Pub Date : 2023-11-07DOI: 10.33667/2078-5631-2023-20-60-64
M. G. Soykher, M. I. Soykher, G. T. Saleeva, S. M. Soykher, M. A. Kharke
The morphology of the articular tubercle of the temporal bone varies in the population and is being formed during the growth and development of the patient. When planning and implementing comprehensive dental treatment, it is necessary to take into account the individual parameters of the articular tubercle inclination in order to achieve a predictable result. The aim of the research was to study the values of the articular inclination angle depending on the subjects’ skeletal class. Materials and methods A clinical cross-sectional retrospective simple centric study in which 265 patients participated: 80 men and 185 women.Clinical studies included filling in the dental formula, intraoral photographs of dentition, palpation of the masticatory muscles and the TMJ area, analysis of the jaws plaster models. Each subject underwent electronic axiography with registration of the lower jaw hinge axis movements. The assessment of the angle of articular inclination (SCI) during translational movements was carried out: protrusion-retrusion, right media intrusion, left media intrusion. The skeletal class was evaluated on the basis of cephalometry data by analyzing teleroentgenograms (TRG) in a lateral projection with markers of the hinge-suborbital axis. Result . In the course of the study, the average values of the articular inclination angle were obtained for protrusion-retrusion, right-hand media intrusion, left-hand media intrusion according to the «Skeletal class» criterion. Differences were found between skeletal classes in terms of SCI.During protrusion – retrusion, the SCI values were significantly higher in the subjects with skeletal class II than in the subjects with skeletal class III. It should be noted that the subjects with II skeletal class with protrusion – retrusion had the highest values of SCI than the subjects with I and III skeletal classes, but no significant differences were found. Conclusions The values of the sagittal condular inclination depend on the skeletal class of jaw relationship. A decrease in the values of sagittal condular inclination is a risk factor for the maxillofacial dysfunction development. The lowest values of sagittal condular inclination were observed in subjects with the III skeletal class which requires special attention when diagnosing and treating this risk group. The value of the sagittal condular inclination should be taken into account when modeling the anatomy of orthopedic structures during prosthetic treatment.
{"title":"Assessment of the angle of articular inclination in patients with different skeletal classes according to axiography","authors":"M. G. Soykher, M. I. Soykher, G. T. Saleeva, S. M. Soykher, M. A. Kharke","doi":"10.33667/2078-5631-2023-20-60-64","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-20-60-64","url":null,"abstract":"The morphology of the articular tubercle of the temporal bone varies in the population and is being formed during the growth and development of the patient. When planning and implementing comprehensive dental treatment, it is necessary to take into account the individual parameters of the articular tubercle inclination in order to achieve a predictable result. The aim of the research was to study the values of the articular inclination angle depending on the subjects’ skeletal class. Materials and methods A clinical cross-sectional retrospective simple centric study in which 265 patients participated: 80 men and 185 women.Clinical studies included filling in the dental formula, intraoral photographs of dentition, palpation of the masticatory muscles and the TMJ area, analysis of the jaws plaster models. Each subject underwent electronic axiography with registration of the lower jaw hinge axis movements. The assessment of the angle of articular inclination (SCI) during translational movements was carried out: protrusion-retrusion, right media intrusion, left media intrusion. The skeletal class was evaluated on the basis of cephalometry data by analyzing teleroentgenograms (TRG) in a lateral projection with markers of the hinge-suborbital axis. Result . In the course of the study, the average values of the articular inclination angle were obtained for protrusion-retrusion, right-hand media intrusion, left-hand media intrusion according to the «Skeletal class» criterion. Differences were found between skeletal classes in terms of SCI.During protrusion – retrusion, the SCI values were significantly higher in the subjects with skeletal class II than in the subjects with skeletal class III. It should be noted that the subjects with II skeletal class with protrusion – retrusion had the highest values of SCI than the subjects with I and III skeletal classes, but no significant differences were found. Conclusions The values of the sagittal condular inclination depend on the skeletal class of jaw relationship. A decrease in the values of sagittal condular inclination is a risk factor for the maxillofacial dysfunction development. The lowest values of sagittal condular inclination were observed in subjects with the III skeletal class which requires special attention when diagnosing and treating this risk group. The value of the sagittal condular inclination should be taken into account when modeling the anatomy of orthopedic structures during prosthetic treatment.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"6 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432309","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-23-34-39
S. V. Khabarov, O. V. Denisova, A. V. Dalinskaya
Vitamin D plays an important role in maintaining human health and has many positive properties. Its deficiency can negatively affect the body and worsen the quality of life. Worldwide, deficiency of this vitamin is a widespread problem. Different states set their own reference values of vitamin D levels for their populations. The article considers the justifications underlying the establishment of recommendations for its level and the basic units of measurement of 25(OH)D. Understanding the differences in normal vitamin D values between countries makes it possible to more accurately adapt recommendations to specific populations and ensure that optimal vitamin D levels are achieved, which is necessary to maintain the health of the population.
