около 54 % женщин испытывают тревогу в течение всего антенатального периода, депрессивные расстройства проявляются у 34 % женщин. По данным некоторых авторов, нарушения сна, на которые жалуются от 11,5 до 85 % беременных, могут влиять на выраженность антенатальных и постнатальных депрессивных и тревожных симптомов, а также на акушерские исходы. Цель: оценить эффективность курса комплексного лечения женщин с угрозой прерывания беременности (УПБ), проживающих в Луганской области и имеющих статус внутренне перемещенных лиц (ВПЛ), для совершенствования лечебно-профилактических мероприятий и профилактики акушерских и перинатальных осложнений. Материалы и методы. Обследованы 22 пациентки в I и II триместрах, которые находились на стационарном лечении по поводу УПБ в учреждениях здравоохранения Луганской области и имели статус ВПЛ. Беременные методом случайной выборки были распределены на подгруппы (1а и 1б), женщины подгруппы 1б дополнительно получали лечение с использованием L-аргинина, магния лактата дигидрата и пиридоксина гидрохлорида в течение двух недель, а также витаминно-минеральный комплекс. Клинико-акушерское и психометрическое обследование проводилось до и после лечения. Для оценки уровня тревожности применяли тест Спилбергера, депрессивных проявлений — опросник Бека, вегетативных расстройств — опросник А.М. Вейна, качества сна — опросник качества сна Центра сомнологии, определяли концентрации прогестерона и магния. Результаты. После проведенного лечения отмечено статистически достоверное снижение показателей реактивной тревожности, депрессивных проявлений, вегетативных расстройств, улучшение параметров сна, повышение концентрации прогестерона в обследованных группах и магния в группе 1б. Показатель личностной тревожности и концентрация магния в группе 1а после окончания лечения достоверно не изменились. Выводы. Лечение с применением L-аргинина, магния лактата дигидрата, пиридоксина гидрохлорида и витаминно-минерального комплекса показало высокую эффективность в снижении выраженности и частоты психоэмоциональных расстройств у женщин — внутренне перемещенных лиц с УПБ, достижении эмоционального равновесия, снятии беспокойства, тревоги, страхов, связанных с беременностью и родами. Снижение показателей реактивной тревожности, депрессивных расстройств, вегетативных проявлений, улучшение показателей качества сна могут служить критериями эффективности проведенного лечения.

ОСОБЕННОСТИ НУТРИТИВНОГО СТАТУСА НЕДОНОШЕННЫХ ДЕТЕЙ С БРОНХОЛЕГОЧНОЙ ДИСПЛАЗИЕЙ В ПЕРВОМ ПОЛУГОДИИ ЖИЗНИ

Objective of the study: assessment of the nutritional status of infants with bronchopulmonary dysplasia. Materials and methods of research: a retrospective uncontrolled non-randomized cross-sectional comparative study was carried out. It involved 40 premature babies (boys – 19, girls – 21) at the corrected age of 3,3 [2,3–4,0] months and 16 age matched full-term babies (comparison group). Children born prematurely were divided into 2 groups depending on their body mass (BM) at birth: 1st – 25 children with BM less than 1500 g, 2nd – 15 children with BM from 1500 to 2500 g. The first group included subgroups 1A and 1B, depending on the presence or absence of bronchopulmonary dysplasia in children. Physical development was assessed using INTERGROWTH-21st and WHO Anthro, 2009 anthropometric calculators, body composition was determined by air plethysmography using a PEA POD apparatus. Results: the assessment of anthropometric indices (WAZ and HAZ) calculated for postnatal and corrected age revealed the most severe manifestations of nutritional deficiency in children with very low BM at birth who developed bronchopulmonary dysplasia. The percentage of fatty BM was statistically significantly lower in children of subgroups 1A and 1B compared to full-term infants (p<0,006), as well as fatfree BM (p<0,012). Conclusion: the slow development of anthropometric indicators of premature babies with very low BM, especially those with bronchopulmonary dysplasia, indicates the need for timely correction of their nutrition.

Molecular Characterization of Chicken Anaemia Virus Circulating in Commercial Poultry Flocks in Egypt during 2020

Chicken Anemia Virus (CAV) is an extremely contagious immunosuppressive disease causing high economic losses in poultry production. In the present study, tissue samples (bone marrow, thymus, and spleen) were collected from 86 different broiler chicken farms located in fourteen governorates in Egypt during 2020. They suffered from retard growth, weakness, and a drop in egg production with an observed mortality rate ranged 5-15%. A total of 26 samples were positive for CAV using PCR in six governorates in Lower Egypt with a 30% incidence rate, especially in Sharkia (78%), Ismailia (62.5%), and Alexandria (60%). The viral protein1 (VP1) gene of CAV was genetically characterized by sequencing of 10 selected viruses in six governorates. revealing that all Egyptian strains were clustered into two groups (A, B) that was distinct from vaccine strains (Del-Ros, Cux-1, and 26PA) which were clustered in group C. The seven Egyptian viruses in this study (A-Egypt-AN1-2020 to A-Egypt-AN7-2020) were clustered with the viruses from Japan, Argentina, and Malaysia in group A, and the other three viruses (A-Egypt-AN8-2020, A-Egypt-AN9-2020, A-Egypt-AN10-2020) were clustered with the viruses from Nigeria, and India in group B. The Egyptian viruses in the current study acquired new specific mutations clustering them into new subgroups (2A, 2B). By mutation analysis comparing with Del-Rose reference strains, V75I, M97L, and K139Q, E144Q were recorded in all viruses in the group A and B. All Egyptian viruses in the current study had specific new mutations at Y13N, H22N. Moreover, mutation at G74E in Egyptian viruses recorded in the current study was related to sub group 2A, I83V in three strains (A/Egypt/AN1/2020, A/Egypt/AN2/2020, A/Egypt/AN4/2020), and S140A in the hypervariable region was found in four strains (A/Egypt/AN1/2020, A/Egypt/AN2/2020, A/Egypt/AN4/2020 and A/Egypt/AN5/2020) in subgroup 2A. Furthermore, Q139 and Q144 amino acid substitutions, which are important in viral replication, were observed in all viruses. The field viruses in the study were distinct from the vaccinal strains by phylogenetic analysis and A.A. identity. In conclusion, the CAV was continuously circulating in Egypt from different genotypes. It acquired new specific mutations clustering them in a new subgroup, and it was distinct from vaccinal strains. Therefore, it is important to conduct continuous monitoring on the genetic evolution of CAV and further studies on the pathogenicity of the virus and the vaccine efficacy.

