Ural State Medical University Research Articles

Improving the complex therapy of dysphonia in respiratory infections and SARS-COV-2

Significantly aggravating the clinical course and negatively affecting the quality of life of patients, voice disorders in acute respiratory viral infection (ARVI) and SARS-CoV-2 require correction of treatment. Aim. To determine the effectiveness of Homeovox® in the complex therapy of dysfunctions in patients with respiratory infections and SARS-CoV-2 Materials and methods. The clinical study was conducted by a single-stage observational method, without intervention, at the clinical base of the Department of Otorhinolaryngology of the South Ural State Medical University in the period 2022–2023. The results of a study of 45 patients who suffered from acute respiratory and coronavirus infection SARS-CoV-2, accompanied by dysphonia, are presented. Results. There was a significant difference in the results of conservative treatment of patients previously divided into 2 groups according to the study design. Thus, in the second group (n=22), in addition to medical and economic standards, who received a multicomponent homeopathic medicine in accordance with the instructions, earlier recovery periods and statistically reliable restoration of vocal function were established until complete restoration of vocal function. Standard medical and economical therapy of patients of the first (n=23) and second groups included: administration of antiviral and antihistamines, local decongestants, irrigation therapy, symptomatic treatment. Conclusion. The assessment of dysphonia on three scales: the VASH scale, the Wilson Yanagihara scale and the GRBAS classification of voice disorders confirmed the restoration of voice function and recovery at an earlier date in patients who additionally took a homeopathic drug

Melatonin Level and Activity of Nucleolar Organizer Regions in the Prognosis of Infertility in Women with Ovarian Endometriosis

Introduction. Endometriosis is a multifactorial disease, affecting about 10 % of women of reproductive age. The purpose of the work is predicting the development of infertility in women with ovarian endometriosis by determining urine melatonin levels and activity indicators of nucleolar organizer regions in endometrioid ovarian heterotopias.Materials and methods. In the Clinic of South Ural State Medical University from 2018 to 2020, 2 groups of women with ovarian endometriosis were studied: group 1 — with infertility (n = 22); group 2 — without it (n = 27). The level of urinary 6-SMT and the activity of ribosomal synthesis were determined.Results. The level of 6-SMT is reduced in patients with stage I ovarian endometriosis. At stagesII and III, the level of 6-SMTis lower in women with infertility than without it: Stage II — (38.82±1.49) ng/ml and (93.04±3.64) ng/ml (p < 0.001); Stage III — (42.84±1.85) ng/ml and (58.06±1.65) ng/ml (p = 0.340). The activity of ribosomal synthesis in epithelial cells of endometrioid heterotopias increases at stage III. In fibroblasts of the stroma of endometrioid heterotopias, the activity of ribosomal synthesis is higherin women with stage III infertility, and in histiocytes— in women with stage II infertility. A logistic stepwise regression analysis was carried out and the most important predictors influencing the development of infertility were identified.Discussion. The decrease in melatonin in women with ovarian endometriosis, suffering from infertility, as well as in stage I ovarian endometriosis is consistent with the research of M. I. Yarmolinskaya et al. (2019). In the presence of infertility, activation of connective tissue histiocytes begins in the early stages. The results obtained may reflect the immunomodulatory effect of melatonin, which is expressed inincreased functional activity of connective tissue histiocytes and fibroblasts.Conclusion. Using mathematical analysis, the most important indicators that influence the reproductive prognosis in women with ovarian endometriosis (activity of nucleolar organizer regions, urine 6-SMT level) were determined, which makes it possible to create a model for calculating an individual reproductive prognosis.

АНАЛИЗ ФАКТОРОВ РИСКА КСЕРОСТОМИИ И ЗДОРОВОГО ОБРАЗА ЖИЗНИ СТУДЕНТОВ СТОМАТОЛОГИЧЕСКОГО ФАКУЛЬТЕТА УРАЛЬСКОГО ГОСУДАРСТВЕННОГО МЕДИЦИНСКОГО УНИВЕРСИТЕТА