{"title":"Reference values of vitamin D status: Why is everything not so clear","authors":"S. V. Khabarov, O. V. Denisova, A. V. Dalinskaya","doi":"10.33667/2078-5631-2023-23-34-39","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-23-34-39","url":null,"abstract":"Vitamin D plays an important role in maintaining human health and has many positive properties. Its deficiency can negatively affect the body and worsen the quality of life. Worldwide, deficiency of this vitamin is a widespread problem. Different states set their own reference values of vitamin D levels for their populations. The article considers the justifications underlying the establishment of recommendations for its level and the basic units of measurement of 25(OH)D. Understanding the differences in normal vitamin D values between countries makes it possible to more accurately adapt recommendations to specific populations and ensure that optimal vitamin D levels are achieved, which is necessary to maintain the health of the population.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"87 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432177","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-23-53-56
V. S. Kuznetsova, N. N. Kiseleva, D. A. Voshchinkina, V. P. Mudrov
The problem of the spread of syphilis is becoming acute due to the rapid increase in the number of initially detected cases of the disease. When analyzing and interpreting the obtained laboratory data, there is always the possibility of obtaining contradictory results, both false positive and false negative, which do not coincide with the clinical picture of the patient. Since in practice false positive results of serological tests for syphilis are detected more often than false negative ones, special importance is attached to the identification and study of the causes of their occurrence. At the analysis stage, the cause may be the cross-reactivity of the test system with various ‘particles’ in the analyzed samples, due to the peculiarities of its design and antigenic composition. For this work, sets of reagents Abbott GmbH (CMIA), Mindray (CLIA), as well as reagents produced by Vector-Best (ELISA) were used. During the study, it was found that one of the possible ‘particles’ leading to cross-reactivity of test systems may be IgG antibodies to cytomegalovirus.
{"title":"Influence of infectious diseases on detection of antibodies to treponema pallidum","authors":"V. S. Kuznetsova, N. N. Kiseleva, D. A. Voshchinkina, V. P. Mudrov","doi":"10.33667/2078-5631-2023-23-53-56","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-23-53-56","url":null,"abstract":"The problem of the spread of syphilis is becoming acute due to the rapid increase in the number of initially detected cases of the disease. When analyzing and interpreting the obtained laboratory data, there is always the possibility of obtaining contradictory results, both false positive and false negative, which do not coincide with the clinical picture of the patient. Since in practice false positive results of serological tests for syphilis are detected more often than false negative ones, special importance is attached to the identification and study of the causes of their occurrence. At the analysis stage, the cause may be the cross-reactivity of the test system with various ‘particles’ in the analyzed samples, due to the peculiarities of its design and antigenic composition. For this work, sets of reagents Abbott GmbH (CMIA), Mindray (CLIA), as well as reagents produced by Vector-Best (ELISA) were used. During the study, it was found that one of the possible ‘particles’ leading to cross-reactivity of test systems may be IgG antibodies to cytomegalovirus.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"6 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432313","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-23-29-33
O. A. Klimenkova, E. Yu. Mezina, D. M. Krikunova, V. P. Pashkova, V. S. Berestovskaya
