Urgent Problem Of Modern Medicine Research Articles

Головная боль у пациентов с дисплазией соединительной ткани

Headache in patients with connective tissue dysplasia (CTD) is an urgent problem of modern medicine. The article discusses different types of headache in patients with connective tissue dysplasia. The most well studied are differentiated forms of connective tissue dysplasia (Ehlers — Danlos syndrome, Marfan syndrome, etc.) and, accordingly, variants of cephalgia in them are described. A significant problem is the dissection of the carotid and vertebral arteries, which are variants of acute cerebrovascular accident. The interrelation of primary and secondary headaches with CTD syndrome is shown. The variety of clinical manifestations of headaches and connective tissue dysplasia in the same patient makes it difficult to diagnose, which can contribute to the chronicity of cephalalgia, the appointment of inadequate therapy and the development of complications. Further study of headache options in patients with CTD will improve the provision of medical care to this category of patients.

Сахарный диабет и анемия: современный взгляд на проблему

Diabetes mellitus is one of the urgent problems of modern medicine, which is primarily due to its significant prevalence in the population and high disability of patients. Anemia is a frequent and often untimely diagnosed complication of diabetes mellitus, which not only worsens the quality of life of patients, but also affects the development of its chronic complications and cardiovascular pathology. The main factors in the development of anemic syndrome in patients with diabetes include diabetic nephropathy, autoimmune disorders, metabolic disorders of iron, folic acid, vitamin B12, as well as the effects of proinflammatory cytokines. According to our data, anemia is diagnosed in 67.4% of all patients with diabetes mellitus. It is most often identified in patients with type 2 of the disease and is mainly represented by the iron deficiency form, as well as a manifestation of diabetic nephropathy.

MODERN APPROACH TO THE DIAGNOSIS AND TREATMENT OF FLAMING NEVUS

Capillary malformations (capillary angiodysplasia, CAD) in patients are an urgent problem of modern medicine due to functional, cosmetic, psychological disorders and social maladjustment of this category of patients in the absence of timely adequate treatment.

Algorithm of rapid diagnosis of chronic autoimmune hepatitis by saliva by the method of monochrome analysis of nanoparticles

Сhronic autoimmune hepatitis is an urgent problem of modern medicine due to the widespread prevalence among all autoimmune diseases (more than 25%) and the difficulty of its diagnosis due to the lack of reliable serological tests for its detection. The purpose of this work was to study the possibility of the method of monochrome analysis of nanoparticles in noninvasive detection of AIG and to develop an algorithm for rapid diagnosis of chronic autoimmune hepatitis by saliva. The goal was solved by performing a number of tasks: the development of a diagnostic algorithm for monochrome analysis of nanoparticles to determine the severity and pathophysiological orientation of homeostatic shifts in patients with a verified diagnosis of chronic autoimmune hepatitis using samples of oropharyngeal flushes (saliva), as well as the calculation of diagnostic specificity and sensitivity of the test. Materials and methods: The studies were conducted at the Center for European and Oriental Medicine from 2019 to 2022, and 14 patients with a verified diagnosis of autoimmune hepatitis were examined. It was found that the most typical saliva spectra of patients with autoimmune liver damage were characterized by three-modality and predominance of light scattering on particles of super-large diameter (over 1000 nm) and a significant increase in the contribution to light scattering of nanoparticles of small and medium hydrodynamic size, which was statistically significant (p<0.001) when conducting a comparative analysis with the saliva spectra of practically healthy individuals and patients with general somatic liver diseases of non-autoimmune genesis. The indicators of diagnostic sensitivity for autoimmune hepatitis were 95%, diagnostic specificity - 93%. Conclusions: the results of the conducted scientific research were the developed algorithm for the use of laser spectroscopy of saliva for noninvasive rapid diagnosis of chronic autoimmune hepatitis, when with a timely diagnosis, therapeutic measures will be maximally effective and aimed at preventing complications and systemic manifestations of the disease, and the calculation of diagnostic sensitivity and specificity of the method of monochrome analysis of nanoparticles.

