Ural State Medical University Research Articles

ОЦЕНКА ВОСПРИЯТИЯ СТРАХА БОЛИ ПАЦИЕНТАМИ С ОСТЕОПОРОЗОМ И ХРОНИЧЕСКИМ ПАРОДОНТИТОМ

Subject. Fear of future pain.
 Objectives. To assess relationship between age and fear of future pain in women who were diagnosed with osteoporosis and chronic periodontitis.
 Methodology. The study was carried out by the Department of Preventive Dentistry and Propedeutics of Dental Disease, Ural State Medical University, and the Department of Control Systems Modeling, Ural Federal University. First, the review of domestic and foreign research literature was carried out. Next, the group of female participants was formed to take online survey; statistical analyses of the outcomes was carried out. Then, generalization involved results and conclusions, writing a research paper. To assess fears of future pain, the patients who met the following criteria were selected: women after the age of 45 with the known history of osteoporosis and chronic periodontitis, without any psychiatric disorders, who agreed and gave their written informed consents to participate in the research study. For assessment of fears of future pain, the Fear of Pain Questionnaire (FPQ-III) was completed by the women with osteoporosis and chronic generalized periodontitis. FPQ-III consists of 30 items divided into three subscales: Fear of Sever Pain, Fear of Minor Pain, and Fear of Medical Pain. Results of FPQ-III were rated on a 5-point Likert scale ranging from 1 to 5. The total score (from 30 to 150) and subscale scores (from 10 to 50) were calculated for each participant.
 Conclusion. The study found the positive linear relation between age and fear of future severe pain in women with osteoporosis and chronic periodontitis from both age groups (p ≤ 0.05). No relation between Fear of Minor Pain and Medical Pain was found (p ≥ 0.05).

Development of Drugs with Direct Antiviral Action Based on Azaheterocyclic Systems.

This article discusses the results of studies carried out in recent years by a team of scientists from the Postovskii Institute of Organic Synthesis, Ural Branch, Russian Academy of Sciences, in cooperation with the First President of Russia Boris Yeltsin Ural Federal University, Ural State Medical University, Volgograd State Medical University, and other scientific and production organizations of the country to create triazavirin (riamilovir) and other direct etiotropic antiviral drugs based on azaheterocyclic derivatives.

P-097 The Microbiota Difference in Normal and Abnormal Semen Samples Assessed by Real-time RCR

Abstract Study question Does microbiota differ in semen samples with normal and abnormal parameters? Summary answer The higher prevalence of obligate anaerobes and lactobacilli was more typical for semen samples with abnormal parameters compared to samples with normozoospermia. What is known already For a long time, semen in healthy men was considered to be sterile, and the detection of microorganisms was associated with pathologies. More recently, it has been shown that microbiota can be present in semen samples with normal semen parameters. Some researchers, usually using 16S RNA sequencing, cautiously suggested that certain microbial groups could be associated with norm and pathology. Study design, size, duration 825 semen samples from men who came to the “Garmonia” Medical Center (Yekaterinburg, Russia) seeking preconception care in 2019-2021, were included in the study. Depending on the spermiograms results, the samples were divided into two groups: Group 1 – normozoospermia (n = 350), Group 2 – samples with abnormal parameters (n = 475). Participants/materials, setting, methods Semen microbiota was analyzed by real-time PCR Androflor kit (DNA Technology, Russia). Detection rates of 18 bacteria/bacterial groups and 4 consolidated groups of microorganisms (obligate anaerobes (OA), gram-positive facultative anaerobes (GPFA), gram-negative facultative anaerobes GNFA), and mycoplasmas) were compared in Group 1 and Group 2. Two-tailed Fisher’s exact test was performed to check the significance of the differences. Main results and the role of chance Bacterial DNA was detected more often in the samples with abnormal spermiograms (Group 2) than in normozoospermia samples (Group 1): 79.6% and 73.4% respectively (p = 0.045). There was no difference in detection rates of GPFA, GNFA and mycoplasmas in both groups, whereas the detection rate of OA was significantly higher in Group 2 samples than in Group 1 (44.0% and 36.3%, respectively, p = 0.026). When analyzing the detection rate of different bacteria/bacterial groups we registered significant differences for 7 of them. For all the groups, the higher detection rate was associated with Group 2 (abnormal semen samples). In these samples, the detection rate of lactobacilli was 23.4% (compared to 13.7% in Group 1, p < 0.001), Megasphaera spp./Veillonella spp./Dialister spp. – 21.1 (12.0% in Group 1, p = 0.001), Bacteroides spp./Porphyromonas spp./Prevotella spp. – 26.7% (17.1% in Group 1, p = 0.001), Anaerococcus spp. – 15.2% (9.7% in Group 1, p = 0.021), Peptostreptococcus spp./Parvimonas spp. – 18.1% (12.3% in Group 1, p = 0.026), Eubacterium spp. – 24.8% (18.9% in Group 1, p = 0.043). Limitations, reasons for caution Androflor PCR kit uses the 103 genome-equivalent/ml threshold for most of the target microbial groups; samples with lower DNA level are considered as negative. Hence, it is possible that the results may be different when using another threshold. Wider implications of the findings Further research should determine the microbiota variants in semen samples with different abnormalities, such as asthenozoospermia, leukospermia, etc. These findings could expand our understanding of the contribution made by specific microorganisms to diseases, which potentially could lead to the development of new therapeutic options or improvement of the existing ones. Trial registration number Ethics Committee of Ural State Medical University (Protocol № 7 dated September 20, 2019)