Background. Recently, the demand for the measurement of vitamin D has been growing at a rate outrunning other types of laboratory tests. However, estimates of the prevalence of this nutrient status among population groups vary widely, based on target levels considered adequate or optimal for maintaining good health. The lack of a unified approach to stratifying the values of vitamin D in a patient’s blood creates difficulties in assessing the status of this nutrient. Objective. Stratification of vitamin D results in pediatric and adult patients examined between 2017 and 2022 at the St. Petersburg Consultative and Diagnostic Centre for Children, using criteria of different research groups and professional societies. Materials and methods. Vitamin D measurements were carried out using an immunochemical analyzer from January 2017 to December 2022 in 15,946 samples from children and 9,163 from adults. Results. Using stratification criteria proposed by various research groups and professional societies, the range of vitamin D deficiency in 2017–2019 ranged from 3.0 % to 63.9 % in children and from 2.4 % to 81.7 % in adults. In 2020–2022 deficient status was less common for all criteria: from 0.2 % to 51.2 % in children and from 0.1 % to 42.5 % in adults. An inverse relationship was noted for vitamin D levels associated with risk of harm. In 2017–2019 such values were detected in 1.0 %, in 2020–2022 in 2.8 % of children. In adults, similar rates increased from 1.8 % in 2017–2019 up to 3.5 % in 2020–2022. Conclusions. The wide variation in approaches reflects the uncertainty in research findings, recommendations, and guidelines involving vitamin D. Consensus on vitamin D thresholds will help arrive at the most likely conclusions from an evidence-based clinical perspective when establishing an association between a risk factor and an outcome.
{"title":"Problem of determining vitamin D status","authors":"O. A. Klimenkova, E. Yu. Mezina, D. M. Krikunova, V. P. Pashkova, V. S. Berestovskaya","doi":"10.33667/2078-5631-2023-23-29-33","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-23-29-33","url":null,"abstract":"Background. Recently, the demand for the measurement of vitamin D has been growing at a rate outrunning other types of laboratory tests. However, estimates of the prevalence of this nutrient status among population groups vary widely, based on target levels considered adequate or optimal for maintaining good health. The lack of a unified approach to stratifying the values of vitamin D in a patient’s blood creates difficulties in assessing the status of this nutrient. Objective. Stratification of vitamin D results in pediatric and adult patients examined between 2017 and 2022 at the St. Petersburg Consultative and Diagnostic Centre for Children, using criteria of different research groups and professional societies. Materials and methods. Vitamin D measurements were carried out using an immunochemical analyzer from January 2017 to December 2022 in 15,946 samples from children and 9,163 from adults. Results. Using stratification criteria proposed by various research groups and professional societies, the range of vitamin D deficiency in 2017–2019 ranged from 3.0 % to 63.9 % in children and from 2.4 % to 81.7 % in adults. In 2020–2022 deficient status was less common for all criteria: from 0.2 % to 51.2 % in children and from 0.1 % to 42.5 % in adults. An inverse relationship was noted for vitamin D levels associated with risk of harm. In 2017–2019 such values were detected in 1.0 %, in 2020–2022 in 2.8 % of children. In adults, similar rates increased from 1.8 % in 2017–2019 up to 3.5 % in 2020–2022. Conclusions. The wide variation in approaches reflects the uncertainty in research findings, recommendations, and guidelines involving vitamin D. Consensus on vitamin D thresholds will help arrive at the most likely conclusions from an evidence-based clinical perspective when establishing an association between a risk factor and an outcome.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"79 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432696","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-23-19-22
N. V. Bagisheva, M. V. Moiseeva, A. V. Mordyk, V. V. Streltsova, E. P. Antipova
The aim of the study. To determine the severity of the current COVID-19 in patients with CHF. Materials and methods. The study included data from 98 patients diagnosed with COVID-19 in combination with CHF. The data on the duration of hospitalization, the severity of the lesion, the dynamics of the level of laboratory parameters are analyzed. Results. In 68 patients with CHF 2A, stage I of CHF in 27 patients and in 3 patients – stage 0. CHF of functional class I – 23 patients, FC II – 73 patients, FC III – 2 patients. The average duration of hospitalization was 15 days. Blood saturation (SpO2) in the range of 95–100 % was determined in 75 patients, 90–95 % – in 20 people, less than 90 % – in 3 patients. In 42.86 % of patients, an increase in the level of D-dimer was detected according to laboratory studies. Conclusions. Patients 60 years and older with CHF 2A and FC II with pronounced clinical symptoms are at risk of severe infection requiring hospitalization. Concomitant diseases of the cardiovascular system increase the duration of hospitalization.