Subject. Xerostomia. Objectives. To analyze risk factors, to identify the incidence of xerostomia and a healthy lifestyle of students of the Faculty of Dentistry of the Ural State Medical University (USMU). Methodology. The work was carried out at the Department of Therapeutic Dentistry and Propaedeutics of Dental Diseases, at the Department of General Chemistry of USMU, at the Department of Controlled Systems Modeling of UrFU. The objects of the study were: a questionnaire consisting of two parts and volunteers – students of the Faculty of Dentistry of USMU. The first part of the questionnaire is based on the questionnaire "List of cases of xerostomia" modified by the authors of this study to 12 questions. The second part of the questionnaire (author's) consists of 29 questions on a healthy lifestyle (HLS), which also affect the development of xerostomia. Thus, the total number of questions in the questionnaire was 41. Statistical processing of the results was carried out on a personal computer using the Microsoft Excel 2007 application software package; the reliability of the differences was assessed by the Student's t-distribution using the Statistica 6.0 software package; the confidence interval for mathematical expectation M ± m was determined, where M is the sample average. The differences are considered. Conclusions. Students of the Faculty of Dentistry of USMU adhere to the rules aimed at maintaining the health of the oral cavity: they change their toothbrush (from 3 to 5 times a year – 85%), brush their teeth for at least three minutes (more than 48%) twice a day (77.7%) and use additional means of interdental hygiene (76.7%). 38% indicate dry lips. Dryness in the nose is emphasized by 14.1% of students. "Dry mouth is associated with elevated blood sugar", 2% of the study participants noted. It is advisable to investigate the problem of prevention of dental diseases, individual and professional oral hygiene programs, as well as regular general hygiene measures and the elimination of bad habits among students.

Analysis of central pontine myelinolysis in HIV-infected patients

Aim: to conduct a clinical and epidemiological analysis of cases of central pontine myelinolysis (CPM) in HIV-infected patients. Materials and methods. Four patients hospitalized in the infectious diseases department of No. 1 Clinic of the South Ural State Medical University were under dynamic observation. Results and its discussion. Four patients hospitalized in the infectious diseases department of Clinic No. 1 of the South Ural State Medical University were under dynamic observation. Patient management was carried out in accordance with current clinical recommendations for the provision of medical care to patients with HIV infection with a set of clinical and laboratory methods, including examination of lumbar puncture, its cytological and biochemical composition, determination of DNA of cytomegalovirus (CMV) and Epstein-Barr viruses (EBV) herpes simplex types 1 and 2, T. gondii, Cr. Neoformans, M. Tuberculosis, Cryptococcus neoformans, the presence of pathogens of bacterial infections. All patients underwent magnetic resonance imaging (MRI) of the brain. Conclusion. The process of demyelination of the central nervous system develops regardless of the level of CD4 lymphocytes and HIV viral load. The main method for verifying the diagnosis is MRI of the brain

5 P consortium “Children’s Medicine”

Medical consortia help solve current healthcare problems. Four scientific medical institutions (GBUZ of the Moscow region “Research Institute of Childhood of the Ministry of Health of the Moscow Region”, Scientific Research Clinical Institute of Pediatrics and Pediatric Surgery named after Academician Yu. E. Veltishchev Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after N. I. Pirogov” of the Ministry of Health Russia, the Federal State Budgetary Institution “Medical Genetic Research Center named after Academician N. P. Bochkov”, the Federal Budgetary Institution “Moscow Research Institute of Epidemiology and Microbiology named after G. N. Gabrichevsky” of Rospotrebnadzor) and one higher educational institution (the Federal State Budgetary Educational Institution of Higher Education “Ural State Medical University” of the Ministry of Health of the Russian Federation) united into the 5P “Children’s Medicine” consortium to solve pressing problems of children’s healthcare in accordance with the basic principles of personalized medicine. Organizing large congresses with international participation dedicated to the problems of children’s healthcare is an opportunity for doctors in the Russian Federation and other countries to share knowledge and best practices on saving a child’s life and treating diseases from an early age of the patient through direct communication. A systematic approach can be considered the most effective for solving problems in all areas, including children’s healthcare, and the 5 P “Children’s Medicine” congress helps doctors go beyond the boundaries of the familiar and familiar, learn new things, and get ideas for further professional growth.