History of the Traumatology, orthopedics and military surgery department at the Ural State University (on the 130th anniversary of V.D. Chaklin's birth)

The work presents information about V.D. Chaklin, corresponding member of the USSR Academy of Medical Sciences, laureate of the USSR State Prize, honored scientist of the RSFSR, Professor, about the chair of traumatology, orthopedics and military surgery at the Ural State Medical University in 1934, the clinical base of which became the Research Institute of Traumatology. The staff of the department under the guidance of Professor V.D. Chaklin carried out pedagogical and scientific activities, made a great contribution to the development of methods of reconstructive surgery. There are monographs by V.D. Chaklin and theses defended by the staff of the department. From the beginning of Great Patriotic War professor V.D. Chaklin was appointed the main traumatologist of Evacuation Hospital Administration of Sverdlovsk Regional Dispensary, headed the courses of medical personnel improvement in traumatology and orthopedics, was the adviser of Evacuation Hospitals, continuing to direct the work of UNITO and the department. V.D. Chaklin during his work in Sverdlovsk created the institute and chair of traumatology and orthopedics, the formation of the Ural scientific school of traumatology and orthopedics began, he brought up pupils — doctors and candidates of sciences, left 13 monographs for future generations.

АЛЬЯНС НАУКИ И ПРАКТИКИ: ОПЫТ ПРОВЕДЕНИЯ МЕЖДУНАРОДНЫХ СТАЖИРОВОК ПО СТОМАТОЛОГИИ В УГМУ

Objectives. Since 2018, the Faculty of Dentistry of UGMU has started implementing an international student exchange program within the framework of IADS (International Association of Dental Students), during which students undergo internships at the Faculty of Dentistry and at the dental clinic of UGMU for 2-4 weeks. The purpose of this event is to show the possibilities of such a form of training for future dentists as an international internship at the Faculty of Dentistry, as part of the exchange of students between universities.
 Material, methods, results. In July 2018, 4 fifth-year students studying in the specialty "Dentistry" at the Faculty of Medicine of the University of Ljubljana (Slovenia) and 1 fourth-year student of the Faculty of Dentistry of the Tehran University of Medical Sciences (Iran) (in English) came to the IADS internship in the profile "Dentistry". In July 2021, a scientific and clinical internship of foreign dental students was held for three students from Croatia and Germany. The training cycle consists of lectures and practical exercises with the development of manual skills. During the internship, the guests get acquainted with the structure of USMU, visit the bases of the Faculty of Dentistry for practical training, the vivarium and the central research laboratory of USMU.
 Conclusions. The experience of conducting international internships for foreign students is a promising direction in the development of the university, which is successfully being introduced into the international space. A vivid proof of this statement is that the Dental Faculty of the Ural State Medical University (USMU) in 2021 was awarded an award for conducting an international clinical exchange from the International Association of Dental Students (IADS).

