Vol 41, No 5 (2024)

Objective. To study the influence of base materials used in the manufacture of removable dentures on the immune homeostasis of the oral mucosa, and, as a consequence, on the clinical condition of the oral mucosa and periodontium of supporting teeth. To create fundamental principles for the development of a pathogenetically substantiated choice of basic dental materials of various chemical natures for removable prosthetics based on the analysis of the parameters of immune homeostasis of the oral mucosa.

Materials and methods. 154 patients aged 40 to 85 using dentures based on acrylic, polyurethane plastics and thermoplastics for 6 months, participated in the study. Indicators of immune homeostasis and the identified clinical manifestations of the influence of the prosthesis material such as chronic periodontitis and gingivitis were compared using the statistical method of conjugate multifield tables.

Results. The indicators CD4+/CD8+, CD11/CD303, CD68, CD204, CD163, Ki-67 phenotypic markers were determined in gingival biopsies of the prosthetic bed of patients using dentures based on acrylic, polyurethane and thermoplastic for 6 months. Analysis of the statistical significance of differences proved the influence of the prosthesis material on indicators of cellular immune homeostasis, with a shift of homeostasis towards the pro-inflammatory phenotype, and the suppression of the anti-inflammatory factor in circulating monocytes.

Conclusions. The study shows that, although each type of removable dentures has its own advantages and disadvantages, the response of the cellular immunity of the oral mucosa to polyurethane dentures is less than to acrylic and thermoplastic ones in relation to the control group. The use of polyurethane prostheses is reasonable as temporary ones during the healing stage of surgical interventions in the oral cavity, in particular tooth extraction and implantation. This type of prosthesis can be recommended as a permanent one for patients with a severe allergic reaction, especially to polymer compounds and dyes.

Objective. To improve the effectiveness of treatment for patients with perforated gastroduodenal ulcers (PGDU) by developing criteria for predicting postoperative complications and mortality.

Materials and methods. The treatment outcomes of 127 patients with PGDU were analyzed. Prognostic scales ASA, SOFA, Peptic Ulcer Perforation Score (PULP), and the Mannheim Peritonitis Index (MPI) were used for the assessment in all the patients. Specialized classifications (DEP and ulcer defect classes) developed at Sklifosovsky Research Institute For Emergency Medicine were employed to determine the surgical approach and the extent of surgical intervention.

Results. Duodenal ulcers were observed in 97(76.4 %) patients, gastric ulcers in 28(22.0 %), and combined ulcers in 2(1.6 %). According to the clinical form, chronic ulcers were identified in 81 (63.8 %) patients, while acute ones were detected in 46(36.2 %) patients. Helicobacter pylori infection was revealed in all patients with chronic ulcers. The majority of patients sought medical care within the first 6 hours after perforation (53 patients, 41.7 %); from 6 to 12 hours – 24 patients (18.9 %), 12–24 hours – 17 patients (13.4 %), and in more than 24 hours – 33 patients (26.0 %). Fatal outcome occurred in 45 (35.4 %) patients, while 82 (64.4 %) patients were discharged after the recovery had been observed. The mortality rate was significantly higher in patients with MPI grades 2 and 3, in those with an initially high risk according to the PULP scale, and those who were hospitalized more than 24 hours after perforation. Indications for laparoscopic ulcer suturing were proposed based on the scales used.

Conclusions. The risk factors for adverse outcomes in PGDU include the following criteria: surgery performed more than 24 hours after perforation, MPI 2-3 grades, and a PULP scale score more than 8. In patients with PGDU who are at high surgical-anesthetic risk and have a complicated comorbid background, the risk of sepsis development is more than 30 %. Laparoscopic techniques for suturing PGDU are preferable when performed within 6 hours of perforation, with a PULP score not more than 7, MPI grade 1, and DEP classification scores less than 9, specifically in IIC, IIIC, IVA, IVB, and IVC ulcer defect classes.

Currently, the issues of treatment and prevention of cardiovascular diseases are still relevant, as cardiovascular pathology remains one of the leading causes of disability and mortality in all developed countries of the world. In the Russian Federation there is a high incidence of the diseases of the circulatory system, so they have the top priority among health problems, despite a slight decrease in morbidity in recent years. The main purpose of this review is to study the experience of applying the Mediterranean diet and its components in therapy and prevention of cardiovascular pathology. Research method: we searched electronic databases PubMed, Scopus, Web of Science, MedLine, Science Direct and eLIBRARY.RU using the following terms: "Mediterranean diet", "cardiovascular diseases", "prevention of cardiovascular diseases", "diet therapy of cardiovascular diseases". On the basis of numerous world clinical studies analysis, it can be assumed that the Mediterranean diet is one of the most reliable and well-studied in terms of prevention of cardiovascular pathology. The aim of this review is to draw the attention of the medical community to such a long-known, extensively studied, scientifically confirmed, accessible and simple way of rationalizing daily nutrition as the consumption of elements of the Mediterranean diet in the daily one. Further wide informing of patients about this way of nutrition from different specialists (general practitioners, cardiologists, nutritionists, gerontologists and others) is required.