研究的目的。确定CHF患者当前COVID-19的严重程度。材料和方法。该研究包括来自98名被诊断为COVID-19合并CHF的患者的数据。对住院时间、病变严重程度、实验室参数动态水平等数据进行了分析。结果。在68例CHF 2A患者中，27例患者为I期CHF, 3例患者为0期。功能级CHF I - 23例，FC II - 73例，FC III - 2例。平均住院时间为15天。75例患者血饱和度(SpO2)在95 - 100%范围内，20例90 - 95%，3例低于90%。在42.86%的患者中，根据实验室研究检测到d -二聚体水平升高。结论。伴有明显临床症状的60岁及以上CHF 2A和FC II患者存在严重感染风险，需要住院治疗。心血管系统的伴随疾病增加了住院时间。
{"title":"Chronic heart failure patient and COVID-19: Focus on laboratory markers of myocardial damage","authors":"N. V. Bagisheva, M. V. Moiseeva, A. V. Mordyk, V. V. Streltsova, E. P. Antipova","doi":"10.33667/2078-5631-2023-23-19-22","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-23-19-22","url":null,"abstract":"The aim of the study. To determine the severity of the current COVID-19 in patients with CHF. Materials and methods. The study included data from 98 patients diagnosed with COVID-19 in combination with CHF. The data on the duration of hospitalization, the severity of the lesion, the dynamics of the level of laboratory parameters are analyzed. Results. In 68 patients with CHF 2A, stage I of CHF in 27 patients and in 3 patients – stage 0. CHF of functional class I – 23 patients, FC II – 73 patients, FC III – 2 patients. The average duration of hospitalization was 15 days. Blood saturation (SpO2) in the range of 95–100 % was determined in 75 patients, 90–95 % – in 20 people, less than 90 % – in 3 patients. In 42.86 % of patients, an increase in the level of D-dimer was detected according to laboratory studies. Conclusions. Patients 60 years and older with CHF 2A and FC II with pronounced clinical symptoms are at risk of severe infection requiring hospitalization. Concomitant diseases of the cardiovascular system increase the duration of hospitalization.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"70 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135433756","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-24-16-19
R. Yu. Mayorov, S. I. Surkichin
Onychomycosis is an infectious disease of the nail apparatus, caused by pathogenic fungi, manifested in the form of changes in color, configuration of the nail plate, as well as inflammatory processes in the soft tissues adjacent to the nail. Classic therapy in the form of systemic antimycotics is not suitable for everyone (for example, elderly patients with severe liver disorders or concomitant chronic diseases); itraconazole and terbinafine are not combined with a large number of drugs. Therefore, the use of auxiliary non-drug treatment methods becomes extremely important. This article discusses the method of podological treatment of nail plates, proving its effectiveness and safety.
{"title":"Podology issues: Optimization of onychomycosis therapy","authors":"R. Yu. Mayorov, S. I. Surkichin","doi":"10.33667/2078-5631-2023-24-16-19","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-16-19","url":null,"abstract":"Onychomycosis is an infectious disease of the nail apparatus, caused by pathogenic fungi, manifested in the form of changes in color, configuration of the nail plate, as well as inflammatory processes in the soft tissues adjacent to the nail. Classic therapy in the form of systemic antimycotics is not suitable for everyone (for example, elderly patients with severe liver disorders or concomitant chronic diseases); itraconazole and terbinafine are not combined with a large number of drugs. Therefore, the use of auxiliary non-drug treatment methods becomes extremely important. This article discusses the method of podological treatment of nail plates, proving its effectiveness and safety.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"121 21","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135541630","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-20-78-82
A. A. Bashtovoy, L. A. Mamedova
Initial caries corresponds to the ICD-10 code – K 02.0 «enamel caries, white (chalky) spot stage» or – K 02.3 «suspended caries» in the form of a pigmented spot on the teeth. If caries in the form of a white spot is not always easy to diagnose and patients rarely seek dental care, then suspended caries is visually detected quite easily, especially with dark pigmentation, which worries patients, so the number of visits to the dentist in this pathology increases dramatically. At the same time, it can be considered that the initial caries goes through several stages in its development, which are detected during external examination in the form of a white spot or light , brown and black spots.
