Pub Date : 2023-10-26DOI: 10.25207/1608-6228-2023-30-5-100-112
M. A. Postnikov, A. M. Golovachev, S. E. Chigarina, D. N. Kudryashov, I. A. Zakharova, S. A. Burakshaev
Background. Inflammatory process in periapical tissues causes tooth extraction in more than 50% of cases. The development of chronic apical periodontitis can be triggered by an intracanal infection in undetected/missed root canal of the mandibular molars. The morphology of mandibular molars is distinguished by additional canals in the mesial root in some cases. Different studies reveal the middle mesial canal in 4.5% to 26% of cases with quite high incidence in youth. The dental therapy has been searching for effective approaches to diagnosis and treatment of chronic periodontitis, enabling the focus of chronic inflammation to be eliminated and the tooth to be saved. Case descriptions. The paper presents clinical cases of patients with destructive changes in bone tissues in the periapical region of the mesial root in mandibular molars. The developing of this pathology is associated with missed anatomy in the mesial root during primary endodontic treatment. The patients underwent clinical examination consisting of basic methods (interview, examination) and additional techniques (intraoral radiography). An additional middle mesial canal in the root of the mandibular molar was identified taking into account the complex morphology of the root system of the tooth and verified by its careful analysis and radiography. The final clinical diagnosis, chronic apical periodontitis (K04.5), was made following the obtained diagnostic results and the ICD-10 classification. Diagnostic examination and endodontic retreatment were performed using a dental operating microscope. Conclusion. An operating dental microscope provides visualization of microscopic anatomotopographical details, promoting the efficiency of diagnosis and treatment of chronic apical periodontitis in mandibular molars. Using dental microscope facilitates systematization of the data obtained during the examination, making a final clinical diagnosis, and development of a reasonable personalized treatment plan focused on detecting an additional middle canal in the mesio-buccal canal of the mandibular molar. Due to the suggested approach, the long-term outcomes of endodontic treatment can be an objective assessed in dynamics, thereby improving the quality of treatment for chronic apical periodontitis in patients.
{"title":"Clinical diagnostic approach in the treatment of chronic periodontitis in mandibular molars: Clinical cases","authors":"M. A. Postnikov, A. M. Golovachev, S. E. Chigarina, D. N. Kudryashov, I. A. Zakharova, S. A. Burakshaev","doi":"10.25207/1608-6228-2023-30-5-100-112","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-100-112","url":null,"abstract":"Background. Inflammatory process in periapical tissues causes tooth extraction in more than 50% of cases. The development of chronic apical periodontitis can be triggered by an intracanal infection in undetected/missed root canal of the mandibular molars. The morphology of mandibular molars is distinguished by additional canals in the mesial root in some cases. Different studies reveal the middle mesial canal in 4.5% to 26% of cases with quite high incidence in youth. The dental therapy has been searching for effective approaches to diagnosis and treatment of chronic periodontitis, enabling the focus of chronic inflammation to be eliminated and the tooth to be saved. Case descriptions. The paper presents clinical cases of patients with destructive changes in bone tissues in the periapical region of the mesial root in mandibular molars. The developing of this pathology is associated with missed anatomy in the mesial root during primary endodontic treatment. The patients underwent clinical examination consisting of basic methods (interview, examination) and additional techniques (intraoral radiography). An additional middle mesial canal in the root of the mandibular molar was identified taking into account the complex morphology of the root system of the tooth and verified by its careful analysis and radiography. The final clinical diagnosis, chronic apical periodontitis (K04.5), was made following the obtained diagnostic results and the ICD-10 classification. Diagnostic examination and endodontic retreatment were performed using a dental operating microscope. Conclusion. An operating dental microscope provides visualization of microscopic anatomotopographical details, promoting the efficiency of diagnosis and treatment of chronic apical periodontitis in mandibular molars. Using dental microscope facilitates systematization of the data obtained during the examination, making a final clinical diagnosis, and development of a reasonable personalized treatment plan focused on detecting an additional middle canal in the mesio-buccal canal of the mandibular molar. Due to the suggested approach, the long-term outcomes of endodontic treatment can be an objective assessed in dynamics, thereby improving the quality of treatment for chronic apical periodontitis in patients.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"24 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134906435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.25207/1608-6228-2023-30-5-64-76
I. S. Knyazhev, L. V. Karaulova, O. V. Reztsov, A. P. Spitsin
Background . Mathematical modeling is widely used in medicine to analyze the body systems in terms of their structure, work and interrelations. The present study investigates factors associated with the adaptation potential of the cardiovascular system, develops multiple regression models for the dependence of the adaptive potential on these factors, and compares the significance of the linear model with non-linear ones. Objectives. To determine changes in the circulatory system in students during the examination period and develop a mathematical model for predicting the adaptive potential of the cardiovascular system. Methods . The cohort observational study enrolled 74 students of Kirov State Medical University, aged 18–23 years, who gave consent to the survey. The participants were divided into two cohorts depending on the dominant type of the autonomic nervous system (group 1 — individuals with the dominance of sympathetic part of the peripheral division of the autonomic nervous system (n = 54) and group 2 — individuals with vagotonic type of regulation (n = 20)). The relationship between the hemodynamic parameters and the initial autonomic tone was considered as the main relevancy criterion of the study. Comparative analysis of hemodynamic parameters depending on the dominant type of autonomic nervous system was carried out in the cohorts. Development of the regression model was based on 74 observations. Data description included median (Me) and interquartile range representing 25th and 75th percentiles. The indicators in independent samples (cohorts) were compared using the non-parametric Mann—Whitney U test. Correlation analysis of relationships between the studied variables involved Spearman’s criterion (r). Differences and correlations were considered significant at p = 0.05. Calculations and analyses were performed using spreadsheets in Statistica Advanced 10 for Windows RU (Statsoft, Russia). Results. The state of the cardiovascular system significantly depends on the dominant type of the autonomic nervous system. Such parameters as stroke volume, cardiac index, cardiac minute output, circulatory efficiency were established to be significantly higher, whereas diastolic blood pressure, mean arterial pressure, cardiovascular index — lower in individuals with activation of the sympathetic part of the autonomic division of the peripheral nervous system. The study revealed significant correlations between the parameters of central hemodynamic and anthropometric parameters depending on the dominant type of the autonomic nervous system. Conclusion . Significant differences of hemodynamic parameters depending on the dominant type of autonomic system indicate the relevance of neurohumoral mechanisms of cardiovascular regulation. The values in adaptive potential exceeded 2.0 points, indicating the stress of the cardiovascular adaptation. The correlation regression analysis showed the greatest significance of the multiple linear regression model