СТОМАТОЛОГИЧЕСКОМУ ФАКУЛЬТЕТУ УГМУ — 45 ЛЕТ: ИСТОРИЯ, СЕГОДНЯШНИЙ ДЕНЬ И ПЕРСПЕКТИВЫ

The article tells about the history of the emergence of the Faculty of Dentistry of the Ural State Medical University, about the first teachers and clinical sites. The history of the creation of its own dental clinic and its role in the development and establishment of the faculty are shown. The indicators of the modern development of the Faculty of Dentistry of USMU, the main indicators and development prospects are touched upon.

АНАЛИЗ ИЗМЕНЕНИЙ ФИЗИКО-ХИМИЧЕСКИХ СВОЙСТВ СМЕШАННОЙ СЛЮНЫ МОЛОДЫХ ЛЮДЕЙ ПОД ВОЗДЕЙСТВИЕМ ЖИДКИХ СРЕДСТВ ГИГИЕНЫ

Subject. Physicochemical properties of mouthwashes developed and produced by Svoboda Company for everyday use and oral hygiene maintenance.
 Objectives. To study dynamics of qualitative and quantitative physicochemical and organoleptic properties of mixed saliva in young people subjected to using hygiene and prophylactic domestic mouthwashes.
 Methodology. The study was carried out by Department of Therapeutic Dentistry and Propaedeutics of Dental Disease, by Department of General Chemistry of Ural State Medical University and by Department of Control Systems Modeling of Ural Federal University. The study involved 40 patients from dental student volunteers (male – 15, female – 25), the average age of volunteers was 18.50 ± 1.6 years. The patients were divided into two groups each containing 20 persons. Mouthwash 1 was a common hygiene oral rinse. Mouthwash 2 was a treatment and prophylactic oral rinse, all participants used the mouthwashes during 3 weeks.
 Results. The use of the reported mouthwashes contributes to increase in cleansing properties of saliva in both groups of subjects. During mouth rinse treatment, the surface tension of saliva increases. The surface tension of mixed saliva is increased by 28.9% (p ≤ 0.05) with Mouthwash 1 and by 9.5 % (p ≤ 0.05) with Mouthwash 2. The surface tension of mixed saliva of subjects of the second group becomes slightly above normal (40-60 erg/cm2; p ≤ 0.05).
 Conclusion. The study of changes in physicochemical properties of mixed saliva in young people, volunteers of the two groups, subjected to liquid oral hygiene products, mouthwashes, during three weeks showed the following results: the treatment and prophylactic oral rinse (Mouthwash 2 with titanium glycerosolvate aquacomplex and sodium hyaluronate) promotes more adequate maintenance of the acid-base balance in the oral cavity, pH change of mixed saliva toward the alkaline and maintenance of the normal level (p ≤ 0.05) of buffer capacity which reduces the risk of dental caries.