{"title":"Features of initial forms of caries in adult patients. Literature review","authors":"A. A. Bashtovoy, L. A. Mamedova","doi":"10.33667/2078-5631-2023-20-78-82","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-20-78-82","url":null,"abstract":"Initial caries corresponds to the ICD-10 code – K 02.0 «enamel caries, white (chalky) spot stage» or – K 02.3 «suspended caries» in the form of a pigmented spot on the teeth. If caries in the form of a white spot is not always easy to diagnose and patients rarely seek dental care, then suspended caries is visually detected quite easily, especially with dark pigmentation, which worries patients, so the number of visits to the dentist in this pathology increases dramatically. At the same time, it can be considered that the initial caries goes through several stages in its development, which are detected during external examination in the form of a white spot or light , brown and black spots.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"7 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432454","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-24-10-16
E. A. Shatokhina, A. A. Lubivets, N. O. Pereverzina
Localized scleroderma (LoS) is an autoimmune connective tissue disease with a variety of clinical manifestations. The dermatologist faces the difficulties of establishing a diagnosis and choosing the most appropriate therapy due to the relatively rare prevalence. This review article explores the challenges of classification, diagnosis, and treatment, as well as the factors that contribute to their occurrence. The greatest difficulties in diagnosing LoS that affected the prognosis and progression of the illness are: a delay in diagnosis, including early detection; omission of the active stage of LoS; difficulties in differential diagnosis; lack of association with Lyme borreliosis; low diagnostic value of laboratory and histological tests; limited use of sensitive instrumental methods for diagnosis; and monitoring the activity of LoS in a doctor’s practice. The main difficulties in treatment are the delay in starting treatment; the use of therapy methods with low evidence-based effectiveness; the rare prescription of highly effective approaches; the insufficient effectiveness of systemic drugs and phototherapy; difficulties in determining the volume, timing, and regimen of therapy for each subtype of LoS; the difficulty of achieving a remission; dependence of treatment approach on the doctor’s specialization; the lack of targeted drugs with evidence-based effectiveness in LoS; the lack of high-level evidence-based effectiveness and safety of therapy in LoS; difficulties in the correction of complications of Lo S.
{"title":"Scleroderma: Difficulties in classification, diagnosis, treatment","authors":"E. A. Shatokhina, A. A. Lubivets, N. O. Pereverzina","doi":"10.33667/2078-5631-2023-24-10-16","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-10-16","url":null,"abstract":"Localized scleroderma (LoS) is an autoimmune connective tissue disease with a variety of clinical manifestations. The dermatologist faces the difficulties of establishing a diagnosis and choosing the most appropriate therapy due to the relatively rare prevalence. This review article explores the challenges of classification, diagnosis, and treatment, as well as the factors that contribute to their occurrence. The greatest difficulties in diagnosing LoS that affected the prognosis and progression of the illness are: a delay in diagnosis, including early detection; omission of the active stage of LoS; difficulties in differential diagnosis; lack of association with Lyme borreliosis; low diagnostic value of laboratory and histological tests; limited use of sensitive instrumental methods for diagnosis; and monitoring the activity of LoS in a doctor’s practice. The main difficulties in treatment are the delay in starting treatment; the use of therapy methods with low evidence-based effectiveness; the rare prescription of highly effective approaches; the insufficient effectiveness of systemic drugs and phototherapy; difficulties in determining the volume, timing, and regimen of therapy for each subtype of LoS; the difficulty of achieving a remission; dependence of treatment approach on the doctor’s specialization; the lack of targeted drugs with evidence-based effectiveness in LoS; the lack of high-level evidence-based effectiveness and safety of therapy in LoS; difficulties in the correction of complications of Lo S.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"121 19","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135541632","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-23-7-10