背景。数学建模在医学上广泛应用于分析人体系统的结构、工作和相互关系。本研究探讨了心血管系统适应潜力的相关因素，建立了适应潜力与这些因素的依赖关系的多元回归模型，并比较了线性模型与非线性模型的显著性。目标。确定学生在考试期间循环系统的变化，并建立预测心血管系统适应潜力的数学模型。方法。这项队列观察研究招募了74名基洛夫国立医科大学18-23岁的学生，他们同意接受调查。根据自主神经系统的主导类型，参与者被分为两组(1组-自主神经系统外周分裂交感部分主导的个体(n = 54)和2组-迷走神经性调节类型的个体(n = 20))。血流动力学参数与初始自主神经张力之间的关系被认为是研究的主要相关性标准。在队列中，根据自主神经系统的主要类型对血流动力学参数进行比较分析。回归模型的建立基于74个观测值。数据描述包括中位数(Me)和四分位数范围，分别代表第25和75百分位。独立样本(队列)的指标采用非参数Mann-Whitney U检验进行比较。研究变量之间关系的相关分析采用Spearman标准(r)。p = 0.05时认为差异和相关性显著。使用Statistica Advanced 10 for Windows RU (Statsoft, Russia)中的电子表格进行计算和分析。结果。心血管系统的状态在很大程度上取决于自主神经系统的主导类型。如中风量，心脏指数，心脏分钟输出量，循环效率等参数被确定为显着较高，而舒张压，平均动脉压，心血管指数-在激活周围神经系统自主神经分裂的交感部分的个体较低。该研究揭示了中枢血流动力学参数和人体测量参数之间的显著相关性，这取决于自主神经系统的主要类型。结论。根据自主神经系统的主要类型，血流动力学参数的显著差异表明心血管调节的神经体液机制的相关性。适应电位超过2.0分，表明心血管适应压力较大。相关回归分析表明，作者建立的多元线性回归模型对预测心血管系统的适应电位具有最大的意义。
{"title":"Econometric predictive model for assessing the functional state of students during the examination period: a cross-sectional exploratory pilot study","authors":"I. S. Knyazhev, L. V. Karaulova, O. V. Reztsov, A. P. Spitsin","doi":"10.25207/1608-6228-2023-30-5-64-76","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-64-76","url":null,"abstract":"Background . Mathematical modeling is widely used in medicine to analyze the body systems in terms of their structure, work and interrelations. The present study investigates factors associated with the adaptation potential of the cardiovascular system, develops multiple regression models for the dependence of the adaptive potential on these factors, and compares the significance of the linear model with non-linear ones. Objectives. To determine changes in the circulatory system in students during the examination period and develop a mathematical model for predicting the adaptive potential of the cardiovascular system. Methods . The cohort observational study enrolled 74 students of Kirov State Medical University, aged 18–23 years, who gave consent to the survey. The participants were divided into two cohorts depending on the dominant type of the autonomic nervous system (group 1 — individuals with the dominance of sympathetic part of the peripheral division of the autonomic nervous system (n = 54) and group 2 — individuals with vagotonic type of regulation (n = 20)). The relationship between the hemodynamic parameters and the initial autonomic tone was considered as the main relevancy criterion of the study. Comparative analysis of hemodynamic parameters depending on the dominant type of autonomic nervous system was carried out in the cohorts. Development of the regression model was based on 74 observations. Data description included median (Me) and interquartile range representing 25th and 75th percentiles. The indicators in independent samples (cohorts) were compared using the non-parametric Mann—Whitney U test. Correlation analysis of relationships between the studied variables involved Spearman’s criterion (r). Differences and correlations were considered significant at p = 0.05. Calculations and analyses were performed using spreadsheets in Statistica Advanced 10 for Windows RU (Statsoft, Russia). Results. The state of the cardiovascular system significantly depends on the dominant type of the autonomic nervous system. Such parameters as stroke volume, cardiac index, cardiac minute output, circulatory efficiency were established to be significantly higher, whereas diastolic blood pressure, mean arterial pressure, cardiovascular index — lower in individuals with activation of the sympathetic part of the autonomic division of the peripheral nervous system. The study revealed significant correlations between the parameters of central hemodynamic and anthropometric parameters depending on the dominant type of the autonomic nervous system. Conclusion . Significant differences of hemodynamic parameters depending on the dominant type of autonomic system indicate the relevance of neurohumoral mechanisms of cardiovascular regulation. The values in adaptive potential exceeded 2.0 points, indicating the stress of the cardiovascular adaptation. The correlation regression analysis showed the greatest significance of the multiple linear regression model ","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"71 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135013496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.25207/1608-6228-2023-30-5-15-40
V. N. Lokshin, I. I. Kutsenko, I. O. Borovikov, V. P. Bulgakova, E. I. Kravtsova, M. I. Biryukova, O. I. Borovikova, J. V. Nikogda
Background. The relevance of the problem is related to the high prevalence of chronic endometritis (CE); its role in female infertility, implantation failures during assisted reproductive technology procedures, and recurrent miscarriage; as well as the lack of a unified strategy in the diagnosis and treatment of this pathology. The present systematic review with a meta-analysis focuses on evaluating the impact of CE and its therapy on the outcome of in vitro fertilization. In addition, the effect of CE of various severity on the outcomes of assisted reproductive technologies is analyzed. Objective . To analyze the effect of CE of varying severity and its treatment on the outcomes of in vitro fertilization. Methods . Using PubMed, Medline, Scopus, Embase, ELibrary, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry, and Russian Science Citation Index, a systematic search was conducted for articles published over the past 12 years that met the following criteria: randomized controlled trial examining the effect of CE of varying severity on fertility and ways to treat it. The following indicators were calculated: ongoing pregnancy/live birth, clinical pregnancy, and miscarriage rates. A total of 4145 patients (from ten studies) were included. A meta-analysis was performed using Stata 11.0 software (The Cochrane Collaboration, Oxford, UK). The heterogeneity was considered low at I 2 <30%, moderate at 30–50%, and high at >50%. Results . Women with CE exhibited lower ongoing pregnancy/live birth (OR 1.97; p = 0.02) and clinical pregnancy rates (OR 2.28; p = 0.002) as compared to women without it. CE treatment increased the ongoing pregnancy/live birth (OR 5.33; p < 0.0001) and clinical pregnancy rates (OR 3.64; p = 0.0001). In vitro fertilization outcomes were comparable in women treated for CE and women without CE (ongoing pregnancy/live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Women with severe CE exhibited lower ongoing pregnancy/live birth (OR 0.43; p = 0.003) and clinical pregnancy rates (OR 0.40; p = 0.0007). Mild CE showed no significant effect on in vitro fertilization outcomes (ongoing pregnancy/ live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Conclusion . The conducted meta-analysis showed that CE significantly reduces the ongoing pregnancy/live birth and clinical pregnancy rates in infertile women undergoing in vitro fertilization. Noteworthy is that antimicrobial therapy in such patients improves the results of assisted reproductive technologies, which are comparable to those of patients without CE. The negative impact of this pathology on the implantation capacity of the endometrium is most often observed in the severe form, while its mild form has virtually no effect on the in vitro fertilization outcome.