There are several theories of the origin of diseases of the epithelial coccygeal tract: empirical, neurogenic, ectodermal and acquired. Most Russian scientists consider this pathology to be congenital, while foreign colleagues believe that it is a consequence of sacrococcygeal area injuries. This pathology is quite common, affecting more than 5 % of the adult population, it also occurs in children and adolescents. This disease decreases the quality of patients` life significantly, affecting all aspects of their life.

Conservative methods of treatment do not provide a complete cure, since they do not eliminate the causes of the disease. These include sclerotherapy and obliteration of the cavity with silver nitrate or hydrochloric acid. These methods are not used nowadays.

Surgical treatment is the most effective one for this pathology. Surgical intervention, despite its apparent simplicity, turns out to be quite complex, which makes it inaccessible to any general surgeon. Treatment results are often disappointing due to the high incidence of complications after surgery, as well as the long period of activity limitation. Therefore, the resulting rough scar is a cosmetic defect, and the risk of recurrence remains quite high. Studying the literature data, one can see that the authors` opinions concerning surgical tactics for this disease differ. At the moment, there is no single approach and surgical tactic for the treatment of epithelial pilonidal cyst. The problem of creating and introducing new methods of treatment of pilonidal disease remains relevant nowadays.

Objective. To study the possibility of using new GASTROAXILIUM mixtures in complex therapy of patients with severe surgical abdominal pathology.

Materials and methods. The study of characteristics of the developed mixtures was carried out by standard and non-standard methods in an accredited laboratory. Clinical studies were conducted in accordance with the Procedure for conducting studies of the effectiveness of specialized dietary therapeutic and dietary preventive food products. Statistical processing was carried out using analysis of variance.

Results. GASTROAXILIUM, specialized food product for tube feeding developed by the specialists of the Research and Production Center for Healthy Nutrition Technologies of Saratov State Medical University named after V.I. Razumovsky, differs from foreign ones in its technological solutions. In the main group a statistically significant reduction in the duration of postoperative intestinal paresis was noted, both in planned and emergency surgeries, in contrast to the comparison group.

Conclusions. We consider that the results of the use of daily nutritional complex of oligomeric dry mixtures for enteral nutrition GASTROAXILIUM are in agreement with the literature data, they will successfully complement the scientific data on the necessity for nutritional support and will play an important role in improving the quality of treatment of patients with severe postoperative abdominal pathologies.

Objective. To assess navigation literacy of primary health care personnel (using the example of the heads of medical and obstetric centers in Orenburg region).

Materials and methods. Navigation literacy of primary health care personnel was assessed among all heads of medical and obstetric centers in Orenburg region (n = 58). For this purpose, a single-stage continuous online survey was conducted using a combined questionnaire developed by the Central Research Institute for Healthcare Organization and Informatization of the Ministry of Heath of the Russian Federation.

Results. The level of navigation literacy among the heads of the medical and obstetric centers of Orenburg region in 65.7 % of cases was excellent and sufficient. In the list of navigation skills, the heads of the medical and obstetric centers noted difficulties in the implementation of: issues of medical insurance (48.3 %), legal aspects of medical care and protection of patients' rights (27.5-48.3 %), healthcare reform (36.2 %). It was found out that from 63.7 % to 91.4 % of the heads of the medical and obstetric centers are aware of the ongoing state measures in the field of public health. The majority of the respondents (60.0 %) noted that they search for necessary information for professional purposes using digital tools. However, every third respondent (32.7 %) mentioned the difficulties in finding it on legislative issues, interpreting the quality and safety of food products according to their product labeling (27.6 %), solving problems related to mental health and well-being (18.9 %). These data demonstrate the need to improve navigation literacy of medical and obstetric centers managers in the digital environment.

Conclusions. The modern multilevel and multicomponent healthcare system is associated with the need to improve the navigation literacy of medical personnel. The data obtained determined the main directions for improving navigation literacy of the heads of medical and obstetric centers.

A method of treatment,described in this clinicalcase, isaimedateliminatingdisorders of occlusalrelationships of the dentition, (PatentNo.2797641dated06/07/2023) contributing to the normalization of TMJ functioning.

At the first stage of treatment, a repositioning occlusal splint was used, applied to all teeth of the lower jaw, which was being corrected for six months. This stage was considered completed on the basis of the following criteria: absence of the patient`s complaints and smooth movements of the mandible without deviations and clicks on objective examination, as well as formation of symmetrical graphs of the TMJ condyles movement on axiographic examination, an optimal location of the TMJ condyles on sagittal projections of MSCT and positive changes in the bioelectric activity of the masticatory muscles, towards higher and more symmetrical values on both sides.