A. A. Novikov, E. N. Aleksandrova, G. E. Bajmakanova, G. V. Lukina, N. A. Bodunova, V. I. Vechorko, O. V. Averkov, S. N. Shcherbo, M. I. Savina, T. I. Turkina, I. E. Khatkov
Janus kinases inhibitors (JAKi) have an immunosuppressive effect due to the normalization of levels of proinflammatory cytokines, are used in the treatment of cytokine storm in COVID-19. This fact makes it necessary to search a predictor of an efficacy of this small-molecules. The aim of the study. To evaluate the possibility of using cytokines in predicting the efficacy of JAKi in COVID-19. Materials and methods. We examined 86 patients with COVID-19: 50 men and 36 women. The age was 57,0; (50,0–65,0) years. The SARS-CoV-2 presence was confirmed by PCR. The control group consisted of 30 healthy donors matched by sex and age. The criterion for the efficacy of JAKi was recovery, in efficacy – switching to another drug, or death. The serum concentration of IL-1β, –6, –8, –17, TNF-α and GM–CSF by ELISA was estimates using Invitrogen test-systems (USA), according to the manufacturer’s instructions. Results. In COVID-19 patients who received baricitinib (BTC), compared with healthy individuals, basal (before JAKi starting) IL-6, TNF-α serum concentrations were increased; tofacitinib (TFT) – IL-6, ruxilitinib (RLT) – IL-6 and TNF-α. A decrease of IL-1β and GM–CSF serum concentration was noted before the start of TFT and RLT. Basal concentrations of IL-6 and TNF-α are most statistically strongly associated with the diagnosis COVID-19. After 5 days of treatment with BTC, there was an increase in IL-8 level compared to the basal, a decrease in the GM–CSF concentration and a slight increase IL-6 concentration relative to healthy donors (p < 0.05 in all cases). Basal concentration of IL-17 (more than 13.9 pg/ml) indicated the possibility of successful RLT treatment (area under the ROC-curve = 0.99; AP = 99 %; DS = 80 %; OP+ = 5.0; OP– = 0.2; CI: 0.9–1.0). Conclusions. Basal serum concentration of cytokines may predict JAKi efficacy in COVID-19 patients.
{"title":"Cytokines in predicting JAK inhibitors clinical efficacy for COVID-19","authors":"A. A. Novikov, E. N. Aleksandrova, G. E. Bajmakanova, G. V. Lukina, N. A. Bodunova, V. I. Vechorko, O. V. Averkov, S. N. Shcherbo, M. I. Savina, T. I. Turkina, I. E. Khatkov","doi":"10.33667/2078-5631-2023-23-7-10","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-23-7-10","url":null,"abstract":"Janus kinases inhibitors (JAKi) have an immunosuppressive effect due to the normalization of levels of proinflammatory cytokines, are used in the treatment of cytokine storm in COVID-19. This fact makes it necessary to search a predictor of an efficacy of this small-molecules. The aim of the study. To evaluate the possibility of using cytokines in predicting the efficacy of JAKi in COVID-19. Materials and methods. We examined 86 patients with COVID-19: 50 men and 36 women. The age was 57,0; (50,0–65,0) years. The SARS-CoV-2 presence was confirmed by PCR. The control group consisted of 30 healthy donors matched by sex and age. The criterion for the efficacy of JAKi was recovery, in efficacy – switching to another drug, or death. The serum concentration of IL-1β, –6, –8, –17, TNF-α and GM–CSF by ELISA was estimates using Invitrogen test-systems (USA), according to the manufacturer’s instructions. Results. In COVID-19 patients who received baricitinib (BTC), compared with healthy individuals, basal (before JAKi starting) IL-6, TNF-α serum concentrations were increased; tofacitinib (TFT) – IL-6, ruxilitinib (RLT) – IL-6 and TNF-α. A decrease of IL-1β and GM–CSF serum concentration was noted before the