Perspective and current state of international standards influence on prevention and treatment of diseases through the prism of developing high-quality and safe medicines

The aim of the work was to examine international legislation covering the legal responsibility in the pharmaceutical field; to analyze activities of international organizations in the area of combating counterfeit drug distribution. Materials and methods. The study was based on international legal instruments aimed at ensuring legal certainty concerning consideration of drug falsification and similar crimes and imposition of criminal liability for activities related to the falsification of medicines. During the work we used methods of information retrieval, analysis, systematization and generalization. Results. An urgent problem of modern medicine is the use of high-quality drugs for the treatment and prevention of diseases. Compliance with standards, in particular international ones, during the development of drugs is the key to both effective treatment and further research in the field of basic clinical medicine, including obtaining new scientific data, improving methods of prevention, diagnosis and treatment of internal diseases. Transformation processes related to Ukraine’s European integration, development of the pharmaceutical industry market, establishment of additional requirements for the quality and safety of medicines necessitate the implementation of state policy aimed at implementing European Union (EU) legal regulations governing legal liability for offenses. committed in pharmaceutical activities. Special attention is paid to the issues of harmonization of the Ukrainian national legislation with the international legislation on the regional level developed by the Council of Europe and the EU on combating the falsification of medicines, including the imposition of criminal liability. Conclusions. The implementation of the international legislation norms of providing legal liability for offenses in pharmaceutical activity into the national legislation plays a positive role, eliminating the shortcomings of the relevant Ukrainian legislative acts.

The role of mitochondria in the pathogenesis of the "complex" wound process

Wound healing is a complex biological process involving various cells, mediators, and components of the extracellular matrix involved in the processes of coagulation, inflammation, angiogenesis, epithelialization, and fibroplasia. Wound healing is described by four interrelated phases: hemostasis, inflammation, proliferation and remodeling. Each of the phases has its role at the molecular and tissue levels, and if a defect occurs in the chain of one of the phases of the wound healing process, the healing process is disturbed and a chronic wound condition occurs. Various factors such as infections, arterial and venous circulatory disorders, type 2 diabetes and chronic inflammation contribute to this. Prolonged non-healing wounds represent an urgent problem of modern medicine. Oxidative stress plays a crucial role in the pathogenesis of chronic wounds. In this review the pathogenesis of chronic wounds and its involvement of reactive oxygen species (ROS), oxidative stress, the role of mitochondria in ROS generation as well as the prospects of mitochondrial-directed antioxidants in the treatment of chronic wounds are considered.

Development of the Composition of Combined Medicinal Pencils for the Treatment of Dental Diseases

Introduction. Prevention and treatment of periodontal diseases remains one of the urgent problems of modern medicine. According to WHO, the prevalence of dental diseases among adults is 90–95 %, among adolescents – 80–83 %. The health of the body as a whole largely depends on the state of the oral cavity. It is important for the effective treatment of diseases to have a properly selected dosage form, which provides both convenience of use and purposeful use of the action of the pharmacologically active drug contained in it. Medicinal pencils as a dosage form are very limited on the pharmaceutical market, so their development is relevant. As a local anesthetic component, anilocaine is included in the composition of pencils at a concentration of 5 %, antimicrobial action is provided by the introduction of metronidazole in a concentration of 1 % in order to prevent the occurrence of infection.Aim. Substantiation of the composition and technology of the medicinal pencil for the treatment and prevention of infectious and inflammatory diseases of the oral cavity.Materials and methods. For the study, we used medicinal pencils with an active pharmaceutical substance – anilocaine (FS 42-2846-97, LLC "Perm Chemical Company", Perm, shelf life of 5 years), metronidazole (FS 42-0257-07, JSC "Medisorb", Perm, shelf life of 3 years); basic components – PEO-400 (FS 42-1242-96, LLC "Neftegazkhimkomplekt", Moscow, shelf life of 3 years), PEO-1500 (FS 42-1885-96, LLC "Neftegazkhimkomplekt", Moscow, shelf life of 3 years), PEO-4000 (FS 42-3337-96, LLC "Neftegazkhimkomplekt", Moscow, shelf life 3 years), second ingredient – purified water (FS.2.2.0020.18), the UVOI-"MF" 1812S6 obtained at the reverse osmosis plant (JSC "NPK Median-Filter", Russia). In the course of the research, technological, structural-mechanical and biopharmaceutical methods were used.Results and discussion. Based on technological, structural-mechanical and biopharmaceutical studies, the composition of medicinal pencils with anesthetic, anti-inflammatory and antimicrobial effects for the treatment and prevention of infectious and inflammatory diseases of the oral cavity is proposed and justified for the first time. Biopharmaceutical availability of medicinal pencils is determined by the conductometric method.Conclusion. The conducted complex of studies will expand the range of domestic medicines for the treatment and prevention of infectious and inflammatory diseases of the oral cavity.