{"title":"Chronic endometritis and infertility — in vitro fertilization outcomes: systematic review and meta-analysis","authors":"V. N. Lokshin, I. I. Kutsenko, I. O. Borovikov, V. P. Bulgakova, E. I. Kravtsova, M. I. Biryukova, O. I. Borovikova, J. V. Nikogda","doi":"10.25207/1608-6228-2023-30-5-15-40","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-15-40","url":null,"abstract":"Background. The relevance of the problem is related to the high prevalence of chronic endometritis (CE); its role in female infertility, implantation failures during assisted reproductive technology procedures, and recurrent miscarriage; as well as the lack of a unified strategy in the diagnosis and treatment of this pathology. The present systematic review with a meta-analysis focuses on evaluating the impact of CE and its therapy on the outcome of in vitro fertilization. In addition, the effect of CE of various severity on the outcomes of assisted reproductive technologies is analyzed. Objective . To analyze the effect of CE of varying severity and its treatment on the outcomes of in vitro fertilization. Methods . Using PubMed, Medline, Scopus, Embase, ELibrary, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry, and Russian Science Citation Index, a systematic search was conducted for articles published over the past 12 years that met the following criteria: randomized controlled trial examining the effect of CE of varying severity on fertility and ways to treat it. The following indicators were calculated: ongoing pregnancy/live birth, clinical pregnancy, and miscarriage rates. A total of 4145 patients (from ten studies) were included. A meta-analysis was performed using Stata 11.0 software (The Cochrane Collaboration, Oxford, UK). The heterogeneity was considered low at I 2 <30%, moderate at 30–50%, and high at >50%. Results . Women with CE exhibited lower ongoing pregnancy/live birth (OR 1.97; p = 0.02) and clinical pregnancy rates (OR 2.28; p = 0.002) as compared to women without it. CE treatment increased the ongoing pregnancy/live birth (OR 5.33; p < 0.0001) and clinical pregnancy rates (OR 3.64; p = 0.0001). In vitro fertilization outcomes were comparable in women treated for CE and women without CE (ongoing pregnancy/live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Women with severe CE exhibited lower ongoing pregnancy/live birth (OR 0.43; p = 0.003) and clinical pregnancy rates (OR 0.40; p = 0.0007). Mild CE showed no significant effect on in vitro fertilization outcomes (ongoing pregnancy/ live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Conclusion . The conducted meta-analysis showed that CE significantly reduces the ongoing pregnancy/live birth and clinical pregnancy rates in infertile women undergoing in vitro fertilization. Noteworthy is that antimicrobial therapy in such patients improves the results of assisted reproductive technologies, which are comparable to those of patients without CE. The negative impact of this pathology on the implantation capacity of the endometrium is most often observed in the severe form, while its mild form has virtually no effect on the in vitro fertilization outcome.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"39 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.25207/1608-6228-2023-30-5-87-99
A. G. Serdyukov, V. V. Martynenko, V. R. Khan, T. S. Dyachenko, A. A. Voronkov, A. N. Redko
Background. The variety of current methods for assessing the healthcare personnel resources remains insufficient to completely evaluate the actual staffing and needs of certain medical institutions. Using a combination of different sources of data enables a more comprehensive picture of the healthcare personnel situation to be obtained. Objective. To identify the potential for improving approaches to assessment of the personnel situation in community pediatric services at the regional level. Methods. The present study involved data from Krasnodar Krai, Astrakhan and Volgograd Oblasts: Federal Statistical Monitoring form No. 30 “Information on Medical Organization” for 2007–2022, as well as depersonalized data from the regional registers of medical workers and assigned population of Krasnodar Krai as of 01.01.2023. The methodology involved statistical and analytical methods. The study estimated the following parameters: community pediatric staffing in relation to? the child population, the staffing level of pediatric full-time positions, the rate of part-time jobs, and the average number of children per pediatrician. Results. The study justified the possibility of using additional sources of data to evaluate the personnel situation in local, municipal or regional healthcare institutions. The authors suggested an interactive analytical board for graphical visualization of the current state of healthcare human resources. Conclusion. The introduction of additional sources of information and monitoring in the healthcare human resources policy encourages a systematic comprehensive approach to estimating the staffing requirements.