start of TFT and RLT. Basal concentrations of IL-6 and TNF-α are most statistically strongly associated with the diagnosis COVID-19. After 5 days of treatment with BTC, there was an increase in IL-8 level compared to the basal, a decrease in the GM–CSF concentration and a slight increase IL-6 concentration relative to healthy donors (p < 0.05 in all cases). Basal concentration of IL-17 (more than 13.9 pg/ml) indicated the possibility of successful RLT treatment (area under the ROC-curve = 0.99; AP = 99 %; DS = 80 %; OP+ = 5.0; OP– = 0.2; CI: 0.9–1.0). Conclusions. Basal serum concentration of cytokines may predict JAKi efficacy in COVID-19 patients.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"78 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432578","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 : 2023-11-07DOI: 10.33667/2078-5631-2023-20-44-49
N. M. Khelminskaya, A. V. Posadskaya, V. I. Kravets, D. A. Eremin, A. A. Lapchenko, S. N. Kovalenko, A. V. Kravets, L. M. Vinokurova
Relevance. According to the conclusion of the European Federation of Periodontology, late complications of dental implantation include inflammation of the tissues in the reimplantation zone after the completion of osseointegration in the form of periimplantation mucositis and reimplantitis. According to many authors, in the first two months after dental implantation, in the case of initial insufficiency of soft tissue thickness in the operation area, when a minimum volume of biological width (3 mm on average) is formed, bone tissue loss is provoked, this property is especially pronounced when using lamellar dental implants. In the maxilla, overimplantation of a massive plate implant can lead to the development of inflammation of the paranasal sinuses. The most traditional options for mucosal augmentation in the area of implantation in the maxilla are grafting with local tissues or autotransplantation of a free flap from a donor site. Also used are resorbable collagen matrices (Resorbable Collagen Matrix – RCM) or membranes that protect the underlying tissues from external influences, completely close the surgical wound, prevent pathological scarring and allow you to control the epithelialization process. The purpose of the study. To increase the effectiveness of complex treatment of complicated reimplantitis in the maxilla, sinusoethmoiditis, by sanitation and the use of a collagen membrane for the combined closure of the oro-antral fistula. Material and methods. The article is devoted to the clinical case of complications of the use of a lamellar dental implant in the maxilla, diagnosis and treatment by an interdisciplinary surgical team of the City Clinical Hospital N.I. Pirogov of the Department of Healthcare of Moscow. A staged surgical intervention for the removal of a detailed laminar implant, unilateral ethmoidotomy and maxillary sinusectomy, and combined closure of the oro-antral communication with the use of local tissue plasty with a flap from the cheek and the installation of a collagen membrane are described. Results. To close a large bone defect in the area of the alveolar part of the maxilla, the bioPLATE Contur membrane was used, which is characterized by increased extensibility up to 50% of the original dimensions and elasticity. The mucoperiosteal flap was laid without tension over the collagen membrane and fixed with two-row interrupted sutures. The sutures were removed on the 14th postoperative day, the wound was epithelialized throughout, without signs of inflammation. Conclusions. Complications of dental implantation in the maxilla are manifested in the form of a loss of bone volume and a defect in the alveolar margin of the maxilla, the development of inflammatory complications of adjacent tissues and anatomical structures. This requires a multidisciplinary approach in diagnosis and surgical treatment with a comprehensive planning of patient rehabilitation. The use of a combined method of closing a bone defect with a collage