Analysis of gingival recession risk factors

Relevance. In most cases, modern dentistry can successfully treat gingival recessions, thus achieving both aesthetic and functional goals. Conservative, surgical, orthodontic, instrumental, injection procedures and methods, which help adequately manage the position of the gingival margin according to the cementum-enamel junction and keep the smile beautiful and healthy, primarily preserve teeth. Meanwhile, timely identification of risk factors associated with gingival recession is no less of a priority in the individualized preventive approach to supporting patients at the dentist appointment.Materials and methods. The research was conducted at the Department of Operative Dentistry and Introduction to Dental Diseases of the Ural State Medical University and the Department of Control Systems Modeling of the Ural Federal University in Yekaterinburg. The study examined 60 young adults: 20 men (33.3%) and 40 women (66.7%) who presented to the dentist. The patients were allocated into two groups according to their age. Each group consisted of 30 patients: the first group contained 20 to 24-year -olds and the second group comprised 35 to 44-year -old patients.Results. The analysis of gingival recession risk factors revealed aggressive tooth brushing in 19% subjects of the first group (р ≥ 0.05), poor oral hygiene in 17% cases (vs 19% in the second group (р ≥ 0,05); overhanging restorations – 12% cases (р ≥ 0.05); thin gingival biotype –14% (р ≥ 0,05).Conclusion. Effective customized control of gingival recession risk factors primarily allows normalizing oral hygiene, timely arresting inflammation in the marginal and papillary gingiva, eliminating trauma from tooth brushing and interdental cleaning devices, as well it provides an interdisciplinary approach to patient management at the dental appointment.

TESTING AS A CRITERION FOR VALIDATION OF THE LEVEL OF TRAINING OF STUDENTS

The article presents the view of the staff of the Department of Pharmacology and Clinical Pharmacology of the Ural State Medical University (USMU) on modern methods of teaching university students, using test modular controls, justification of the necessity and usefulness of this system of assessing students’ knowledge, in connection with the formation in the minds of students of clear definitions of clinical phenomena and unambiguity of criteria for diagnosis, as well as the practical significance of the further application of the acquired knowledge by future specialists due to the development of the specifics of manipulations and algorithmic actions during the performance of medical duty.

General medical practice in educational programs of the Ural State Medical University. Place and role in the training of primary care physicians

<h3></h3> В статье обсуждаются место и роль дисциплины «Общая врачебная практика» в образовательных программах Уральского государственного медицинского университета как фактор повышения качества подготовки специалистов для первичного звена здравоохранения на этапах специалитета, ординатуры, программ дополнительного образования врачей. Показан опыт кафедры профилактической и семейной медицины в разработке учебных программ, системообразующим вектором которых является научно обоснованная профилактика, базирующаяся на биопсихосоциальной концепции. Такой подход способствует приобретению обучающимися компетенций, требуемых Федеральными государственными образовательными стандартами высшего образования, формирует навыки, необходимые для успешного выполнения трудовых функций действующих профессиональных стандартов.

90 years of the Ural State Medical University: development of scientific activity

Since the foundation of the Ural State Medical University (USMU), the importance of scientific activity in the training of specialists with higher medical education has been determined. A contribution to the history of medical science in the Urals since the 30s of the twentieth century was made by those who began work at the Sverdlovsk State Medical Institute, whose discoveries made it possible to find new methods of diagnosis and treatment, to identify the causes of any disease. For 90years, the results of the activities of representatives of the established scientific directions and schools of Ural State Medical University have been used in the educational process and healthcare. The article describes the promotion of scientific activity of Ural State Medical University and its productivity over the previous decade. We analyzed reports on research activities for 20102020, materials based on the results of monitoring the effectiveness of Ural State Medical University, scientometric databases Russian Science Citation Index (RSCI), Web of Science, Scopus. Along with the development of traditional medical research areas and schools, the university researches in the areas of scientific medical platforms, cooperates with leading scientific, educational and medical organizations. The development of personalized medicine, digital medicine, reconstructive medicine, as well as the use of cellular technologies, and the fight against infectious diseases are highlighted among the topical areas. Over the current decade, the number of publications indexed in international abstract databases has increased 4times in Scopus, 2times in Web of Science, and 2.6times in RSCI. The total number of citations of articles over five years (20162020) in Scopus was 990, Web of Science 766. The number of articles included in the list of the Higher Attestation Commission under the Ministry of education and science of the Russian Federation, for a number of years on average 456. There is the dynamic development of the scientific activity of Ural State Medical University with a focus on cooperation with leading research teams of other organizations, the implementation of research on a state assignment, accompanied by a significant increase in publication activity.