АНАЛИТИКА ПАРАМЕТРОВ САЛИВАРНОГО СТАТУСА СТУДЕНТОВ-КУРИЛЬЩИКОВ ПРИ ИСПОЛЬЗОВАНИИ СПРЕЯ С МУКОПРОТЕКТОРОМ

Subject. The subject of this study is the salivary status in the patients.
 Objectives. The objective is to identify specifics of data analytics of the salivary status in student smokers effected by using a mucoptorotective dental spray. 
 Methodology. The study is made by the Ural State Medical University Department of Preventive Dentistry and Propedeutics of Dental Disease, the Ural State Medical University Department of General Chemistry, the Ural Federal University Department of Control Systems Modeling. The objects of the study are unstimulated mixed saliva and a mucoptorotective spray that helps to protect the oral mucosa against inflammations, facilitates penetration across epithelial membranes, acts as a controlled multifunctional drug delivery system for parodontium tissues. The two study groups were formed from 20 volunteers in the age of 20 to 24 years old (4 women and 36 men, the average age was 22,35 years old): the first (main) group consisted of smoking patients, the second (reference) group consisted of non-smokers. The clinical assessment of the oral cavity of patients included: analysis of complaints, analysis of anamnesis, examination, evaluation of the hygiene index (OHI, Greene, Vermillion, 1964), dental caries severity index (using DMFT and DMFS indices), the state of gingival inflammation, PMA index (Parma). Unstimulated mixed saliva was studied, the quantitative analysis of the secretion was made by analyzing color, transparency, presence of inclusions, pH value, the functional activity of minor salivary glands. The statistical analysis of results was made using a PC with Microsoft Excel 2007 software program; the statistical significance was assessed using Student’s t-distribution by Statistica 6.0 software package.
 Conclusions. Given the reduction of objective values of index assessment of oral health status used as indicators of changes in oral health, the study of the data analytics of salivary status in student smokers in the course of using a mucoptorotective spray revealed the harmful effects of tobacco on salivary composition and parameters. The findings prove smoking-related oral homeostatic disruption promoting development and progression of dental diseases of the hard tissues, parodontium, oral mucosa. Application of the dental spray with titanium glycerosolvate aquacomplex is proved to be an effective way to prevent development and progression of such diseases.

РЕЗУЛЬТАТЫ ВНЕДРЕНИЯ ДИСТАНЦИОННЫХ ОБРАЗОВАТЕЛЬНЫХ ТЕХНОЛОГИЙ НА ПРИМЕРЕ ПОКАЗАТЕЛЕЙ ГОСУДАРСТВЕННОЙ ИТОГОВОЙ АТТЕСТАЦИИ СТУДЕНТОВ СТОМАТОЛОГИЧЕСКОГО ФАКУЛЬТЕТА УГМУ ЗА 2019, 2020 И 2022 ГОДЫ

The educational process has undergone significant changes throughout the history of mankind. Over the past few years, in connection with the COVID-19 pandemic, a model of distance and mixed learning format has been integrated into the educational activities of universities, implying the use of distance educational forms. To assess the effectiveness of this model of education, it is necessary to analyze the final academic performance of a graduate student, his readiness for practical activity, possession of a certain set of skills and abilities in comparison with the classical model of education. In the course of this study, it was found that the academic performance of students of the Faculty of Dentistry according to the results of the state final certification, when comparing the classical model of education with distance learning, remains at a high level: there are no unsatisfactory results in all three stages of certification, high rates of obtaining positive grades by certified students remain, which indicates the correct choice of the trajectory of the educational process.
 Subject. Results of the state final certification at the Ural State Medical University in 2019, 2020 and 2022.
 Objectives. Comparative analysis of the results of the training of graduates of the Faculty of Dentistry in various training conditions.
 Methodology. The data of the results of the State final certification of students of the Faculty of Dentistry for the period in 2019, 2020 and 2022 were studied. The selected time period includes the period of preparation of students in the conditions of a pandemic using various learning technologies.
 Results. In the analyzed period, the indicators of the state final certification were consistently high and equivalent relative to the total number of graduates, regardless of the form of study. When comparing all formats of the educational process, according to the results of the certification, there were no unsatisfactory results, which indicates the effectiveness of both the classical form of full-time education and the mixed form of the educational process in the distance format.
 Conclusion. Given the similarity of the results of the final certification, we can conclude about the effectiveness of forms of distance education along with classical ones.