Management of patients with chronic low back pain and fibromyalgia

Management of patients with chronic low back pain and fibromyalgia is an urgent problem of modern medicine. In real clinical practice, fibromyalgia (FM) is often undiagnosed, with chronic back pain no combined diseases are detected, so patients do not receive comprehensive therapy, as demonstrated by two clinical observations. One patient suffered from chronic lumbodynia (skeletal-muscular lumbar pain against the background of lower lumbar facet joint lesions), chronic insomnia, anxiety disorders. The second patient suffered from FM combined with osteoarthritis of the hip joints and sacroiliac joint. Comprehensive personalized treatment, which included identifying and treating comorbidities, working with patients’ misconceptions about the causes of pain, predicting and planning physical activity, conducting an educational program with elements of cognitive behavioral therapy (CBT), regular exercise therapy, and pharmacotherapy, led to significant improvement in the patients’ condition. In both observations, a persistent (for 6 months) positive effect in the form of pain reduction, improvement of the functional state, emotional status, and sleep of the patients was achieved.he study also discusses the issues of effective therapy of chronic musculoskeletal chronic lumbar pain and FM, doctors’ poor awareness of FM and criteria for its diagnosis. It is noted that regular therapeutic exercises, restriction of excessive physical and static loads form the basis of management of patients with chronic back pain. Patients with chronic back pain often have misconceptions about their disease, its prognosis, and effective therapies, so identifying and resolving these problems using CBT contributes to a positive treatment outcome.

Influence of different prevention options on cognitive dysfunction in the early and remote postoperative period in otolaryngological interventions with controlled hypotension

Annotation. Cognitive dysfunction complicates the course of the early postoperative period, and in the longer term worsens the quality of life of patients due to their professional, social and domestic maladaptation, so the prevention of cognitive disorders is an urgent problem of modern medicine. The aim of the study was to investigate the effect of drugs with antioxidant properties and effects on choline metabolism on the state of cognitive function of patients after otolaryngological surgery with controlled hypotension. The data of neurocognitive testing of 127 patients were analyzed, including: patients of group 1 (control, n=33) did not receive prevention of cognitive dysfunction, patients of group 2 (n=32) were prescribed ethylmethylhydroxypyridine succinate, patients of group 3 (n=30) – choline alfoscerate, patients of group 4 (n=32) – choline alfoscerate and ethylmethylhydroxypyridine succinate. The assessment of cognitive function of all patients was conducted before surgery, 7 days and 3 months after surgery using the Lurie test, the Toulouse-Pieron test, the Trial Making Test and the Stroop test. Statistical processing of the obtained data was performed in the statistical package “SPSS 20” (SPSS Inc.) using parametric and non-parametric methods of evaluation of the obtained results. The results of neurocognitive testing of otolaryngological patients who underwent surgery under general anesthesia using controlled arterial hypotension, showed that cognitive impairment, registered in the early postoperative period in 24.4% of patients, significantly decreased within 3 months after surgery and reached 11%. Perioperative use of choline alfoscerate reduces the incidence of postoperative cognitive dysfunction in the early postoperative period from 39.4% to 16.7%, while the combination of choline alfoscerate with ethylmethylhydroxypyridine succinate reduces the incidence to 12.5%. No significant effect of perioperative prophylactic medication on the frequency of cognitive dysfunction was found in the long postoperative period of otolaryngological interventions with controlled hypotension. The obtained results can serve as a justification for the subsequent purposeful determination of clinical predictors of postoperative cognitive impairment.