On Extensive Training of University Students of the Faculty of Preventive Medicine in Food Hygiene as a Variable Part of the Educational Program

Introduction: The key objective of national projects is to maintain and promote health of citizens. Nutrition makes a significant contribution to health protection; yet, problems related to quantitative and qualitative characteristics of nutrition, food safety, and high risks of nutrition-related diseases are obvious. Current trends necessitate the development of new approaches to training specialists majoring in preventive medicine. The students mastering a specialty program shall acquire general cultural and professional competencies and be ready to perform medical, organizational, managerial, and research activities, including those needed to respond to challenges related to safe and high-quality nutrition. The required competency building occurs when studying the main academic disciplines and may be then reinforced and deepened by the variable part (or elective academic component) of the educational program. Objective: To substantiate the content of the variable part of the educational program on food safety aimed to improve the quality of training of public health physicians in this area. Materials and methods: Based on the requirements of the federal higher education standard, professional standard and an exemplary educational program of higher education for students majoring in medical and preventive care, the curriculum of the Ural State Medical University was supplemented with optional academic disciplines containing separate sections on food hygiene, as well as the discipline titled “Sanitary and Epidemiological Surveillance over Food Production and Sale”. Results and conclusions: The experience in the development and implementation of optional academic disciplines has demonstrated their high demand by students and general satisfaction with results of training. It has also created conditions for multiple repetition and consolidation of learning materials by means of food examinations in class, hygienic education according to individual and group programs, and studies of new technologies for food production, circulation, quality and safety assurance.

On the Question of Learning to Communicate With a Patient: "Who is on the Captain's Bridge?"

The experience of the implementation of the educational project "Communicative skills of a doctor" in the Ural State Medical University in Yekaterinburg, its main guidelines and principles, as well as the results of studying the content of the patient's image in the context of its impact on the effectiveness of interaction in medical consultation in the direction of its patient-orientation are presented.

ХАРАКТЕРИСТИКА КЛИНИЧЕСКИХ И МИКРОБИОЛОГИЧЕСКИХ ПОКАЗАТЕЛЕЙ ПОЛОСТИ РТА У ПАЦИЕНТОВ С ПАРОДОНТИТОМ И ГИПОТИРЕОЗОМ НА ФОНЕ КЛИНИЧЕСКОЙ ТЕРАПИИ С ПРИМЕНЕНИЕМ СИНБИОТИКА

Subject. Microbial landscape of the oral cavity is a highly sensitive systemic indicator reacting to changes in different body organs and systems by qualitative and quantitative shifts. The unique ability of microbiocenosis of the oral cavity to self-regulate and maintain the ecological balance creates a personal health profile of an individual and assumes that a timely correction of microbiocenosis shall be added to required treatment patterns for various dental and somatic diseases. This approach ensures the protective effect of growth of opportunistic pathogenic bacteria improving quality of therapy and patient recovery time. Objectives. To study dynamics of clinical and microbiological changes in the oral cavity in patients with periodontitis and hypothyroidism on the background of complex therapy with inclusion of synbiotic Maxilac. Materials and methods. Based in the Ural State Medical University Department of Therapeutic Dentistry and Propedeutics of Dental Decease, the study of oral microbiology was carried out on 50 generalized moderate periodontitis patients aged 44 to 59 years during the period from 2017 to 2021. The average age of the subjects was 50.50±3.5 years. Two groups were formed: the main group (30 patients with “primary hypothyroidism” receiving hormone therapy) and the comparison group (20 patients). The patients in the main group were prescribed general therapy by the endocrinologist based on the phase, stage and the severity of the disease. During examination all patients underwent the complex clinical and laboratory evaluation before treatment, in its course and after it, as well they were subjected to full mouth debridement and the course of the complex periodontal therapy in accordance with clinical recommendations. Microbiota was corrected by active ingredient probiotic (lyophilized probiotic bacteria) — 4.5*109 CFU (colony-forming unit): Lactobacillus elveticus, lactis, rhamnosus, plantarum, casei; Bifidobacterium longum, breve, bifidum; Sreptococcus thermophilus. Results. The study of microbiocenosis of the oral cavity of patients with primary hypothyroidism demonstrated changes in species and the number of microorganisms in the oral cavity. Conclusions. Timely diagnostics and correction of disbiotic changes included in the dental treatment protocol will allow to select the most appropriate dental treatment strategy.