{"title":"Opportunities for improving personnel situation assessment in community pediatric services: a retrospective analytical descriptive study","authors":"A. G. Serdyukov, V. V. Martynenko, V. R. Khan, T. S. Dyachenko, A. A. Voronkov, A. N. Redko","doi":"10.25207/1608-6228-2023-30-5-87-99","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-87-99","url":null,"abstract":"Background. The variety of current methods for assessing the healthcare personnel resources remains insufficient to completely evaluate the actual staffing and needs of certain medical institutions. Using a combination of different sources of data enables a more comprehensive picture of the healthcare personnel situation to be obtained. Objective. To identify the potential for improving approaches to assessment of the personnel situation in community pediatric services at the regional level. Methods. The present study involved data from Krasnodar Krai, Astrakhan and Volgograd Oblasts: Federal Statistical Monitoring form No. 30 “Information on Medical Organization” for 2007–2022, as well as depersonalized data from the regional registers of medical workers and assigned population of Krasnodar Krai as of 01.01.2023. The methodology involved statistical and analytical methods. The study estimated the following parameters: community pediatric staffing in relation to? the child population, the staffing level of pediatric full-time positions, the rate of part-time jobs, and the average number of children per pediatrician. Results. The study justified the possibility of using additional sources of data to evaluate the personnel situation in local, municipal or regional healthcare institutions. The authors suggested an interactive analytical board for graphical visualization of the current state of healthcare human resources. Conclusion. The introduction of additional sources of information and monitoring in the healthcare human resources policy encourages a systematic comprehensive approach to estimating the staffing requirements.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"58 1-2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.25207/1608-6228-2023-30-5-77-86
O. S. Lavrukova, E. L. Kazakova, A. Yu. Polyakov
Background. Establishing regularities in postmortem intervals comprises one of the main tasks of the forensic science of death and cadaveric phenomena. The knowledge of these regularities is directly related to reconstructing the postmortem conditions and, consequently, to determining the postmortem interval. Objective. To analyze postmortem changes in cadaver tissues and dynamics of their impedance parameters under the conditions of natural biocenosis. Methods. The study involved the cadavers of model biological objects – eight pigs, aged one to two months, weighing up to 10 kg. Experimental studies of cadaver decomposition were carried out under natural biocenosis conditions, daily for 28 days with two replications. Changes in cadaver tissues during decomposition were recorded and analyzed. The subject of biophysical studies was the tissue impedance parameters of three diagnostic zones of the biological object: the musculocutaneous flap, the cartilaginous part of the third rib and the calcaneal tendon. Impedance measurements for each postmortem interval were performed at five studied current frequencies: 100 and 120 Hz, 1, 10 and 100 kHz. A total of 2,400 readings were taken. Statistical analysis of the study results was carried out by means of Statistica 8.0 (StatSoft Inc., USA). Results. Postmortem biological changes in cadaver tissues correlate with the nature of their impedance dynamics. The study of impedance under conditions of natural biocenosis established its identical dependence on the postmortem interval for all current frequencies of the study of all diagnostic zones of model biological objects: in the initial interval of 0–4 days, the impedance gives a “surge” followed by a smoother decrease. Cadaver tissues were recorded to indicate the presence of impedance dispersion in general in the studied frequency range and the absence of dispersion directly for high frequencies. Conclusion . Understanding the causes and essence of postmortem processes contributes to assessing and substantiating changes in any characteristics of tissues measured quantitatively, including impedance indicators, as well as to predicting the prospects of their use for specific practical purposes, in particular, for determining the postmortem interval.
{"title":"Postmortem tissue changes and dynamics of their impedance parameters: a preclinical experimental study","authors":"O. S. Lavrukova, E. L. Kazakova, A. Yu. Polyakov","doi":"10.25207/1608-6228-2023-30-5-77-86","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-77-86","url":null,"abstract":"Background. Establishing regularities in postmortem intervals comprises one of the main tasks of the forensic science of death and cadaveric phenomena. The knowledge of these regularities is directly related to reconstructing the postmortem conditions and, consequently, to determining the postmortem interval. Objective. To analyze postmortem changes in cadaver tissues and dynamics of their impedance parameters under the conditions of natural biocenosis. Methods. The study involved the cadavers of model biological objects – eight pigs, aged one to two months, weighing up to 10 kg. Experimental studies of cadaver decomposition were carried out under natural biocenosis conditions, daily for 28 days with two replications. Changes in cadaver tissues during decomposition were recorded and analyzed. The subject of biophysical studies was the tissue impedance parameters of three diagnostic zones of the biological object: the musculocutaneous flap, the cartilaginous part of the third rib and the calcaneal tendon. Impedance measurements for each postmortem interval were performed at five studied current frequencies: 100 and 120 Hz, 1, 10 and 100 kHz. A total of 2,400 readings were taken. Statistical analysis of the study results was carried out by means of Statistica 8.0 (StatSoft Inc., USA). Results. Postmortem biological changes in cadaver tissues correlate with the nature of their impedance dynamics. The study of impedance under conditions of natural biocenosis established its identical dependence on the postmortem interval for all current frequencies of the study of all diagnostic zones of model biological objects: in the initial interval of 0–4 days, the impedance gives a “surge” followed by a smoother decrease. Cadaver tissues were recorded to indicate the presence of impedance dispersion in general in the studied frequency range and the absence of dispersion directly for high frequencies. Conclusion . Understanding the causes and essence of postmortem processes contributes to assessing and substantiating changes in any characteristics of tissues measured quantitatively, including impedance indicators, as well as to predicting the prospects of their use for specific practical purposes, in particular, for determining the postmortem interval.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.25207/1608-6228-2023-30-5-41-53
E. V. Kolesnikova, A. V. Zharov, M. A. Penzhoyan, D. I. Dupleeva