Actualization of the modern approach to the treatment of gastric ulcer

Despite the generally accepted fact that Helicobacter pylori is the main cause of gastric and duodenal ulcers, its role is not always decisive. It was found that this pathogen does not have a sufficient level of invasiveness, and in about 70% of cases does not lead to morphological disorders of the gastric and intestinal mucosa. Speaking about the possible causes of the development of peptic ulcer, one cannot but take into account the influence of stressful situations, aggravated heredity, and nutritional errors. One of the urgent problems of modern medicine is to increase the effectiveness of peptic ulcer treatment and prevent recurrence of the disease, and the main direction of antiulcer therapy is the eradication of Helicobacter pylori with the parallel administration of antisecretory drugs. Meanwhile, it should be noted that the lack of certainty in matters of pathogenesis over a number of years led to the unreasonable prescription of a large number of various medications, ranging from antacids and antispasmodics to sedatives and tranquilizers. Such a wide variety of therapeutic drugs used indicates that for a long time it was not possible to confirm the real effectiveness and clinical efficacy of most antiulcer drugs, which once again confirmed the correctness of the phrase said by the famous therapist V.Kh. Vasilenko regarding the fact that "gastroduodenal ulcers heal due to treatment, despite treatment and even in spite of treatment".

The Use of Antibacterial Drugs and Awareness About the Antibiotic Resistance Problem Among the Students of a Medical University

Background. The growth of antibiotic resistance is an urgent problem of modern medicine associated with the irrational use of antibacterial drugs. The solution to this problem requires a comprehensive analysis of the situation not only from the patients’ standpoint, but also from that of medical specialists. Aim. To establish the level of awareness about the problem of antibiotic resistance and to study the practice of antibacterial drug use among senior students of a medical university. Material and methods. A one-time sociological study was conducted in the format of an online survey of the 5th–6th year students of the medical and pediatric faculties of the Siberian State Medical University of the Ministry of Health of the Russian Federation. Results. An invitation to the survey was sent to 406 5th–6th year students of the pediatric and medical faculties; 334 students voluntarily completed the questionnaire (return rate — 82.3%). Most students are aware of the problem of antibiotic resistance. 58.8% of the students took drugs as prescribed by a doctor, adhering to the prescribed duration of treatment. The most commonly used antibiotics were: amoxicillin/clavulanic acid — 57.6%, amoxicillin — 29%, azithromycin — 19.4%, ciprofloxacin — 13.4%, 3rd generation cephalosporins — 8.1%. It was found that 45.4% of students used antibiotics parenterally, of which half (50.4%) performed injections at home or in the dormitory. Up to 89.2% of respondents consider it necessary to use medications to restore the intestinal microflora against the back-ground of antibiotic therapy. Conclusions. Despite the high awareness of the problem of antibiotic resistance and adherence to medical recommendations regarding the use of antibiotics, it is necessary to increase the competence in the field of rational antibiotic therapy for both students and practitioners.