的相关性。根据欧洲牙周病联合会(European Federation of Periodontology)的结论，牙种植的后期并发症包括骨整合完成后再植区组织的炎症，表现为种植周粘膜炎和再植炎。根据许多作者的研究，在种植牙后的前两个月，在手术区软组织厚度最初不足的情况下，当形成最小生物宽度体积(平均3毫米)时，引起骨组织丢失，这一特性在使用板层种植牙时尤其明显。在上颌骨，大量钢板植入物的过度植入可导致鼻窦炎症的发展。上颌种植区粘膜增强最传统的方法是局部组织移植或自体供体游离皮瓣移植。可吸收胶原基质(可吸收胶原基质- RCM)或膜，保护底层组织免受外部影响，完全关闭手术伤口，防止病理性瘢痕形成，并允许您控制上皮化过程。研究的目的。目的:提高上颌复杂再植炎、鼻窦炎的综合治疗效果，采用卫生和胶原膜联合封闭口-窦瘘。材料和方法。这篇文章专门介绍了在上颌使用板层牙种植体的并发症的临床病例，由莫斯科保健部的nii Pirogov市临床医院的一个跨学科外科小组进行诊断和治疗。本文描述了分阶段的手术干预，包括去除详细的椎板植入物，单侧筛窦切开术和上颌窦切除术，并结合使用脸颊皮瓣和胶原膜的局部组织成形术关闭口-窦交通。结果。为了关闭上颌骨牙槽部分区域的大骨缺损，使用了生物板Contur膜，其特点是可扩展性增加到原始尺寸和弹性的50%。粘膜瓣在胶原膜上无张力放置，用两排间断缝线固定。术后第14天拆除缝合线，伤口完全上皮化，无炎症迹象。结论。上颌种植牙的并发症主要表现为上颌牙槽缘骨体积损失、缺损、邻近组织及解剖结构炎症并发症的发生。这需要多学科的方法在诊断和手术治疗与病人康复的综合规划。采用胶原可吸收膜与颊粘膜骨膜瓣联合双排缝线缝合的方法修复骨缺损，可达到术后满意的疗程，避免口-窦瘘复发，为患者进一步的牙科康复做好准备。
{"title":"Clinical case of treatment of complications of the use of plate dental implants on the maxilla","authors":"N. M. Khelminskaya, A. V. Posadskaya, V. I. Kravets, D. A. Eremin, A. A. Lapchenko, S. N. Kovalenko, A. V. Kravets, L. M. Vinokurova","doi":"10.33667/2078-5631-2023-20-44-49","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-20-44-49","url":null,"abstract":"Relevance. According to the conclusion of the European Federation of Periodontology, late complications of dental implantation include inflammation of the tissues in the reimplantation zone after the completion of osseointegration in the form of periimplantation mucositis and reimplantitis. According to many authors, in the first two months after dental implantation, in the case of initial insufficiency of soft tissue thickness in the operation area, when a minimum volume of biological width (3 mm on average) is formed, bone tissue loss is provoked, this property is especially pronounced when using lamellar dental implants. In the maxilla, overimplantation of a massive plate implant can lead to the development of inflammation of the paranasal sinuses. The most traditional options for mucosal augmentation in the area of implantation in the maxilla are grafting with local tissues or autotransplantation of a free flap from a donor site. Also used are resorbable collagen matrices (Resorbable Collagen Matrix – RCM) or membranes that protect the underlying tissues from external influences, completely close the surgical wound, prevent pathological scarring and allow you to control the epithelialization process. The purpose of the study. To increase the effectiveness of complex treatment of complicated reimplantitis in the maxilla, sinusoethmoiditis, by sanitation and the use of a collagen membrane for the combined closure of the oro-antral fistula. Material and methods. The article is devoted to the clinical case of complications of the use of a lamellar dental implant in the maxilla, diagnosis and treatment by an interdisciplinary surgical team of the City Clinical Hospital N.I. Pirogov of the Department of Healthcare of Moscow. A staged surgical intervention for the removal of a detailed laminar implant, unilateral ethmoidotomy and maxillary sinusectomy, and combined closure of the oro-antral communication with the use of local tissue plasty with a flap from the cheek and the installation of a collagen membrane are described. Results. To close a large bone defect in the area of the alveolar part of the maxilla, the bioPLATE Contur membrane was used, which is characterized by increased extensibility up to 50% of the original dimensions and elasticity. The mucoperiosteal flap was laid without tension over the collagen membrane and fixed with two-row interrupted sutures. The sutures were removed on the 14th postoperative day, the wound was epithelialized throughout, without signs of inflammation. Conclusions. Complications of dental implantation in the maxilla are manifested in the form of a loss of bone volume and a defect in the alveolar margin of the maxilla, the development of inflammatory complications of adjacent tissues and anatomical structures. This requires a multidisciplinary approach in diagnosis and surgical treatment with a comprehensive planning of patient rehabilitation. The use of a combined method of closing a bone defect with a collage","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"4 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432197","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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