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.

Effect of Six-Month Postoperative Endothelial Cell Density on Graft Survival after Descemet Membrane Endothelial Keratoplasty

To analyze if 6-month endothelial cell density (ECD) affects long-term ECD outcome and graft survival 5 years after Descemet membrane endothelial keratoplasty (DMEK) in eyes with Fuchs endothelial corneal dystrophy (FECD). Retrospective cohort study. A total of 585 DMEK eyes were included. The study group was divided into 4 groups based on 6-month ECD quartiles: group 1 (n= 146) with 313 to 1245 cells/mm2, group 2 (n= 148) with 1246 to 1610 cells/mm2, group 3 (n= 145) with 1611 to 1938 cells/mm2, and group 4 (n= 146) with 1939 to 2760 cells/mm2. Group 1 was further split into subgroups 1a (n= 36) with 6-month ECD of ≤828 cells/mm2, 1b (n= 37) with 829 to 1023 cells/mm2, 1c (n= 37) with 1024 to 1140 cells/mm2, and 1d (n= 36) 1141 to 1245 cells/mm2. Descemet membrane endothelial keratoplasty. Long-term ECD, graft survival, and postoperative complication rates. For group 1, 6-month ECD decreased from 951 (±233) cells/mm2 (n= 146) to 735 (±216) cells/mm2 (n= 99) at 5 years postoperatively. Group 1 graft survival probability was 0.95 (95% confidence interval [CI], 0.91-0.99] at 5 years postoperatively, which was lower than for groups 2 to 4 (P= 0.001). Five-year graft survival in subgroup 1a was 0.79 (95% CI, 0.67-0.94), which was lower than in subgroups 1b to 1d (P= 0.001). Preoperative ECD did not influence graft survival (P= 0.400), and higher 6-month ECD values were associated with lower graft failure rates (hazard ratio, 0.994; 95% CI, 0.99-1.00; P= 0.001). Six-month ECD is associated with DMEK graft survival. High early cell loss after DMEK negatively affects long-term ECD outcome and graft survival. Grafts in the lowest 6-month ECD subgroup (≤828 cells/mm2) are at higher risk of failure within 5 years after DMEK. To ensure sufficiently high 6-month ECD, preoperative graft quality assessment should be optimized, and cellular stress induced to the graft should be minimized. Additionally, developing therapeutic options for the treatment of low postoperative ECD could further improve DMEK graft longevity.

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%.

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.

High Frequency of Enterocytozoon bieneusi Genotype WL12 Occurrence among Immunocompromised Patients with Intestinal Microsporidiosis.

Microsporidiosis is an emerging opportunistic infection causing severe digestive disorders in immunocompromised patients. The aim of this study was to investigate the prevalence of intestinal microsporidia carriage among immunocompromised patients hospitalized at a major hospital complex in the Tunis capital area, Tunisia (North Africa), and perform molecular epidemiology and population structure analyses of Enterocytozoon bieneusi, which is an emerging fungal pathogen. We screened 250 stool samples for the presence of intestinal microsporidia from 171 patients, including 81 organ transplant recipients, 73 Human Immunodeficiency Virus (HIV)-positive patients, and 17 patients with unspecified immunodeficiency. Using a nested PCR-based diagnostic approach for the detection of E. bieneusi and Encephalitozoon spp., we identified 18 microsporidia-positive patients out of 171 (10.5%), among which 17 were infected with E. bieneusi. Microsporidia-positive cases displayed chronic diarrhea (17 out of 18), which was associated more with HIV rather than with immunosuppression other than HIV (12 out of 73 versus 6 out of 98, respectively, p = 0.02) and correlated with extended hospital stays compared to microsporidia-negative cases (60 versus 19 days on average, respectively; p = 0.001). Strikingly, internal transcribed spacer (ITS)-based genotyping of E. bieneusi strains revealed high-frequency occurrence of ITS sequences that were identical (n = 10) or similar (with one single polymorphic site, n = 3) to rare genotype WL12. Minimum-spanning tree analyses segregated the 17 E. bieneusi infection cases into four distinct genotypic clusters and confirmed the high prevalence of genotype WL12 in our patient population. Phylogenetic analyses allowed the mapping of all 17 E. bieneusi strains to zoonotic group 1 (subgroups 1a and 1b/1c), indicating loose host specificity and raising public health concern. Our study suggests a probable common source of E. bieneusi genotype WL12 transmission and prompts the implementation of a wider epidemiological investigation.

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

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.