Background. Today, no unified clinical classification of vulvar lichen sclerosus is registered (is yet to be registered?). Isolation of pathogenetically and clinically different variants of its course enable new approaches to the treatment to be developed. Objective. To develop a pathogenetic therapy for the sclerosing variant of vulvar lichen sclerosus, taking into account its clinical and immunological characteristics. Methods. A prospective cohort study was conducted from 2018 to 2022 on the basis of Regional Clinical Hospital No. 2, Krasonodar, Russia. 292 patients aged 20 to 70 years were histologically diagnosed with vulvar lichen sclerosus. After a clinical examination using the scale for assessing subjective and objective clinical signs of vulvar lichen sclerosus, 154 patients with a sclerosing variant of the disease course were selected for the study. The control cohort consisted of 30 women of the same age category without vulvar lichen sclerosus, taking into account the exclusion criteria. The study involved a clinical assessment (in points) of objective and subjective criteria characteristic of this variant of vulvar lichen sclerosus, as well as an assessment of the level of cytokines (interleukin-20; interleukin-23; interleukin-10; tumor necrosis factor α, interferon γ) in peripheral blood of the patients from the main and control groups. One month after the immunotherapy with sodium deoxyribonucleate, the authors evaluated its clinical efficacy (using Numerical rating scale for pain (vulvodynia) and Vulvar pruritus severity scale) and immunological efficacy (repeated assessment of the level of the studied cytokines). Analysis and statistical processing of the obtained data were performed using Graph Pad Prism version 6.0 (GraphPad Software, Inc., San Diego, CA). Results . Depigmentation of the vulvar skin against the background of vulvar sclerosis and thickening features a sclerosing variant of vulvar lichen sclerosus compared to vulvar atrophy. Stenosis of the vaginal vestibule is either absent (51.3%) or predominantly corresponds to grade I, and is less specific than depigmentation and even skin atrophy. The subjective signs include a severe vulvar pruritus without or with moderately expressed (in 68.1%) vulvodynia. An immunological study showed a statistically significant increase in the level of interleukin-20 (p < 0.0001), interleukin-23 (p < 0.0001), interferon-γ (p < 0.03), tumor necrosis factor α (p < 0.009) in patients with maximal tissue sclerosis with respect to the control group, along with a statistically significant decrease in the level of anti-inflammatory interleukin-10 (p < 0.01). The immunological efficacy of sodium deoxyribonucleate was confirmed by a statistically significant (compared to baseline) decrease in interleukin-20 (p < 0.0001), interferon-γ and tumor necrosis factor α (p < 0.002), interleukin-23 (p < 0.012) without statistical differences with the control group (except for interleukin-23, the level of
{"title":"Immune pathogenesis and immune therapy of a sclerosing variant of vulvar lichen sclerosus: a prospective cohort study","authors":"E. V. Kolesnikova, A. V. Zharov, M. A. Penzhoyan, D. I. Dupleeva","doi":"10.25207/1608-6228-2023-30-5-41-53","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-41-53","url":null,"abstract":"Background. Today, no unified clinical classification of vulvar lichen sclerosus is registered (is yet to be registered?). Isolation of pathogenetically and clinically different variants of its course enable new approaches to the treatment to be developed. Objective. To develop a pathogenetic therapy for the sclerosing variant of vulvar lichen sclerosus, taking into account its clinical and immunological characteristics. Methods. A prospective cohort study was conducted from 2018 to 2022 on the basis of Regional Clinical Hospital No. 2, Krasonodar, Russia. 292 patients aged 20 to 70 years were histologically diagnosed with vulvar lichen sclerosus. After a clinical examination using the scale for assessing subjective and objective clinical signs of vulvar lichen sclerosus, 154 patients with a sclerosing variant of the disease course were selected for the study. The control cohort consisted of 30 women of the same age category without vulvar lichen sclerosus, taking into account the exclusion criteria. The study involved a clinical assessment (in points) of objective and subjective criteria characteristic of this variant of vulvar lichen sclerosus, as well as an assessment of the level of cytokines (interleukin-20; interleukin-23; interleukin-10; tumor necrosis factor α, interferon γ) in peripheral blood of the patients from the main and control groups. One month after the immunotherapy with sodium deoxyribonucleate, the authors evaluated its clinical efficacy (using Numerical rating scale for pain (vulvodynia) and Vulvar pruritus severity scale) and immunological efficacy (repeated assessment of the level of the studied cytokines). Analysis and statistical processing of the obtained data were performed using Graph Pad Prism version 6.0 (GraphPad Software, Inc., San Diego, CA). Results . Depigmentation of the vulvar skin against the background of vulvar sclerosis and thickening features a sclerosing variant of vulvar lichen sclerosus compared to vulvar atrophy. Stenosis of the vaginal vestibule is either absent (51.3%) or predominantly corresponds to grade I, and is less specific than depigmentation and even skin atrophy. The subjective signs include a severe vulvar pruritus without or with moderately expressed (in 68.1%) vulvodynia. An immunological study showed a statistically significant increase in the level of interleukin-20 (p < 0.0001), interleukin-23 (p < 0.0001), interferon-γ (p < 0.03), tumor necrosis factor α (p < 0.009) in patients with maximal tissue sclerosis with respect to the control group, along with a statistically significant decrease in the level of anti-inflammatory interleukin-10 (p < 0.01). The immunological efficacy of sodium deoxyribonucleate was confirmed by a statistically significant (compared to baseline) decrease in interleukin-20 (p < 0.0001), interferon-γ and tumor necrosis factor α (p < 0.002), interleukin-23 (p < 0.012) without statistical differences with the control group (except for interleukin-23, the level of","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135013348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-05DOI: 10.25207/1608-6228-2023-30-5-54-63
T. O. Okorokova, O. N. Kryuchkova
Background . Initial dual antihypertensive therapy is currently considered as the first management step for the majority of patients with arterial hypertension. However, it often fails to achieve the target blood pressure levels. An approved algorithm for predicting the failure of dual antihypertensive therapy is still to be developed. Objectives . To establish predictors of dual antihypertensive therapy failure in patients with high and very high cardiovascular risk and to create a model for predicting negative outcome of dual antihypertensive therapy. Methods. The paper presents a prospective comparative non-randomized clinical trial. The recruiting of participants and recording of results were carried out in March–December 2019 with 3 months of the follow-up period. The trial involved examination of 88 patients with poor blood pressure control, stage II and III arterial hypertension, high and very high cardiovascular risk of stages 1–3. Clinical and laboratory examination was carried out in compliance with the current regulatory documents. Additional examination included tests for uric acid, high-sensitivity C-reactive protein, as well as respiratory polygraphy and computerized capillaroscopy. All patients were prescribed dual antihypertensive therapy. The primary search for predictors was performed using the binary logistic regression. The predictive model was developed by stepwise variable selection. The diagnostic significance of the binary classifier was assessed by means of ROC-curve analysis; the calculation was performed using MedCalc 20.218 software (MedCalc Software Ltd., Belgium). Results . Administration of two hypotensive drugs appears to be effective in 33% of patients. The final model for predicting negative outcomes of dual antihypertensive therapy included such independent predictors as interventricular septal thickness, daily mean systolic blood pressure, and area density of the capillary network. The odds ratio accounted for 9.1 (95% confidence interval 3.12; 26.82). The area under the ROC curve based on the multiple binary logistic regression model comprised 0.805±0.05 with 95% confidence interval: 0.707-0.882 (p<0.0001). The sensitivity and specificity of the method amounted to 83.1 and 69.0%, respectively. The prediction accuracy comprised 77.3%. Conclusion. The development of patient-oriented algorithms for selection of hypotensive treatment is considered to be essential due to poor blood pressure control during dual antihypertensive therapy. The developed prognostic model may be applied when managing hypertension.