АНАЛИЗ ОСВОЕНИЯ МАНУАЛЬНЫХ НАВЫКОВ РЕСТАВРАЦИИ МОЛЯРОВ СТАРШЕКУРСНИКАМИ СТОМАТОЛОГИЧЕСКОГО ФАКУЛЬТЕТА

Subject. The subject of this research is manual skills in molar restoration.
 Objective. The objective of this research is to analyze the process of mastering manual skills in restoration of phantom molar tooth models by senior dental students.
 Methodology. The study was carried out by the Department of Therapeutic Dentistry and Propedeutics of Dental Disease of Ural State Medical University of the Ministry of Health of the Russian Federation together with the Department of Control Systems Modeling, Ural Federal University. The study involved 54 four- and five-year dental students of Ural State Medical University (24 young male adults, 30 young adult women; the average age was 22.25 ± 1.75 years) in a procedure of dental filling of carious cavities in five “phantom” teeth – extracted molars (Black classification was Class I). This research applied the method developed by Prof. Larisa Lomiashvili together with co-authors for molar restoration using modular techniques. To analyze self-assessment of manual skills for molar restoration by senior students the questionnaire was completed. The questionnaire was made up of three blocks including 12 questions (parameters) evaluated using 1 to 10 rating scale survey, the rating being 10 for “fully satisfied”, and 1 for “completely dissatisfied”. The survey questions were divided into the following blocks: understanding of dental anatomical features, professional skills of students, cognitive motivational factors.
 Conclusions. The analysis of assessment scores and survey responses showed that mastering manual skills by senior students during a molar restoration procedure promotes their accuracy and ability to work with precision. The analysis of mastering manual skills for molar restoration by dental senior students using the survey responses showed rather high self-assessments (p ≤ 0.05).

Sergey Vladimirovich Sazonov — to the 60-th anniversary of the birth

The article is dedicated to the prominent Russian morphologist, Head of the Department of Histology of the Ural State Medical University, Honoured Worker of Higher Education of the Russian Federation, Doctor of Medical Sciences, Professor Sergey Vladimirovich Sazonov. On 17 May 2023 he turned 60 years old. Sergey Vladimirovich devoted his whole life to science, teaching, and his alma mater Ural State Medical University. He opened a number of research and diagnostic laboratories in the Ural Federal District, continuously created and mastered new methods and new research technologies, introduced them into clinical medicine and education.
 Sergey Vladimirovich was one of the organisers of the first scientific medical journal in our region the Bulletin of the Ural State Medical Academy (now the Bulletin of Ural State Medical University). Sergey Vladimirovich successfully carried out material and technical re-equipment of the Department of Histology at Ural State Medical University, created a completely new in content multimedia course of lectures, and now he actively carries out digital transformation of his discipline, skilfully manages the creation of electronic educational resources in histology.
 The article reflects the stages of life and creativity of Professor S. V. Sazonov, his main scientific achievements, professional and personal qualities.

Optimization of the Pedagogical Process in Teaching Chemistry to First-Year Students of the Ural State Medical University

The purpose of research is to determine directions for optimizing the educational process with the introduction of new methodological approaches. For this purpose, the paper set the tasks to analyze the current methodological aspects of the component of the pedagogical process of teaching chemistry to first-year students of the medical and preventive faculty of the Ural State Medical University (USMU, Yekaterinburg); asess the impact of new methodological approaches in teaching on the performance of students. The discipline “Chemistry” is studied in the first semester, classroom hours for the discipline include lectures (32 hours), practical exercises and laboratory work (34 hours), which are conducted at the department of general chemistry of USMU.Materials and methods. The methodology for teaching chemistry to first-year students of the medical and preventive faculty of USMU (Ekaterinburg) is analyzed. The largest faculty was selected for the study. Over the course of 10 years, during the period of Federal State Educational Standard-3, the number of students at this faculty increased from two streams in the 2012-2013 academic year (300 people) up to four streams in the 2022-2023 academic year (700 people). Attestation in the discipline takes place in the form of a written test with an assessment (exam). Statistical processing of data on exam results and rating scores in the semester was carried out in the Microsoft Excel 2019 program. The obtained indexes are presented as arithmetic mean values and standard error of the mean (M±m).Results. Pearson's r-correlation coefficients were calculated to assess the linear relationship of variables: the percentage of correct answers in the exam ticket, the final student rating in the semester, the exam rating, the certification grade. To test the hypothesis about the effectiveness of the chosen teaching methodology, Pearson's test of agreement (χ2 ) was calculated for the sample size of students (n ≥ 100). The pedagogical process carried out in teaching chemistry to first-year students of the medical and preventive faculty is a complex system that includes target, content, activity, performance, resource components. The activity component of the organization of the pedagogical process was modified as follows: a new form of the examination card was developed, as close as possible to the form of control materials for the unified state exam in chemistry, the structure of the practical lesson was rationalized, and a new laboratory workshop was created and tested. The results of the exam in chemistry were analyzed using Pearson's goodness-of-fit test at a significance level of p<0, 05 in two groups of questions: 1 - on topics covered by a laboratory workshop and 2 - on topics not provided with laboratory work. The rating indexes of students when performing tasks related to the first group of questions are significantly higher than in the second group. ><0,05 in two groups of questions: 1 - on topics covered by a laboratory workshop and 2 - on topics not provided with laboratory work. The rating indexes of students when performing tasks related to the first group of questions are significantly higher than in the second group.Conclusion. When using an optimized laboratory practice in chemistry, the most rational form of the lesson is chosen, in which laboratory experiments are included. Comprehensive planning of such classes is carried out differently. The didactic tasks of the lesson are subordinated to highlighting what is essential in the content of the educational material. The presence of an optimized workshop significantly contributes to the choice of the most effective methods and forms of training for a given lesson, leading to an increase in student performance. It is shown that the updated form of the laboratory workshop in chemistry, along with the rationalization of the structure of the lesson and the form of the exam make it possible to achieve maximum learning outcomes with a limited time interval for classroom work. The new form of the examination card, along with the modernized practicum, contributed to the high marks in the exam. It is shown that a properly organized form of passing the exam allows you to adjust the progress of each student and set an objective assessment in chemistry.

