Vol 40, No 1 (2023)

Objective. To study the influence of the temperament, anxiety level, intro-extraversion index, the nature of emotions, the level of happiness and the presence of pathologies of sleep physiology in the individual on the frequency of dream production and their figurative content.

Materials and methods. The research involved 100 respondents – students of E.A. Vagner Perm State Medical University, the average age was 22.5 ± 4.5 years. The study was conducted through anonymous questionnaires using the following personality questionnaires and psychological tests: Eysenck Personality Questionnaire, Comprehensive Sociometric Test: Emotions, Oxford Happiness Questionnaire (OHQ), Comprehensive Test for Detection of Sleep Disorders.

Results. It was found that in 37,7 % of cases out of 100,0 %, the imaginative content of dreams and the frequency of their production directly depend on the temperament of the individual, the level of anxiety affects dreams only in 50,0 % of cases out of 100,0 %. The intro-extraversion index has a significant impact on the nature of dreams and manifests its effect in 61,6 % out of 100,0 %. The complete dependence of the imaginative content of dreams on the quality of emotions is observed in 57.0 % of cases; inversely proportional dependence is noted in 43.0 % of cases. It was determined that the level of happiness has a natural effect on dreams in 66.0 % of cases. Sleep disorders can affect both negatively and positively the imaginative content of dreams and their quantitative production. Assessment of the multifactorial influence of the students' psycho-emotional state showed that the most important role in the cumulative effect on sleep and dreams is played by the level of anxiety and temperament.

Conclusions. Changes in the parameters of dreams are a consequence of the multifactorial interaction of individual psycho–emotional characteristics and typological characteristics of the personality. Determination of temperament and registration of the level of anxiety of the individual can contribute to the prediction of the overall picture of dreams for use in psychological and psychiatric practice.

Objective. To determine the features of the distribution of antigens of the major histocompatibility complex in children of preschool and primary school age with atopic diseases.

Materials and methods. Under observation there were children with a moderate course of the diseases such as atopic dermatitis, atopic dermatitis with concomitant persistent allergic rhinitis, independent persistent allergic rhinitis, atopic bronchial asthma. The patients were identified class I and class II antigens of HLA-complex.

Results. The studies have shown that patients with atopic dermatitis had a high incidence of HLA B15, DRB1*13 and DQB1*0602-8: in patients suffering from atopic dermatitis with concomitant persistent allergic rhinitis – HLA B12, B13 and DQB1 * 01; in patients with independent persistent allergic rhinitis – HLA A10 and DQB1 * 201; in patients with atopic bronchial asthma – HLA B18.

Conclusions. Representation of these antigens of the HLA complex in the tissues was associated with an increase in the risk of atopic diseases by 2.3–4.6 times.

Objective. To study the frequency, clinical and topographic features, risk factors for development, quality of primary diagnosis and treatment of desquamative gingivitis in patients with chronic pathology of the oral mucosa.

Materials and methods. A cohort cross-sectional clinical study with elements of sociological analysis of patients (n = 314; 99 males and 215 females aged 18 to 62 years), who visited the medical advisory center for oral mucosal diseases (OMD) was conducted. According to the results of clinical and laboratory studies, the diagnosis of the main oral mucosal disease was formulated, and patients with desquamative gingivitis were isolated into a separate group. Hygienic (OHI-S) and periodontal (PMA, BoP, PBI, CPITN) indices were evaluated, and impact of oral pathology on the patient’s quality of life using OHIP-49-RU index was assessed for objectification of periodontal status.

Results. High (17.8 %) incidence of desquamative gingivitis was found in patients with chronic oral mucosal diseases of predominantly autoimmune origin (lichen planus, pemphigus vulgaris, erythema multiforme, psoriasis). Desquamative gingivitis develops significantly more often (60.7 %) in women and affects the vestibular surfaces of the anterior-upper dentogingival segment, manifests clinically apparent edema, pain, hemorrhagic and sensory-paresthetic symptoms, which limit the functionality of the patient (chewing, speech, oral hygiene, social communication and professional realization), that significantly reduces the key parameters of patient’s quality of life.

Conclusions. The main reasons for chronization of desquamative gingivitis and low effectiveness of its treatment are the following: low level of polyclinic diagnostics, problems of differential diagnosis, the predominant use of irrational, pathogenetically unjustified means and methods of treatment, as well as the lack of interdisciplinary approaches to the planning of complex therapy.

Literature review on the structure and functioning of limbic system is presented in this article. Nowadays, in medical science there is a problem of the lack of systematic data regarding limbic system, because scientists often explore only one aspect of the structure or functioning of the system components. This review is aimed at overcoming this problem. The method of research involves analysis of numerous scientific articles, which are published in Cyberleninka, Nature, Medscape, National Library of Medicine etc. as well as educational literature on fundamental medical disciplines. It was established that there are available different influences of limbic system structures on behavior, cognitive function, motivation and body as a whole. Therefore, to study the limbic system, scientists should use an integrated approach and consider the limbic system specificity from the point of view of anatomy, histology, physiology and biochemistry.