{"title":"Logistic regression model for predicting failure of dual antihypertensive therapy: a prospective comparative non-randomized clinical trial","authors":"T. O. Okorokova, O. N. Kryuchkova","doi":"10.25207/1608-6228-2023-30-5-54-63","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-5-54-63","url":null,"abstract":"Background . Initial dual antihypertensive therapy is currently considered as the first management step for the majority of patients with arterial hypertension. However, it often fails to achieve the target blood pressure levels. An approved algorithm for predicting the failure of dual antihypertensive therapy is still to be developed. Objectives . To establish predictors of dual antihypertensive therapy failure in patients with high and very high cardiovascular risk and to create a model for predicting negative outcome of dual antihypertensive therapy. Methods. The paper presents a prospective comparative non-randomized clinical trial. The recruiting of participants and recording of results were carried out in March–December 2019 with 3 months of the follow-up period. The trial involved examination of 88 patients with poor blood pressure control, stage II and III arterial hypertension, high and very high cardiovascular risk of stages 1–3. Clinical and laboratory examination was carried out in compliance with the current regulatory documents. Additional examination included tests for uric acid, high-sensitivity C-reactive protein, as well as respiratory polygraphy and computerized capillaroscopy. All patients were prescribed dual antihypertensive therapy. The primary search for predictors was performed using the binary logistic regression. The predictive model was developed by stepwise variable selection. The diagnostic significance of the binary classifier was assessed by means of ROC-curve analysis; the calculation was performed using MedCalc 20.218 software (MedCalc Software Ltd., Belgium). Results . Administration of two hypotensive drugs appears to be effective in 33% of patients. The final model for predicting negative outcomes of dual antihypertensive therapy included such independent predictors as interventricular septal thickness, daily mean systolic blood pressure, and area density of the capillary network. The odds ratio accounted for 9.1 (95% confidence interval 3.12; 26.82). The area under the ROC curve based on the multiple binary logistic regression model comprised 0.805±0.05 with 95% confidence interval: 0.707-0.882 (p<0.0001). The sensitivity and specificity of the method amounted to 83.1 and 69.0%, respectively. The prediction accuracy comprised 77.3%. Conclusion. The development of patient-oriented algorithms for selection of hypotensive treatment is considered to be essential due to poor blood pressure control during dual antihypertensive therapy. The developed prognostic model may be applied when managing hypertension.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135547950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-20DOI: 10.25207/1608-6228-2023-30-4-61-70
A. Mitronin, M. Maksimova, D. Ostanina, O. A. Antonova, Yu. A. Mitronin
Background. At present, the priority direction of medical science and practice is the prevention of dental diseases, especially in patients with somatic pathology. Patients with dyscirculatory encephalopathy develop a complex of neurological disorders, accompanied by impaired motor functions of hands, lips and chewing muscles, which leads to ineffective cleansing of the oral cavity from food residues and formation of soft and mineralized dental deposits on the dental surface. Therefore, these patients should use additional personal hygiene products.Objective. To evaluate the efficacy of hygienic care in patients with dyscirculatory encephalopathy using mouthwash with synbiotic complex.Methods. An observational clinical study was conducted on the basis of Neurology Unit No. 2 of Research Center of Neurology, Department of Cariology and Endodontics and Department of Biological Chemistry, A.I. Yevdokimov Moscow State Medical and Dental University. The study enrolled 82 patients aged from 45 to 74 years with cerebrovascular disease, dyscirculatory encephalopathy, decompensation (I68.7, according to ICD-10). Patients were divided into two study groups: group 1 (n = 44) — patients who used mouthwash with synbiotic complex; group 2 (n = 38) — patients who did not use mouthwash. The efficacy of mouthwash with synbiotic complex was assessed by using an index score of a simplified Greene Vermillion Oral Hygiene Index (OHI-S), Russell Periodontal Index (PI), Papillary Bleeding Index (PBI), and physicochemical parameters of the oral fluid. Statistical processing of the results was carried out using Stat Plus 7 (Analyst Soft Inc., USA).Results. The comparative analysis proved the efficacy of mouthwash with synbiotic complex. The hygienic status improved to (1.50 ± 0.12) points, the state of periodontal tissues — to (PI = (1.94 ± 1.45) points; PBI = (1.12 ± 0.11) points). The hydrogen index (pH) of the oral fluid decreased to weakly alkaline values — (7.92 ± 0.22) points; the activity of alkaline phosphatase decreased by a factor of 1.4, lactate dehydrogenase — by half, aminotransferases — by a factor of 1.3, and D-dimer — by a factor of 1.2.Conclusion. The obtained results demonstrate the efficacy of mouthwash as an additional means for personal hygiene. Mouthwash with synbiotic complex should be included in the daily oral hygiene care for patients with dyscirculatory encephalopathy.