ЦИТОКИНОВЫЙ СТАТУС ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ПАРОДОНТИТОМ, АССОЦИАЦИИ И КОРРЕЛЯЦИИ

Subject. The subject of this research is the immunological parameters of the blood serum and the oral fluid.
 Objectives. The objective of this research is to study the levels of serum and oral cytokines TNF-α, IFN-γ, IL-4, MCP-1 in women with secondary amenorrhea for at least one year.
 Methodology. There were 109 women under the supervision of the Ural State Medical University Department of Preventive Dentistry and Propedeutics of Dental Disease. The main group consisted of 76 women with generalized moderate chronic periodontitis (K05.31)and secondary amenorrhea for at least one year. The control group consisted of 33 post-menopausal women with generalized slight chronic periodontitis in remission. The patients of the both groups underwent laboratory serum and oral fluid testing using enzyme-linked immunosorbent assay. The levels of cytokines TNF-α, IFN-γ, IL-4, MCP-1 were measured in samples using Vector-Best’s tests systems (Vector-Best, Koltsovo, Novosibirsk Region, Russia). The systemic bone mineral density was measured using dual energy X-ray absorptiometry (DXA) with Discovery W QDR Series X-Ray Bone Densitometer (Hologic Inc., USA).
 Conclusion. The levels of interleikins TNF-α, IFN-γ and chemokine MCP-1 were found to be elevated in the blood serum and the oral fluid of women generalized moderate chronic periodontitis against the background of secondary amenorrhea for at least one year. In contrast, the serum values of IL-4 revealed statistically lower levels in comparison with the same values of IL-4 in the patients from the control group. We defined the statistically significant (at 0.05) correlation between parameters of salivary IL-4 levels and spine bone mineral density, and also the statistically significant (at 0.05) weak negative correlation between parameters of blood IFN-γ levels and right-hip bone mineral density.

Nonlinear main components of the cytokine profile in children with community-acquired pneumonia

Cytokines are the key mediators which control and regulate immune and inflammatory responses via complex networks and serve as biomarkers of many diseases. Quantitative determination of cytokines is helpful in assessing immune status and adjusting therapy for various inflammatory diseases, such as sepsis and pneumonia. Since community-acquired pneumonia remains a common cause of childhood morbidity and mortality. At the present stage, prognosis of the disease severity in children is an urgent problem. The aim of our study was to identify associations between cytokine levels in healthy children and in children with community-acquired pneumonia (CAP), depending on the age of patients and severity of the pathological process. The work was carried out at the Department of Microbiology, Virology and Immunology, Department of Propaedeutics of Childhood Diseases and Pediatrics, and at the Research Institute of Immunology at the South Ural State Medical University. The study included 117 children aged 1 to 18 years with radiologically confirmed diagnosis of CAP, either severe or mild degree. The comparison group was composed from 28 healthy children who did not have community-acquired pneumonia, as well as other signs of acute respiratory viral infection at the time of examination, being observed for any chronic disorders. The levels of IL-1β, IFNγ, IL-6, IL-4, IL-10, IL-2, TNFα, IFNλ2 (IL-28A), IFNλ3 (IL-28B), IL-8, MCP-1, IL-17AF, GM-CSF were determined in blood serum by means of ELISA test systems (a “sandwich” technique with peroxidase as an indicator enzyme). For statistical analysis, a multidimensional method was used, i.e., non-linear analysis of the principal components using the CATPCA algorithm. Among the children with CAP, our study revealed a consistent increase of IL-1ß, IL-4, IL-10, IL-2, TNFα, IFNλ2 (IL-28A), IFNλ3 (IL-28B), IL-8, MCP-1, IL-17AF, GM-CSF in blood serum. The highest correlation with severity was shown for IFNλ2 (IL-28A), IFNλ3 (IL-28B) and MCP-1, which may be considered additional biomarkers of the CAP severity. There was also a significant variability of the cytokine profile in healthy children and its significant skewing in pneumonia, especially in severe cases.