Further treatment was carried out by an orthodontist with a non-removable technique,using a brace system. Wearing of the occlusal splint continued until the braces system was put on the teeth of the lowerjaw. It was then replaced by composite liningsin the projection of the firstmolars of the upperjaw.

Dynamicmonitoring of thepatientforhalf ayearafter the end of the treatment indicated remission of TMJ disease.

Normalization of occlusal relationships of dentitions in intact dentitions and small defects through splint therapy followed by the use of a brace systemis a minimally invasive andeffectivemethod of treatment TMJ diseases.

In global literature there is not sufficient information on the course of the polyostotic form of osteoclastoma and methods of its treatment. For this reason, the analysis of this clinical case may be interesting for oncologists, maxillofacial surgeons and dentists of various specialties, who can reveal both the onset and recurrence of the disease. A characteristic feature of the course of this disease is the relapse of neoplasms with localization of foci in various parts of the upper and lower jaw.

A clinical case of polyostotic form of jaw osteoclastoma and patient`s management tactics from 2006 to 2024 are described in the article. The disease was first diagnosed in 2006, when a neoplasm was revealed in the right part of the lower jaw. The neoplasm was removed by resection and mandibular defect was replaced by a carbon implant with further prosthesis.

In 2011 a new neoplasm was detected on the left side in the frontal part of the upper jaw. At the same time a relapse of the disease was diagnosed with a new tumor focus in the lower jaw on the right. Surgical treatment was performed. Firstly, the neoplasm in the frontal area of the upper jaw was removed with replacement of the defect with a resection prosthesis. And secondly, a removal of the tumor on the lower jaw with resection of the chin within healthy tissues and replacement of the defect with an implant made of carbon-carbon material "Uglecon M" were performed.

In 2023 the patient was invited to the dental hospital of the Clinical Multidisciplinary Medical Center of E.A. Vagner Perm State Medical University for dispensary observation and evaluation of the results of the treatment.

The obtained results indicate the need for medical follow-up of patients after surgery for osteoblastoclastoma. The effectiveness of jaw implants made of carbon-carbon composite material " Uglecon M" was proved as well.

Objective. To study the anti-inflammatory activity and some toxicological indicators of the new derivative of pyrazole-3-carboxamide SSP.

Materials and methods. To assess the biological activity of the compound, its anti-inflammatory effect was studied in the model of acute inflammatory edema caused by sub-plantar injection of carrageenan solution into a rat`s hind leg. The duration effect was assessed by the intensity of suppression of the inflammatory response in relation to the control level. In order to study the safety of the substance, the local irritant effect was determined when applied cutaneously in the experiments on rats. The severity of the irritant effect was assessed by the erythema degree, the amount of edema and the increase in local skin temperature. In addition, acute toxicity of the substance under study was determined. The test compound and reference drugs were applied to the skin.

Results. The study of acute toxicity of the compound SSP and the reference drug nystatin when applied cutaneously to rats showed that LD₅₀ of both substances was more than 2500,0 mg/kg. Indicators of the degree of local irritating effect of the drugs demonstrate its absence. At the same time, the studied SSP compound has no anti-inflammatory effect administered either orally or cutaneously.

Conclusions. The data obtained allow us to classify the new silver salt of pyrazol-3-carboxamide SSP as a class 5 non-toxic substance. The studied SSP compound has no local irritant effect and does not demonstrate anti-inflammatory activity in the carrageenan inflammation model.

The article is dedicated to the 80th anniversary of Valery Aleksandrovich Chereshnev, a Russian scientist, academician of the Russian Academy of Sciences, known for his works in the field of immunology and pathophysiology. V.A. Chereshnev began his career at Perm State Medical Institute, where he continued his postgraduate studies after graduating with honors. In 1970, he defended his PhD thesis on the topic “On the role of the properties of microbial cells and macroorganisms in the mechanism of development of an early phagocytic reaction to the introduction of typhoid vaccine”. In 1982, he defended his doctoral dissertation on the topic “Closed chest injury in combination with gamma irradiation (clinic, pathogenesis, treatment, medical protection).” He worked as a lecturer and professor in various educational institutions, and also headed scientific laboratories. In 1988, he became the director of the Institute of Ecology and Genetics of Microorganisms, Ural Branch of the Russian Academy of Sciences, and then organized a branch in Yekaterinburg, which was later transformed into the Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, where he also became the director. Valery Aleksandrovich was elected a corresponding member of the Russian Academy of Sciences, academician of the Russian Academy of Sciences, Chairman of the Ural Branch of the Russian Academy of Sciences and Vice-President of the Russian Academy of Sciences, Chairman of the Committee on Science and High Technologies of the State Duma of the Federal Assembly of the Russian Federation. In addition, he was elected President of the Russian Scientific Society of Immunologists, organized the Society of Immunologists of the Urals. Currently he is actively developing immunological services in the Western Urals.