The intestinal microbiota is a marker of the organism state, capable of direct and indirect interacting. The main mechanisms underlying interactions are immunoregulation and energy metabolism. Metabolites, formed during the life of microbiota, realize their actions through these engagements. Some metabolites arouse negative effects on endothelial vessels, causing and maintaining a systemic inflammatory response, which stands behind major cardiac risk factors. Metabolites and molecules such as lipopolysaccharide or trimethylamine N-oxide initiate endothelial dysfunction, and thus trigger the processes of atherogenesis, insulin resistance and even increase blood pressure by activating inflammasomes and pro-inflammatory cytokines. Short-chain fatty acids including the main metabolites such as acetate, propionate and butyrate are antagonists of lipopolysaccharide and trimethylamine N-oxide. These substances are a source of energy for intestinal epithelial cells. They maintain homeostasis, stimulate the production of anti-inflammatory components and activating reparative processes. Another important factor influencing levels on blood pressure and systemic inflammation is intestinal barrier dysfunction, which is determined by the regulatory protein zonulin. Besides, there are proved receptor interactions, as well as qualitative and quantitative changes in the composition of the microbiota that can influence blood pressure and atherogenesis. Each cardiovascular disease is characterized by its own microbiological pattern and the predominance of specific metabolites. The article presents a review, summarizing experimental and clinical data on the role of microbiota in the development of atherosclerosis and cardiovascular diseases.

Objective. To evaluate the effectiveness of dental orthopedic treatment in patients with complete absence of teeth using removable plate prostheses applying integral qualitative and evaluative indicators. The relevance of the study is dictated by the need to improve the quality of orthopedic treatment in patients with complete absence of teeth, through the introduction of new composite materials, the use of which provides high strength of prosthetic structures. For an objective assessment of the effectiveness of dental orthopedic treatment of patients using removable plate prostheses, integral approaches based on the calculation of qualitative and evaluative indicators have been modified.

Materials and methods. In order to improve the quality of orthopedic treatment of patients with complete absence of teeth, a design of a complete removable plate prosthesis with a combined basis and a method of its manufacture based on the use of digital technologies was developed. In the course of the work, the evaluation of the effectiveness of treatment in patients with complete absence of teeth in the long-term follow-up using integral qualitative and evaluative indicators was carried out.

Results. Clinical and laboratory stages of manufacturing a new design combining analog and digital metols were developed and tested. As a result of clinical studies, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the indicator of the integral assessment of the quality of orthopedic treatment, with the exception of the criterion of the prosthesis integrity.

Conclusions. To conclude, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the integral assessment of the quality of orthopedic treatment, except for the criterion of the integrity of the prosthesis; the introduction of a composite material based on fiberglass into the design of a combined prosthesis allows to improve the strength properties of the prosthesis basis and increase the performance characteristics of the structure. The use of CAD / CAM technologies provides the possibility of using high-strength composite materials, gives sufficient accuracy in the manufacture of the frame of a combined full removable plate prosthesis. Due to satisfactory physical and mechanical properties, the application of the developed design contributes to the predicted increase in the durability of prostheses.

Objective. To study and analyze the clinical and epidemiological picture of the incidence of enterobiosis in children living in the Astrakhan Region for 2017–2021.

Materials and methods. During the work, epidemiological maps of persons with a confirmed diagnosis of Enterobiosis were analyzed, which was identified on the basis of laboratory data (detection of pinworm eggs in perianal folds and feces).

Results. From 2017 to 2021, in the Astrakhan Region, 12 627 cases of human infection with helminth-protozoal infestations were registered, of which 94.9 % (11 982 cases) were children under the age of 17. The share of cases of enterobiosis in children in the structure of the total childhood parasitic morbidity for the analyzed period was 84.1 % (10 071 cases). Thus, enterobiosis was registered in all age groups, most often occurring in children aged 7 to 17 years – 59.1 % (5950 cases). A slightly smaller number of cases of enterobiosis was registered in children aged from 1 to 7 years – 40.0 % (4026 cases); a minimum of enterobiosis cases was registered in children aged 5 to 12 months – 0.9 % (95 cases). Enterobiosis was identified both in urban and rural areas, most often detected in children living in the rural areas of the Astrakhan region – 53.5 % (5,393 cases).