ОЦЕНКА КАЧЕСТВЕННЫХ, КОЛИЧЕСТВЕННЫХ И ОРГАНОЛЕПТИЧЕСКИХ ПАРАМЕТРОВ НОВОЙ ЗУБНОЙ ПАСТЫ С РЕМИНЕРАЛИЗУЮЩИМ КОМПОНЕНТОМ

Subject. The subject of this study is “DentaSwiss Enamel Repair & Protect” treatment-and-prophylactic toothpaste.
 Objective. The purpose of this study is to evaluate organoleptic properties of the new “DentaSwiss Enamel Repair & Protect” treatment-and-prophylactic toothpaste, and its effects on the functional activity of minor salivary glands and oral mucosa.
 Methodology. The study was carried out by the Department of Therapeutic Dentistry and Propedeutics of Dental Disease together with the Department of General Chemistry, Ural State Medical University of the Ministry of Health of the Russian Federation. The study involved 65 volunteer patients recruited from the dental students (24 young male adults, 41 young adult women; the average age of patients was 21.25 ± 1.65 years old). The assessment of mixed saliva was performed for the following parameters: the qualitative analysis of such characteristics of saliva secretions such as color, transparency, presence of inclusions, the hydrogen-ion concentration, the functional activity of minor salivary glands, microcrystallization of mixed saliva.
 Conclusions. The research results showed that the use of “DentaSwiss Enamel Repair & Protect” toothpaste reliably changes the pH-value, the functional activity of minor salivary glands and microcrystallization of mixed saliva which consequently enhances remineralizing effects of mixed saliva and the ability of the tooth enamel to restore. On all parameters, organoleptic properties of “DentaSwiss Enamel Repair & Protect” toothpaste were highly ranked by the study participants scoring the average of 9.95 ± 0.05.

Adaptation of the hearing analyzer under vibration noise exposure in volunteers: Ways of prevention

BACKGROUND: The negative effect of impulse noise and vibration when using small arms on the auditory analyzer in athletes is less investigated and justifies the need for an extended study of volunteers with normal hearing. The study of the initial characteristics of the impulse noise and vibration effects of sports weapons on the auditory analyzer will make it possible to determine the early risk factors for the occurrence of high-frequency hearing loss in shooters by the number of shots from sports weapons and the recovery time of auditory function. AIMS: To conduct a comparative analysis of the effect of impulse noise and vibration exposure depending on the technical characteristics of small arms on volunteers with normal hearing and, based on the results obtained, unify the methods of forecasting and prevention. MATERIALS AND METHODS: At the Department of Otorhinolaryngology of the South Ural State Medical University of the Ministry of Health of Russia, 30 fifth-year students were examined following continuous recruitment of volunteers between September 2022 and November 2022. All interviewed participants gave voluntary written consent to participate in the survey and to the test level of impulse noise. Based on the current regulatory documents, all volunteers were surveyed and underwent audiological and vestibulometric studies, the technical characteristics of noise and vibration exposure as a risk factor for the early development of presbycusis were determined, and ways of preventing hearing loss through lifestyle were proposed. RESULTS: The comparative analysis of the influence of impulse noise and vibration effects showed a dependence on the weight of the small arms cartridge, number of shots, and adaptation time of the auditory analyzer in volunteers with normal hearing considering the changes in the high-frequency spectrum of increasing audiometry thresholds from the average value of indicators. CONCLUSIONS: The use of active explanatory propaganda among young people on a careful attitude to the physiological state of the cochleovestibular apparatus avoids the risk of early presbycusis development.

БОЛЕЗНЬ ШЕГРЕНА И ОСТЕОПОРОЗ В ПРАКТИКЕ ВРАЧА-СТОМАТОЛОГА: КЛИНИЧЕСКИЙ СЛУЧАЙ

Subject. The subject of this research is Sjogren's syndrome.
 Objective. The objective of this research is to report a clinical case of Sjogren's syndrome associated with osteoporosis under hospital outpatient care provided by a dental therapist.
 Methodology. The research design includes description of one clinical case. The study is conducted by the Department of Preventive Dentistry and Propedeutics of Dental Disease, and the Department of Intermediate Level Therapy and Geriatrics of Ural State Medical University. This paper presents clinical observations of the patient developing main symptoms of Sjogren's syndrome, as well it explores somatic/dental status and describes the framework for supervision during dynamic observation.
 Conclusion. The case study allows to explore one of the multiple cases leading to development of chronic Sjogren's syndrome. The patient experiences a worsening of symptoms associated with menopausal transition and with new signs brought on by osteoporosis shows specific symptoms. Clinical manifestations of Sjogren's disease are highly variable, complicating the diagnostic process. This creates a risk of delayed treatment and provokes the development of severe complications, especially against the background of osteoporosis. Rational selection of appropriate modern medical treatment (active general drug therapy) and dynamic observation of a reumatologyst are specially important. However, being an interdisciplinary problem Sjogren's syndrome requires involvement of dental professionals, training in professional oral hygiene procedure which is the initial step of comprehensive maintenance treatment (based on clinical recommendations) and dynamic observation of patients; based on systemic manifestations, other specialists such as a reumatologyst, a gastroenterologist, an endocrinologist, an ophthalmologist may be involved.