Intravenous posaconazole: key features of clinical pharmacology and practical applications

Invasive fungal infections in various categories of patients remain one of the most urgent problems of modern medicine. This is complicated by the imperfection of diagnostic methods, as well as a small range of antimycotics for systemic use. The market launch in 2005 of posaconazole, a second-generation systemic antimycotic from the group of triazoles with a wide spectrum of activity in the form of an oral suspension, was an event in medical mycology. However, pharmacokinetic features of suspension have caused certain problems with its use. The suspension was replaced by a tablet form, largely devoid of these shortcomings, and then a solution for intravenous administration, which was registered in Russia at the end of 2021 (significantly later than in other countries of the world). Registration of an intravenous form of the drug with the possibility of using both for a stepdown approach and in patients who, for different reasons, cannot take posaconazole orally, had a positive impact on the problem of choosing antimycotics for the prophylaxis and treatment of invasive fungal infections. In this article, we will consider the features of the clinical pharmacology of the intravenous form and its place in the prophylaxis and treatment of invasive mycoses.

Meta-Analysis of Non-Alcoholic Fatty Liver Disease and Electromechanical Reconstruction of Myocardium.

In developed countries, non-alcoholic fatty liver disease (NAFLD), which results from obesity, has become endemic and kills many adults annually. Health research centers in most countries are looking to examine the relationship between metabolic syndrome (MetS) and metabolic biomarkers. A bleeding-prone standard liver biopsy or costly magnetic resonance imaging scan is used to diagnose NAFLD. The present study aimed to analyze medical databases using various scientific articles; moreover, this experiment analyzed medical databases using published scientific articles related to NAFLD, endovascular treatment, cardiac arrhythmias and conduction disorders, changes in the geometry of atria and ventricles, changes in myocardial mass volume as well as diastolic flow left and right ventricular systolic functions, coronary blood flow, analysis of the dependence of epicardial fat tissue (EFT) thickness, and the presence of chronic heart failure (CHF). It is demonstrated that the index of EFT in NAFLD positively correlated with the criteria of cardiovascular health, values of the carotid intima-media thickness, and calcification of the coronary arteries on the coronary artery calcium scale (P<0.0001). The index of per EFT significantly correlated with the factor of the age of the NAFLD patients (P=0.04), hemoglobin A1C level (P<0.001), systemic inflammatory index (P=0.02), the index of impaired glucose tolerance (P=0.03), and especially, the patient's diabetes factor (P<0.001). In addition, adiponectin levels were significantly lower in individuals with NAFLD (P=0.001) and patients with MetS (P=0.02). NAFLD in association with an increase in epicardial adipose tissue (EAT) is an independent risk factor for atherosclerosis, coronary heart disease, CHF, as well as structural and electrophysiological myocardial remodeling. The study of pathogenetic mechanisms in the context of the role of EAT and clinical monitoring of its condition are urgent problems of modern medicine.

ПРОГРАММНО-АППАРАТНЫЕ СРЕДСТВА МОНИТОРИРОВАНИЯ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ ПРИ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ И САХАРНОМ ДИАБЕТЕ

The development of effective diagnostic tools for arterial hypertension and diabetes mellitus is one of the most urgent problems of modern medicine. The aim of the project is to develop software and hardware tools for daily monitoring of blood pressure and blood glucose levels based on the patterns of correlation between systemic hemodynamics and blood glucose concentration. 24-hour monitoring of blood pressure and blood glucose level was carried out, the circadian rhythm and daily indices of blood pressure were calculated. Daily pro les and cycle diagrams of diurnal uctuations in blood pressure in groups of patients were constructed. It was found that in 48% of patients with arterial hypertension and 70% of patients with type 2 diabetes mellitus, there is a deviation of the biphasic rhythm compared to the «dipper» norm, which must be taken into account to detect nocturnal hypertension. Statistical indicators of «pressure load» - daily measurement of time indices are calculated. The method of using software and hardware re ects the correlation between uctuations in blood pressure parameters and the concentration of glucose in the blood, which allows for a comparative analysis of indicators in arterial hypertension and type 2 diabetes mellitus.