Enterobiosis was diagnosed during preventive examinations before going to school or kindergarten – 72.7 % (7325 cases). Another part of the children – 20.4 % (2053 cases) sought medical help at medical institutions due to the presence of clinical symptoms of the disease. In rare cases – 6.9 % (693 cases) children were examined as contact ones by one of the family members. As a rule, the clinical picture was noted only in children who addressed for medical help in connection with complaints and symptoms of the disease – 20.4 % (2053 children). In all the cases described by us, children had a mild form of enterobiosis manifested by itching in the perianal region, which occurred in the evening and/or at night – 96.8 % (1987 children), poor sleep – 47.7 % (979 children), nausea – 8.5 % (174 children).

Conclusions. Enterobiosis is most often registered in childhood than in adulthood. Most often enterobiosis infection with pinworms affects children aged 7–17 years. The main reason for infecting children is the presence of onychophagy, geophagy and contact with pets, on the wool of which pinworm eggs can persist for a long time.

Objective. To study a clinical case after a planned thyroidectomy. Venous thromboembolism in the form of deep vein thrombosis or LE is the third most common in the world, being the second only to myocardial infarction and stroke. In epidemiological studies, the annual incidence of pulmonary embolism ranges from 39 to 115 persons per 100 000 of the population; for deep vein thrombosis, the incidence rates range from 53 to 162 per 100 000 of the population. The cross-sectional analysis data show that the frequency of venous thromboembolism is almost 8 times higher in persons over 80 years of age than in the fifth decade of life. Pulmonary embolism is a stop of blood flow in the branch of the pulmonary artery due to obstruction by a clot. The most frequent places of blood clots are the deep veins of the lower extremities. Risk factors for thromboembolism may be surgical operations, varicose veins, age, overweight. This is one of the most common and severe complications of the postoperative period. Our article considers a clinical example of the development of thromboembolism after thyroidectomy, presents the results of pathomorphological studies, autopsy, histological studies.

Materials and methods. The work consisted in the study of a clinical case of pulmonary embolism after a planned surgical intervention for nodular goiter. Histological sections of organs such as the heart, kidneys, gallbladder, thyroid gland, liver were studied.

Results. The results of our study showed that thyroidectomy refers to operations of a high complexity and high risk of multiple complications as well as the occurrence of a fatal outcome. Therefore, a thorough examination of all organs and systems in patients is necessary, especially those who belong to the elderly and severe comorbid pathology groups. This is due to the fact that the risk of death without a proper preparation for surgery with available concomitant diseases (nodular colloidal goiter, empyema of the gallbladder, Gilbert's disease, persistent hepatitis, type 2 diabetes mellitus, hypertension, chronic coronary heart disease) was very high for this patient.

Conclusions. Diffuse nodular toxic goiter is a complex surgical pathology involving many organs and systems. Patients with such a diagnosis require a thorough history collection, carrying out clinical, instrumental and laboratory research methods, including successful surgical intervention.

Objective. To establish in the experiment the changes in histological structure of the internal organs and blood indices in laboratory rats with intragastric introduction of the drug Sutent® in the doses of 7 mg/kg and 35 mg/kg of the weight.

Materials and methods. The study was conducted on 48 breedless white rats divided into the following groups: groups 1 and 4 – received cytotoxic drug Sutent® in the dose of 7 mg/kg (therapeutic dose), groups 2 and 5 – Sutent® in the dose of 35 mg/kg (fivefold exceeding the therapeutic dose), groups 3 and 6 – the control groups. In groups 1, 2, 3 animal were killed 30 days after the onset of the experiment, in groups 4, 5, 6 – two weeks after the drug withdrawal. Every day during 30 days, the experimental groups were introduced the intragastric drug Sutent® in the form of aqueous suspension in the purified water; in the control group the rats received the purified water in the equivalent volume. The histological preparations of organs stained with hematoxylin and eosin as well as the hematological indices of blood were investigated.

Results. The development of hypochromic anemia, thrombocytopenia and granulocytopenia in the was identified. While studying the histological structure of organs, in all experimental groups there was detected a disturbed circulation in the form of venous hyperemia and blood stasis in the capillaries, the development hemorrhages in the lung, liver, kidneys, adrenal glands, pancreas, gastric and esophageal mucosa. In the liver, pancreas and adrenal glands, dystrophic changes in the cells and necrosis foci were observed. In group 2, affection of the cerebral cortex nerve cells, heart cardiomyocytes, thyroid cells, acute duodenitis with formation of microabscesses was established.

Conclusions. Introduction of Sutent® in the dose of 35 mg/kg, compared with the dose of 7 mg/kg, caused a more expressed hematological, hepatological, cardiological and neurological toxicity, more obvious lesion of endocrine organs; it also contributed to the development of associated secondary infection and acute duodenitis.

The article is dedicated to the memory of the Honoured Doctor of the Russian Federation, Doctor of Medical Sciences, member of the European Association of Intensive Care, Academician of the Russian Academy of Laser Sciences, outstanding professor, member of the International Association of Hepatologists, Veniamin Arsenyevich Sitnikov.