ИССЛЕДОВАНИЕ МИНЕРАЛИЗАЦИИ ТВЕРДЫХ ТКАНЕЙ ЗУБОВ, ПОРАЖЕННЫХ ЛУЧЕВЫМ КАРИЕСОМ, С ПОМОЩЬЮ МЕТОДА РАМАН-ФЛЮОРЕСЦЕНТНОЙ ДИАГНОСТИКИ

Subject. Mineralization of hard tissues of teeth affected by radiation caries in patients after radiation therapy of malignant neoplasms.
 Objectives. To develop a digital method for diagnosing radiation caries based on Raman fluorescence technology.
 Methodology. The study was conducted at the Department of Orthopedic Dentistry and Orthodontics of South Ural State Medical University. The study was conducted on two groups of people (cohorts) comparable in sex and age, who voluntarily agreed to take part in it. The main group consisted of 20 people (patients with radiation caries), the comparison group – 20 people (without radiation caries). The main research method was the study of Raman fluorescence of tooth areas using the «InSpectr» hardware-software complex with diagnostic sensitivity according to the integral concentration of aerobic-anaerobic microbial suspension up to 109 KOE/ml. A study was made of teeth in the pathological area in patients of the main group, and in the intact area in patients of the comparison group.
 Results. Raman fluorescent diagnostics of the intact tooth surface and the surface with a pathological focus made it possible to clearly see the difference in mineralization in digitized indicators. So, for example, according to the indicators of patients with damage to the teeth by radiation caries, it can be concluded that the indicators of mineralization in the focus affected by radiation caries ( y = 172 ± 0.04, x = 963 cm-1) are lower than those of the intact area (y = 1174 ± 0.071, x = 963 cm-1)
 Conclusion. The method of Raman fluorescence diagnostics can be used in the diagnosis of radiation caries, since there is a potential difference between the healthy and the affected areas of the hard tissues of the tooth. On the basis of the study, the author recommends using the «InSpectr» hardware-software complex for diagnosing radiation caries.

Comparative evaluation of the effectiveness of the drug Sinupret in preoperative preparation and the postoperative period of observation (treatment) during planned rhino-surgical interventions

Pathology of the nose and paranasal sinuses currently occupy one of the leading places in the general structure of diseases of the ENT organs. The proportion of patients in this group who are treated in highly specialized departments of the hospital and who undergo surgical interventions in the nasal cavity is more than 65%. To equalize the efficacy and safetyof the preparation Sinupret in combination with standard therapy in patients in the preoperative and postoperative periods with planned surgical interventions in violation of the architectonics of the nasal cavity. On the clinical basis of the Department of Otorhinolaryngology of the Ural State Medical University of Yekaterinburg, the comparative efficacy and safety of the use of Sinupret in planned surgical interventions in the nasal cavity in patients in preoperative preparation and postoperative management were evaluated. After performing planned surgical interventions in the nasal cavity (septoplasty and submucosal vasotomy with partial resection of the posterior extremities of the lower nasal turbinates), in the observed who in combination with standard conservative therapy received a plant-based remedy, the average score of the total amount of the SNOT-22 test was 20.4, and in patients who, after a similar operation, received only standard conservative treatment, the average score of the total test amount was 20.4, and in patients who after a similar operation received only standard conservative treatment, the average score of the total test amount of the test SNOT-22 corresponded to 28.1, given that the average score of the total amount of the SNOT-22 test before these interventions and the course of therapy was 56.8. The recovery period of nasal breathing was also shortened and the clinical picture improved in patients receiving complex treatment. The use of herbal remedies in combination with standard therapy can reduce the time spent in the hospital after planned surgical interventions in the nasal cavity, accelerate the healing and restoration of the nasal mucosa after surgery, and also qualitatively facilitate postoperative care.