Реализация дистанционного образования в медицинском университете: анализ удовлетворенности студентов

Aim. Assessment of satisfaction of students of a medical university with the quality of distance learning. Materials and methods. A comparative prospective non-interventional study was conducted in December 2020 – January 2021, which included 167 students of the medical and prophylactic and pediatric faculties of the Ural State Medical University. Anonymous survey, submitted using the Google Forms platform, included answers to 18 open-ended questions with a choice of one or more answer options. Statistical analysis of the survey results was carried out on the basis of a summary of responses from the Google Forms platform, and Fisher’s criterion was also determined for nonparametric data. Results. When comparing the results of the questionnaire survey of students of the Ural State Medical University, it was found that three quarters of the students as a whole quite effectively adapted to the new conditions of on-line education, there were no significant differences in these indicators. Conducting classes in the format of video lessons, on-line testing and individual assignments on specific topics turned out to be the most welcomed by students forms of communication with teachers. At the same time, among the additional advantages of distance learning, students noted the possibility of combining study and work, the flexibility of the educational process and conducting classes in a comfortable home environment.

Аnalysis of cases of progressive multifocal leukethephalopathy in patients with HIV infection: clinical, epidemiological, diagnostic and therapeutic aspects of the problem

Purpose of research. Study of epidemiological, clinical, diagnostic and therapeutic features of progressive multifocal leukoencephalopathy in HIV-infected patients.Materials and methods. We analyzed 10 cases of deaths from PML of patients with HIV infection according to the reports of the Magnitogorsk AIDS Center for 2014–2016, and provided our own clinical observation of a patient with PML who was treated in 1 infectious Department of the South Ural State Medical University of the Ministry of Health of Russia in 2018 year.Results and discussion. In most cases of PML observed with CD4+ less than 50 cells and a viral load of more than 150 000 HIV RNA copies/ml, brain MRI is an informative method of in vivo diagnosis, WARTH slows the progression and improves the prognosis of patients.

КЛИНИКО-ЛАБОРАТОРНОЕ ИССЛЕДОВАНИЕ ФИЗИКО-ХИМИЧЕСКИХ СВОЙСТВ НОВОЙ ЗУБНОЙ ПАСТЫ С КОМПЛЕКСОМ HYALURON-TI FORTE

Subject. Physical-chemical characteristics of the toothpaste Dentaswiss Extra Whitening and structural and optical parameters of mixed saliva before and after volunteer brushing. &#x0D; Objectives. To evaluate physical-chemical characteristics of the new therapeutic and prophylactic toothpaste Dentaswiss Extra Whitening together with changes in structural and optical parameters of the effected mixed saliva.&#x0D; Methodology. The composition and properties of the new therapeutic and prophylactic toothpaste Dentaswiss Extra Whitening are studied based on the results of physical and chemical analysis of three aqueous solutions (prepared with different concentrations) by measuring pH value, calcium ion concentration, electrical conductivity and surface tension. The study involved 32 student volunteers of both sexes (men — 11, women — 21) from the Ural State Medical University Faculty of Dentistry between the ages of 21 to 23 who were comprehensively examined including structural and optical parameters of mixed saliva before and after brushing.&#x0D; Results. The average pH value is 7.91±0.01, the increased calcium ion (Са2+) level is found up to 2.25 mmol/l in all three aqueous suspensions (р≤0.05). Electrical conductivity of suspensions is found to be increased and surface tension is found to be reduced uniformly with the increase in mass fraction (р≤0.05). &#x0D; Conclusion. The study of physical-chemical characteristics of the toothpaste Dentaswiss Extra showed positive changes in pH values, electrical conductivity and surface tension promoting the increased remineralizing properties of mixed saliva (р≤0.05).