背景目前，医学和实践的优先方向是预防牙科疾病，尤其是对有身体病理的患者。循环障碍性脑病患者会发展成一种复杂的神经系统疾病，伴有手、嘴唇和咀嚼肌的运动功能受损，这会导致口腔无法有效清洁食物残渣，并在牙齿表面形成柔软和矿化的牙齿沉积物。因此，这些患者应该使用额外的个人卫生用品。客观的评价使用含合生元复合物的漱口水对循环障碍性脑病患者进行卫生保健的效果。方法。一项观察性临床研究是在A.I.Yevdokimov莫斯科国立医科牙科大学神经病学研究中心2号神经病学单元、Cariology和Endodotics系以及生物化学系的基础上进行的。该研究招募了82名年龄在45至74岁之间的脑血管疾病、循环障碍性脑病、失代偿期患者（根据ICD-10，I68.7）。患者被分为两个研究组：第1组（n=44）——使用含合生元复合物的漱口水的患者；第2组（n=38）——不使用漱口水的患者。通过使用简化的Greene Vermillion口腔卫生指数（OHI-S）、Russell牙周指数（PI）、乳头出血指数（PBI）和口腔液的物理化学参数的指数评分来评估具有合生元复合物的漱口水的功效。使用Stat Plus 7（Analyst Soft股份有限公司，USA）对结果进行统计处理。结果。对比分析证明了含合生元复合物的漱口水的功效。卫生状况改善到（1.50±0.12）分，牙周组织状态改善到（PI=（1.94±1.45）分；PBI=（1.12±0.11）分）。口腔液的氢指数（pH）降至弱碱性值——（7.92±0.22）点；碱性磷酸酶活性下降1.4倍，乳酸脱氢酶下降一半，氨基转移酶下降1.3倍，D-二聚体下降1.2倍。循环障碍性脑病患者的日常口腔卫生护理应包括含合生元复合物的漱口水。
{"title":"Evaluating the Efficacy of Synbiotic Mouthwash in Patients with Dyscirculatory Encephalopathy: Observational Clinical Study","authors":"A. Mitronin, M. Maksimova, D. Ostanina, O. A. Antonova, Yu. A. Mitronin","doi":"10.25207/1608-6228-2023-30-4-61-70","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-4-61-70","url":null,"abstract":"Background. At present, the priority direction of medical science and practice is the prevention of dental diseases, especially in patients with somatic pathology. Patients with dyscirculatory encephalopathy develop a complex of neurological disorders, accompanied by impaired motor functions of hands, lips and chewing muscles, which leads to ineffective cleansing of the oral cavity from food residues and formation of soft and mineralized dental deposits on the dental surface. Therefore, these patients should use additional personal hygiene products.Objective. To evaluate the efficacy of hygienic care in patients with dyscirculatory encephalopathy using mouthwash with synbiotic complex.Methods. An observational clinical study was conducted on the basis of Neurology Unit No. 2 of Research Center of Neurology, Department of Cariology and Endodontics and Department of Biological Chemistry, A.I. Yevdokimov Moscow State Medical and Dental University. The study enrolled 82 patients aged from 45 to 74 years with cerebrovascular disease, dyscirculatory encephalopathy, decompensation (I68.7, according to ICD-10). Patients were divided into two study groups: group 1 (n = 44) — patients who used mouthwash with synbiotic complex; group 2 (n = 38) — patients who did not use mouthwash. The efficacy of mouthwash with synbiotic complex was assessed by using an index score of a simplified Greene Vermillion Oral Hygiene Index (OHI-S), Russell Periodontal Index (PI), Papillary Bleeding Index (PBI), and physicochemical parameters of the oral fluid. Statistical processing of the results was carried out using Stat Plus 7 (Analyst Soft Inc., USA).Results. The comparative analysis proved the efficacy of mouthwash with synbiotic complex. The hygienic status improved to (1.50 ± 0.12) points, the state of periodontal tissues — to (PI = (1.94 ± 1.45) points; PBI = (1.12 ± 0.11) points). The hydrogen index (pH) of the oral fluid decreased to weakly alkaline values — (7.92 ± 0.22) points; the activity of alkaline phosphatase decreased by a factor of 1.4, lactate dehydrogenase — by half, aminotransferases — by a factor of 1.3, and D-dimer — by a factor of 1.2.Conclusion. The obtained results demonstrate the efficacy of mouthwash as an additional means for personal hygiene. Mouthwash with synbiotic complex should be included in the daily oral hygiene care for patients with dyscirculatory encephalopathy.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44540494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-20DOI: 10.25207/1608-6228-2023-30-4-18-27
A. Romanenko, S. Sirak, Z. K. Shamanova, Yu. V. Verevkina, N. Bykova, V. N. Lenev, A. Arutyunov
Background. Treatment and prevention of inflammatory periodontal diseases represent a serious general medical and social problem, which remains relevant due to the significant prevalence of periodontitis among the population, as well as the associated loss of teeth and the negative impact of periodontal foci of infection on the body as a whole. Chronic generalized periodontitis is difficult to treat: it is only possible to achieve periods of remission. Therefore, it is of great theoretical and practical importance to develop further ways to improve methods for treating inflammatory-dystrophic damage of periodontal tissues in chronic generalized periodontitis.Objective. To perform an index estimation of treatment efficacy in patients with moderately severe chronic generalized periodontitis.Methods. An experimental randomized single-arm study was conducted examining 204 patients diagnosed with moderately severe chronic generalized periodontitis. Patient examination and data analysis were carried out at the Dentistry Department of the Stavropol State Medical University and the Department for General Practice Dentistry of the Kuban State Medical University in 2021–2022. The study included patients aged 35 to 65 years diagnosed with moderately severe chronic generalized periodontitis. Patients with somatic diseases in the decompensation stage were not eligible for the study. The patients were randomly divided into three groups (closed-envelope method). Group 1 was treated using conventional methods. As well as conventional therapy, Group 2 was prescribed vitamin D (Aquadetrim® at a dose of 5000 IU once per day while monitoring vitamin D blood level). The third group of patients was prescribed conventional therapy along with the developed pharmacotherapy, which included vitamin D (Aquadetrim® at a dose of 5000 IU once per day), vitamin A (3.44% oil solution of retinol acetate at a dose of 50 000 IU, 15 min after a morning meal), and 2-ethyl-6-methyl-3-hydroxypyridine (Mexidol® at a dose of 125 mg twice a day). In each patient, the treatment efficacy was analyzed in adjacent oral cavity segments (split-mouth design) according to clinical pocket depth, attachment loss, and bleeding on probing. Also, the authors used the X-ray index to assess the condition of osseous structures and the simplified oral hygiene index. The specified indices were estimated prior to treatment and at one and 12 months following treatment. The statistical analysis of study results was performed using Excel Microsoft Office 2016 (Microsoft, USA).Results. The obtained data indicate that the immediate clinical outcomes (after one month) of combination therapy in patients from all three groups were approximately the same. However, the efficacy of treatment measures in the long-term period (12 months) was different, as evidenced by the dynamics of index values. Only in Group 3 patients, the full implementation of pharmacotherapeutic measures as part of the combination therapy of peri