Информационные технологии на службе трансформации медицинского образования, медицинской науки и телемедицины Приложение. Проект бизнес-акселератора «Лаборатория медицинских проектов»

Digital transformation also plays a special role in the strategic renewal of a modern medical university. We are talking not only about re-equipping IT resources in medical education, but also about a kind of resetting the potential of a medical worker, upgrading his professional capital, modernizing the corporate culture, socialization, communication, and optimizing all his internal processes. The purpose of the study is to summarize the experience of organizing and creating a set of interrelated events designed to involve and train students in the skills of using effective information technologies in order to successfully master the curriculum in the context of the digital transformation of medical education. The methodological basis of this study was system-activity, competency-based, informational, individually differentiated approaches. The basis of the research materials was the results of the activities of students and teachers of the Ural State Medical University (USMU). Data on the dynamics of the number of students' involvement, their reports on the topic of the direction, the expansion of the range of research topics, the dynamics of the number of student publications, lectures and master classes by members of the expert council and involved medical IT specialists were used. In general, for four years at the USMU a team of expert teachers interested in the active development of this area at the university has been created. It was possible to attract to work a large number of students from USMU, other universities in Russia and neighboring countries. The study revealed the effectiveness of the work carried out at the USMU in the direction of "Information technologies for the digital transformation of medical education, medical science and telemedicine". The main problems and contradictions in the development of digital literacy and the interest of students and teachers of a medical university are identified, and directions for its improvement are identified.

СИСТЕМНЫЙ АНАЛИЗ КЛИНИЧЕСКИХ ПОКАЗАТЕЛЕЙ РЕЦЕССИИ ДЕСНЫ

The article presents a systemic analysis of clinical parameters in patients with gingival recession experience (GR).The study was carried out at the Department of Therapeutic Dentistry and Propedeutics of Dental Diseases (the Federal State Budget Educational Institution of Higher Education “Ural State Medical University” of the Ministry of Health of the Russian Federation), the Department of Simulation of Controlled Systems (the Federal State Educational Institution of Higher Education “Ural Federal University”) and in outpatient settings on the basis of a dental clinic “TAKI-Dent” LLC (Yekaterinburg). The study involved 30 patients: 10 men (33.3%) and 20 women (66.7%), who consulted a dentist. The systemic analysis of clinical indicators of gingival recession revealed that the prevalence of mild gingival recession was 90%, and that of moderate – 10%. Gingival recession experienced by patients in the age group of 35-44 years old in 80% of cases belongs to class I, according to Miller, and in other 20% - to class III. Wedge-shaped defects were detected in the case of gingival recession in 76.7% of those examined, and were detected mainly in the central segment of the lower jaw and in the lateral sections of the upper jaw (p<0.05). It was ascertained that 50% of patients experience trauma of the gingival margin by overhanging edges of fillings and overhanging edges of crowns. Malocclusion was 60% (p<0.05). An important condition for the prevention of GR is monitoring the performance of individual oral hygiene, proper teeth cleaning and personification when prescribing personal hygiene products.

Endometrial receptivity during hormonal therapy in women of reproductive age with abnormal uterine bleeding due to ovulatory disorders

Background. After an episode of abnormal uterine bleeding, it is of critical importance to restore endometrial receptivity to prevent the recurrence of abnormal uterine bleeding and implement reproductive plans.
 Aim. To study endometrial steroid receptor expression in women of reproductive age after an episode of abnormal uterine bleeding due to ovulatory dysfunction during micronized progesterone or combined oral contraceptive therapy with bioidentical estrogen and dienogest.
 Materials and methods. A cohort prospective study was conducted. The study included 70 females aged 1840 years who were observed with abnormal uterine bleeding due to ovulatory dysfunction at the Department of Obstetrics and Gynecology of Ural State Medical University based at the Yekaterinburg Municipal Hospital №40 from 2016 to 2018. After a bleeding episode, the patients received a combined oral contraceptive with bioidentical estrogen and dienogest or micronized progesterone.
 Results. During therapy, variable changes in the expression of estrogen and progesterone receptors in the stromal and glandular components of the endometrium during the 6-month follow-up were observed.
 Discussion. Changes in steroid receptor expression and endometrial receptivity during hormone therapy are similar, although certain trends are identified which can guide the choice of hormone therapy.
 Conclusion. Due to the lack of complete recovery of steroid receptor expression and endometrial receptivity, even 6 months after hormonal treatment, short courses of hormonal rehabilitation after abnormal uterine bleeding due to ovulatory dysfunction are not sufficient, and permanent hormonal contraception or periodic courses of progestogens are required to prevent a relapse of the endometrial proliferation.