Physical factors in the medical rehabilitation of patients with chronic cerebral ischemia in the outpatient stage

To develop a new technology for medical rehabilitation of the patients with chronic cerebral ischemia on an outpatient basis using therapeutic physical factors (such as ozone therapy and magnetic field in combination with endomassage) against the background of rational pharmacotherapy and psychocorrection. There have been observed 122 patients with chronic cerebral ischemia stage I. They were divided into three groups by simple randomization. The patients of the group of comparison 1 (GC1) (n=39) had neurotropic pharmacotherapy (Cerepro and Mexidol) and a group psychotherapy; the rehabilitation programme of the patients of the group of comparison 2 (GC2) (n=41) included ozone therapy (intravenous infusions of ozone-oxygen mixture) in addition to the treatment program of GC1; the patients of the main group (MG) (n=42) received a combination of magnetic field exposure and endomassage in addition to the treatment program of GC2. Clinical monitoring, coagulation hemostasis, and cerebral vascular ultrasound were used to assess the treatment efficiency. The rehabilitation treatment performed on an outpatient basis with the inclusion of ozone therapy and the combined effect of magnetic field and endomassage in MG ensured the leveling of clinical symptoms in 91.2% of cases (p<0.01). The efficiency of rehabilitation in GC1 was 74.4%, with the additional use of ozone therapy in GC2 - 82.6%. The use of the new technology with the use of intravenous infusions of ozone-oxygen mixture and magnetic field in combination with endomassage against the background of rational pharmacotherapy and psychocorrection in medical rehabilitation of the patients with chronic cerebral ischemia on an outpatient basis provides a reliably significant increase in the effectiveness of rehabilitation measures.

Актуальні питання нейрореабілітації в бійців ООС та в потерпілих мирної території після черепно-мозкової травми

Traumatic brain injury remains one of the most urgent problems of modern medicine, and its consequences are not only a medical, but also a socio-economic problem. Despite the study of clinical, structural-morphological, biochemical, neurophysiological, hemodynamic changes in patients who have suffered traumatic brain injury, it does not give up its leading position among the causes of disability in young and middleaged people, the most active in the labor and social sense of the population. An in-depth study of the distant period of traumatic brain injury is necessary, due to the high percentage of its consequences, and the lack of a correlation between the clinical symptoms of acute and distant periods of brain injury. Purpose of study. The purpose of the stydy is to learn about the effects of entrop and piracetam on structural and morthological, biochemical, neurophysiological, hemodynamical processes in brain to improve the results of an integrated treatment of a mild Traumatic Brain Injury (concussion) when ensuring rehabilitative measures in the remote period of time. Content. Inspected 82 civilians and 82 JFO combatants with mild TBI in the remote period of time. All patients were males. The dynamic of functioning brain state has been studied using the electroencephalography data. Cerebral blood flow has been studied using the ultrasonic dopplerography method and characteristic of the cognitive disorders by MMSE. Results. In the remote period of time the use of piracetam and entrop in the integrated treatment of patients with mild TMI has positively affected the EEG and cognitive functions trends. The study results have shown that the cerebral hemodynamic didn`t change sighnificantly after adding piracetam and entrop to the standart treatment protocol. These researches on patientsd by MMSE scale confirmed anti-amnestic focus of pharmacotherapeutic effect in both nootropic drugs (piracetam and enthrop) in aspect of impact on cognitive dissfunction. To summarize. Treatment of patients with mild TBI in remote period with usage of piracetam and entrop demonstrates the multimodal effect of these drugs on CNS, their great pharmaceutical potential and contributes to the effectiveness of neurorehabilitation measures, which improve quality of life of patients, who had brain injuries.