{"title":"Efficacy Evaluation of Combination Therapy in Patients with Generalized Periodontitis According to the Index Estimation of Periodontal Status: Experimental Randomized Single-Arm Study","authors":"A. Romanenko, S. Sirak, Z. K. Shamanova, Yu. V. Verevkina, N. Bykova, V. N. Lenev, A. Arutyunov","doi":"10.25207/1608-6228-2023-30-4-18-27","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-4-18-27","url":null,"abstract":"Background. Treatment and prevention of inflammatory periodontal diseases represent a serious general medical and social problem, which remains relevant due to the significant prevalence of periodontitis among the population, as well as the associated loss of teeth and the negative impact of periodontal foci of infection on the body as a whole. Chronic generalized periodontitis is difficult to treat: it is only possible to achieve periods of remission. Therefore, it is of great theoretical and practical importance to develop further ways to improve methods for treating inflammatory-dystrophic damage of periodontal tissues in chronic generalized periodontitis.Objective. To perform an index estimation of treatment efficacy in patients with moderately severe chronic generalized periodontitis.Methods. An experimental randomized single-arm study was conducted examining 204 patients diagnosed with moderately severe chronic generalized periodontitis. Patient examination and data analysis were carried out at the Dentistry Department of the Stavropol State Medical University and the Department for General Practice Dentistry of the Kuban State Medical University in 2021–2022. The study included patients aged 35 to 65 years diagnosed with moderately severe chronic generalized periodontitis. Patients with somatic diseases in the decompensation stage were not eligible for the study. The patients were randomly divided into three groups (closed-envelope method). Group 1 was treated using conventional methods. As well as conventional therapy, Group 2 was prescribed vitamin D (Aquadetrim® at a dose of 5000 IU once per day while monitoring vitamin D blood level). The third group of patients was prescribed conventional therapy along with the developed pharmacotherapy, which included vitamin D (Aquadetrim® at a dose of 5000 IU once per day), vitamin A (3.44% oil solution of retinol acetate at a dose of 50 000 IU, 15 min after a morning meal), and 2-ethyl-6-methyl-3-hydroxypyridine (Mexidol® at a dose of 125 mg twice a day). In each patient, the treatment efficacy was analyzed in adjacent oral cavity segments (split-mouth design) according to clinical pocket depth, attachment loss, and bleeding on probing. Also, the authors used the X-ray index to assess the condition of osseous structures and the simplified oral hygiene index. The specified indices were estimated prior to treatment and at one and 12 months following treatment. The statistical analysis of study results was performed using Excel Microsoft Office 2016 (Microsoft, USA).Results. The obtained data indicate that the immediate clinical outcomes (after one month) of combination therapy in patients from all three groups were approximately the same. However, the efficacy of treatment measures in the long-term period (12 months) was different, as evidenced by the dynamics of index values. Only in Group 3 patients, the full implementation of pharmacotherapeutic measures as part of the combination therapy of peri","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44229803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-20DOI: 10.25207/1608-6228-2023-30-4-110-136
S. Tekucheva, E. Bazikyan, Ya. I. Afanasyeva, M. Postnikov
Background. Currently, the issues of diagnosis and treatment of patients with dentoalveolar injuries combined with temporomandibular joint disorders are highly relevant due to a progressive increase in the number of cases of this pathology among the population. Despite the availability of the comprehensive methodology in diagnostics of dentoalveolar injuries, dentists lack standardized algorithms for effective examination and systematization of the data obtained in the diagnostics of such groups of patients, which is necessary for personalized planning and pathogenetic therapy. The authors present the algorithm they developed for comprehensive assessment of dentoalveolar injuries in patients with temporomandibular joint disorders.Case descriptions. The paper presents clinical cases of two patients with abnormal occlusion associated with temporomandibular joint disorder. The patients underwent a comprehensive morphofunctional examination of the dentoalveolar complex in accordance with the diagnostic algorithm patented by the authors, including following methods: clinical (interview, examination), anthropometric (anthropometry of dentition), radiological (cone-beam computed tomography, magnetic resonance imaging of the temporomandibular joint), functional (surface electromyography of the masticatory muscles, computer kinesiography, electro-vibrography, ultrasound examination of the temporomandibular joint), to make the final diagnosis and to determine the order and scope of treatment.Conclusion. The authors presented and proved clinically the algorithm of morphofunctional diagnostics for the dento-alveolar complex of patients with temporomandibular joint disorders, combining clinical, anthropometric, radiological and functional methods of examination, which allow the most dento-alveolar characteristics to be considered in order to make the main diagnosis and a personalized treatment protocol for such groups of patients
{"title":"Copyright Research Protocol for Comprehensive Assessment of the Dento-Alveolar Complex in Patients with Temporomandibular Joint Disorders: Clinical Cases","authors":"S. Tekucheva, E. Bazikyan, Ya. I. Afanasyeva, M. Postnikov","doi":"10.25207/1608-6228-2023-30-4-110-136","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-4-110-136","url":null,"abstract":"Background. Currently, the issues of diagnosis and treatment of patients with dentoalveolar injuries combined with temporomandibular joint disorders are highly relevant due to a progressive increase in the number of cases of this pathology among the population. Despite the availability of the comprehensive methodology in diagnostics of dentoalveolar injuries, dentists lack standardized algorithms for effective examination and systematization of the data obtained in the diagnostics of such groups of patients, which is necessary for personalized planning and pathogenetic therapy. The authors present the algorithm they developed for comprehensive assessment of dentoalveolar injuries in patients with temporomandibular joint disorders.Case descriptions. The paper presents clinical cases of two patients with abnormal occlusion associated with temporomandibular joint disorder. The patients underwent a comprehensive morphofunctional examination of the dentoalveolar complex in accordance with the diagnostic algorithm patented by the authors, including following methods: clinical (interview, examination), anthropometric (anthropometry of dentition), radiological (cone-beam computed tomography, magnetic resonance imaging of the temporomandibular joint), functional (surface electromyography of the masticatory muscles, computer kinesiography, electro-vibrography, ultrasound examination of the temporomandibular joint), to make the final diagnosis and to determine the order and scope of treatment.Conclusion. The authors presented and proved clinically the algorithm of morphofunctional diagnostics for the dento-alveolar complex of patients with temporomandibular joint disorders, combining clinical, anthropometric, radiological and functional methods of examination, which allow the most dento-alveolar characteristics to be considered in order to make the main diagnosis and a personalized treatment protocol for such groups of patients","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45821762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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