ANXIETY DISORDERS AMONG MEDICAL STUDENTS

Background: Concerns about the psychological health of students are determined by their lifestyle, specific working conditions, and the role that this social group plays in society. Compensatory mechanisms of students do not always cope with new living conditions and the requirements of higher education, which leads to stress, psychological and social conflicts, as well as to the use of psychoactive substances. Aim. The paper aims to identify the prevalence of anxiety disorders among medical students to develop recommendations for primary and secondary psychological prevention. Materials and methods: the study was conducted throughout the year. The first- and fourth-year students (52.6 % and 47. 4 % respectively) of the medical faculty of the South Ural State Medical University participated in the study (n = 612). The study involved both females (66.8 %) and males (33.2 %). To identify various anxiety disorders, the Yale-Brown Scale, ICD-10 criteria (F41.0 and F41.1), and anonymous survey were used. To assess the reliability of the values obtained, the Student’s t-test was used. Relative values and their representative errors were calculated. Results: anxiety disorders were detected in 65.8 % of first-year students and more than half of fourth-year students. Moreover, anxiety disorders are 1.5 times more common in females than in males. Depressive conditions were found in every fifth student, regardless of the year of study. More than half of first-year students and every third fourth-year student suffer from obsessive-compulsive disorder of varying severity. Severe and extremely severe obsessive-compulsive disorder in first-year students occurs 2 times more often than in fourth-year students. Conclusion: anxiety disorders are widespread among medical students, which requires their primary and secondary prevention. First-year students are particularly affected by adaptation to new living conditions and the requirements of higher education.

Anti-VEGF therapy of wet age-related macular degeneration: analysis of patients lost to follow-up

To study the reasons for patients receiving anti-VEGF therapy for «wet» age-related macular degeneration (wAMD) in clinical environment to cease monitoring in the clinic. This retrospective cohort study included patients with wAMD which received anti-VEGF therapy (ranibizumab, aflibercept) in the Ural State Medical University clinic from 2011 to 2019 (n=241). A subgroup of patients continuing treatment (n=90) was compared with a subgroup of lost to follow up patients (LTFU, n=151, 62.7%). Observation lasting less than 12 months was an exclusion criterion. Statistical analysis included a comparison of demographic and clinical data. The reasons for treatment discontinuation were determined using a phone survey. Characteristic for the LTFU subgroup were shorter duration of the follow-up (p<0.0001), lower number of intravitreal injections (p<0.0001), lower baseline (p<0.0001) and final best corrected visual acuity (p<0.0053) as well as higher values of therapy intensity coefficient (the ratio of the number of intravitreal injections to the duration of the follow-up, p<0.0001). According to the results of the phone survey, the following categories of LTFU were identified: ceased regular monitoring/treatment - 83 (55.0% of the LTFU subgroup), continued treatment in another clinic - 14 (9.3%), deceased - 18 (11.9%), status unknown - 36 (23.8%). The most common causes of LTFU were dissatisfaction with treatment results, financial burden and general comorbidities, which were named by 50, 27 and 17 respondents, respectively. In accordance with identified reasons for LTFU, we determined the directions for increasing the effectiveness of wAMD treatment: early diagnosis and start of treatment; using the most effective drugs and therapeutic regimens; increasing the availability of anti-VEGF therapy.

South Ural state medical University, Department of Dermatovenerology

The article discusses modern ideas about the role of microbial agents in the pathogenesis of the most common dermatoses in pediatric practice. The paper shows the importance of the skin microbiome and foci of chronic inflammation in the induction and maintenance of the pathological process in the dermis in atopic dermatitis, psoriasis. Presented own clinical observations of two girls at the age of 1 2 years with a diagnosis: vulgar psoriasis with lesions of the skin, scalp, and at the age of 5 years with a diagnosis of atopic dermatitis, childhood phase, erythematous-squamous form, mild course. The preparation of activated zinc pyrithione has anti-inflammatory, antifungal and antimicrobial activity, a high safety profile and can be used to control inflammation and correct the skin microbiome. The use of the preparation of activated zinc pyrithione significantly reduces the need for external corticosteroids.