Features of the clinic and course of cutaneous and sexually transmitted diseases in HIV infected patients from the Volgograd region of Russia

HIV infection still remains an urgent problem of modern medicine. The incidence has continued to rise in recent years. The variety of clinical manifestations of the infection, not pathognomonic in the early stages, leads to misdiagnosis for an extended time period. The aim of the study was to assess the structure of skin diseases and sexually transmitted diseases in patients with HIV infections in the Volgograd region, to identify the features of the clinic and the course of these pathologies. A retrospective analysis of case histories of 306 HIV-infected patients who applied for medical care to dermatological institutions in Volgograd over the past 5 years was carried out. The authors describe the diverse features of the clinic, the course of skin diseases, syphilis and urogenital infections in patients with HIV infection. Knowledge of these signs of related specialties will allow for doctors to avoid treatment, diagnostic and tactical errors and will contribute to the early diagnosis of HIV infection and skin diseases and sexually transmitted diseases alike.

Mechanisms of macro-, micro- and ultramicroscopic transformation of bodies in diabetes

The study of structural changes of organs and tissues in the context of diabetes is one of the urgent problems of modern medicine. According to WHO, in all countries of the world the number of patients with diabetes exceeds 175 million. According to an expert estimate of the spread of this disease by 2025 will make about 300 million people. More than 1 million people with diabetes have been officially registered in Ukraine. WHO has recognized the disease as a non-communicable epidemic. The dramatic increase in the prevalence of diabetes requires a detailed study of this problem. It is established that the prevalence of diabetes increases among the population of the countries of the world depending on the region, the level of economic development of the country, gender and age. Thus, according to IDF findings, there is a tendency for the highest prevalence of diabetes among the urban (urban) able-bodied population of developing countries in persons between 40 and 59 years of age, approximately equal in both male and female. The number of patients is increasing, mainly due to patients with type 2 diabetes. Type 2 diabetes (type 2 diabetes mellitus) is a severe progressive chronic disease that is an independent risk factor for heart failure (CH) and cardiovascular complications. In the XXI century. the steady growth of type 2 diabetes and the frequency of its serious consequences is of great concern to the world medical community. It is important that at the time of diagnosis of type 2 diabetes, the prevalence of complications leading to a decline in quality of life, early disability and premature death is already high enough. Despite the presence in the fight against this disease effective drugs, modern technologies, new educational and preventive techniques, mankind loses the fight against diabetes year after year, which leads to disability due to its complications, reducing the life expectancy and quality of life of patients, loss working capacity and premature mortality. Thus, the current prevalence and incidence of diabetes and life-threatening complications suggest that there is a non-communicable diabetes epidemic in the world and in Ukraine in particular. The article represents analysis of work of numerous researchers who studied statistіcal, clinical and morphological aspects of the impact of diabetes on cardiovascular system. Main morphogenetic, morphological and clinical aspects of complications of diabetes, pathologies of microcirculation of patients with diabetes were dedicated, what makes possible to predict and detect on the early stages vascular complications in diabetes and to perform effective prevention and treatment.

Burnout syndrome in dentists. Literature review

The problem of the development of emotional burnout syndrome in dentists is one of the most urgent problems of modern medicine. Currently, the authors do not have a single point of view on the essence of emotional burnout. Emotional burnout affects both the doctor and the patient. The solution to this problem requires further research.&#x0D; Objective. Based on the literature data, to identify the main factors of the development of emotional burnout of dentists, to analyze the existing strategies for overcoming stress and to determine which of them are applicable in the work of a dentist.&#x0D; Methods. The search for literature sources was carried out in three databases (e-library, PubMed, Web of Science) according to the keywords: “burnout syndrome in dentistry”, “burnout in dentistry”, “emotional stress in dentistry”, “strategies for overcoming stress in dentistry”, “coping strategies in dentistry”, “emotionally charged situations in dentistry”. 130 literary sources were analyzed. Criteria for inclusion: literature reviews, research, and articles on the personal point of view of specialists on the problem of emotional burnout, and on strategies for coping with stress in certified dentists. Exclusion criteria: articles on emotional burnout, stress, and depression in dental students.&#x0D; Results. Based on the analyzed literature on the topic of the development of emotional burnout syndrome in dentists, there is no single point of view on the essence of emotional burnout. Some authors consider it as a type of stress, othersthe result of the influence of stressful factors, against which pathological processes develop, such as: headache, problems of the cardiovascular system, exacerbation of chronic diseases, pain in the spine. The psychological state of burnout can adversely affect a person’s health, family relationships, and service interactions.&#x0D; Conclusion. This paper presents the main approaches to determining the essence of the burnout syndrome, a systematic analysis and generalization of materials on the problem in the professional activities of dentists. Emotional burnout affects both the doctor and the patient. The solution to this problem requires further research.

Morphological features of changes in peripheral olfactory structures in SARS-COV-2 coronavirus infection

Coronavirus infection caused by the SARS-CoV-2 virus is an extremely important and urgent problem of modern medicine. It spreads quickly, has a high probability of a severe course and a large number of critical complications in patients from the risk group. The presence of pathognomonic symptoms, one of which is the development of hypo– or anosmia, makes it possible to quickly differentiate coronavirus infection from other acute respiratory viral infections, that is, to isolate the patient on time and begin correct treatment, taking all possible risks into account. The aim is to identify the morphological features of olfactory structural elements in patients with coronavirus disease (COVID-19) for a better understanding of the mechanisms of olfactory disorders development in coronavirus infection. Materials and methods. The basis of the work is a retrospective analysis of autopsy material, namely the mucous membrane of the upper parts of the nasal cavity (olfactory epithelium) and olfactory bulbs of nine deceased (4 women and 5 men) aged from 53 to 79 years with a laboratory-confirmed diagnosis of COVID-19 and anosmia in anamnesis. We used standard hematoxylin and eosin staining and immunohistochemical reactions in accordance with the TermoScientific protocols (USA) with antibodies to neurospecific beta-III tubulin (clone TuJ-1) and RnDsystems protocols with antibodies to olfactory marker protein (OMP) and angiotensin converting enzyme (ACE-2). To compare the results, a control group of 9 deaths (3 women and 6 men) aged from 59 to 68 years with a laboratory-refuted diagnosis of COVID-19 was formed. The causes of death of these patients were complications of diabetes, coronary heart disease and cerebrovascular disorders of the ischemictype. Results. The average age of the deceased with a laboratory-confirmed diagnosis of COVID-19 and a history of anosmia and the control group was 64.67 ± 7.73 and 62.33 ± 6.48 years, respectively. The expression of olfactory marker protein (OMP) and neurospecific beta-III tubulin (clone TuJ-1) was partially positive (40.89 (25.00–52.00) and 42.44 (29.00–55.00) cells in the field of view at a magnification of 200×, respectively) in seven out of nine sections of the olfactory mucous membrane of deaths with a laboratory-confirmed diagnosis of COVID-19 and anosmia in anamnesis. The reaction with antibodies to angiotensin converting enzyme (ACE-2) was focally or subtotally absent (34.33 (14.00–49.00) cells in the field of view at 200× magnification). There was expression of these three markers in control sections of the olfactory mucosa of a deceased with a laboratory excluded diagnosis of COVID-19 and no symptoms of anosmia (Mann–Whitney test, P &lt; 0.05). In sections of olfactory bulbs of patients with COVID-19 weak (Mann–Whitney test, P &lt; 0.05) expression of receptors for angiotensin-converting enzyme (ACE-2) (26.78 (15.00–39.00) cells in field of view at a magnification of 200×) was revealed in contrast to control sections (100.56 (94.00–107.00) cells in the field of view at a magnification of 200×). Conclusions. The development of anosmia in SARS-CoV-2 coronavirus infection has specific features. This may be due to the primary destruction of cells expressing receptors for the angiotensin-converting enzyme (ACE-2-positive: sustentacular cells of the olfactory mucosa, neurons of the olfactory bulbs). Subsequent dysfunction of olfactory cells (OMP- and TuJ-1-positive) is also possible.