Vol 31, No 5 (2020)

Puncture vertebroplasty is one of the common treatments in patients with spinal diseases of various origins. The paper details general recommendations for puncture vertebroplasty and depicts its procedure. It also presents the biomechanical characteristics of one of the commonly used bone cements, such as polymethyl methacrylate. Indications for and contraindications to vertebroplasty and its complications are described. Particular attention is paid to the use of this technique for vertebral hemangiomas, metastatic lesion, and osteoporosis.

Objective: to evaluate the reproductive system of women with rheumatoid arthritis (RA). Subjects and methods. Examinations were made in 27 women aged 37.65±8.76 years with RA and its duration of 7.01±4.23 years. A control group consisted of 21 apparently healthy women aged 36.8±8.3 years. Enzyme immunoassay was used in all to measure the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), total testosterone, cortisol, free thyroxine, thyroid stimulating hormone (TSH) and anti-thyroid peroxidase antibodies. Pelvic ultrasonography and ovarian artery blood flow Doppler sonography were performed. Results. Menstrual irregularities were present in 14 (51.85%) women with RA. Hypomenstrual syndrome was most frequently diagnosed. The average age of menopause onset was 36.54±1.09 years in patients with RA. The endocrine factor (66.66%) prevailed in the structure of the causes of infertility. The level of LH, FSH, E2, PRL, and TSH was statistically significantly higher in women with RA than in controls. Pelvic ultrasonography and ovarian artery blood flow Doppler sonography revealed a significant decline in the number of antral follicles and an increase in the resistance index and systolic/diastolic ratio in the patients with RA compared with the controls. RA disease activity parameters were directly correlated with the level of E2, PRL, and TSH, whereas the clinical stage was with the level of FSH. There was an inverse correlation of the volume of the ovaries and the number of antral follicles with the clinical stage of RA. Thus, the parameters of reproductive function in the women with RA differ from those in the healthy population. This confirms the concept of the impact of the hormonal background on the course of autoimmune processes, while it is not inconceivable that RA makes a considerable contribution to the development of endocrine disorders, inter alia, by affecting the indicators of reproductive function.

In the period of global digitalization of medicine, one of the promising areas is the organization of population screening with artificial intelligence (AI), above all, for socially significant diseases. In our country, these are annual fluorographic examinations for tuberculosis. The transition to digital fluorography has already predetermined positive trends in a systematic approach to the timely detection of tuberculosis. The prospects for further improvement of screening for tuberculosis are determined primarily by the need for a systematic approach to routine repetitive studies, which involves the use of AI to recognize the disease, to select and form groups for further examination by a medical specialist. Whether this is possible in the near future and how the creation of AI is going on is discussed in this review.

Aim. To develop a model by machine learning to predict the risk of cardiovascular diseases (CVD) and validate the model using Russian medical data. Materials and methods. The data set was obtained from the Framingham study, consisting of 4,363 patients without CVD, 852 (19.5%) of which died of myocardial infarction and stroke within 10 years of observation. Incoming model features: gender, age, systolic blood pressure, cholesterol, smoking, body mass index, heart rate. The original data set was divided into 2 parts: the training data set (80% of the records) and the validate data set (the remaining 20%). Additionally, the model was evaluated by an external data set included 411 depersonalized patient data from the Russian citizens. Results. The WML.CVD.Score model was created by the serial neural network with one input, two hidden and one output layer. Accuracy results on a training dataset: Accuracy 81.15%, AUC 0.80. The same indicators on the validate data set were: Accuracy 81.1%, AUC 0.76. Test results for the test data set: Accuracy 79.07, AUC 0.86. On the Russian test data, the AUC for the SCORE scale was 0.81 versus 0.86 for the developed model, which showed the validity of the use of machine learning in order to increase the predictive model. Conclusion. The developed model has demonstrated high accuracy to CVD predicting in both internal and external validation. The model can be used in medical practice for patients in Russia.

В приведенном клиническом наблюдении диагноз рака правых отделов ободочной кишки пациенту можно было поставить своевременно, но в силу ряда неясных причин окончательный диагноз был установлен значительно позднее.

The paper demonstrates a new low-traumatic method to prevent post-pneumonectomic mediastinal lung herniation - anterior mediastinal plastic surgery using own tissues, which is performed simultaneously with pneumonectomy in patients with advanced pulmonary tuberculosis.

The paper presents the results of a study on the use of the calcium-containing medication Osteomed Forte to improve the regenerative capacity of bone tissue in diaphyseal tubular bone fractures.

It has been established to date, that we can counteract the COVID-19 pandemic, by expanding preventive measures and starting to use two widely available drugs. In addition to the WHO’s social protective factors against COVID-19 (to enhance prevention and to improve treatment in infected patients, by reducing a viral load), there may be the following measures: • daily 60-second oropharyngeal rinsing with a 0.5-1% hydrogen peroxide solution (do not swallow); after 10 minutes, oropharyngeal washing with warm water (this is not recommended for children younger than 16 years); • daily 4-fold oropharyngeal rinsing and nasopharyngeal washing with a 0.23% povidone-iodine solution for 15 seconds (do not swallow). The coronavirus in the oropharynx and nasopharynx can be inactivated using 2 readily available agents (hydrogen peroxide and povidone-iodine). These measures are recommended for medical personnel and people who are in lockdown or quarantine, are infected at an early stage, and have had close contact with patients with COVID-19. These are not recommended for severely ill patients who have already developed pulmonary manifestations.

By mixing with oral fluid, balms have an effect on its physicochemical properties, which affects the health of teeth and gums. Objectlve. To evaluate the effect of balms containing peptides on some physicochemical parameters of mixed saliva. Materlal and methods. At the beginning of the investigation, the authors studied the physicochemical properties of the solutions of 3 peptide-containing rinses for the prevention of inflammatory processes; the solutions had a remineralizing effect and were used for emergency care in case of acute inflammation. At Stage 2 of the investigation, the authors explored the physicochemical properties of mixed saliva from the students of the Faculty of Dentistry, Ural State Medical University (Yekaterinburg), before and after application of balms. Results. The solutions of the test balms have a weak acid medium, which creates unfavorable conditions for the reproduction of the most common oral bacteria. The acid buffer capacity of all the balms is about 2 times the base buffer capacity. The low surface tension values of rinse solutions suggest that the latter contain surfactants that provide cleaning and antibacterial effects. The osmolality values of the balms are 10 times higher than those of mixed saliva, which reduces edemas in case of inflammation. The balm that is used as a prophylactic agent was shown to result in a slight change in salivary pH within an hour after application. All the test balms are able to reduce the surface tension of saliva and increase its buffering properties, especially against acids, which is one of the main factors for the resistance of tooth enamel to caries. Concluslon. The test balms/rinses generally have a beneficial effect on the physicochemical parameters of mixed saliva, which ensures their efficacy.

Purpose. To assess the link between p-defensin-2concentration in breastmilk with the severity of AD in its debut in infants and young children. Materlals and methods. 25 samples of breastmilk were analyzed. 2 groups were selected. The first group included 14 samples from mothers whose children got AD in the last 6 months: mild AD and moderate AD. Analysis of breastmilk samples by the enzyme-linked immunosorbent assay was conducted to find the p-defensin-2 concentration. ELISA Kit for p-Defensin-2 (DEFb2) was used. Results and dlscusslon. We have showed that in the breastmilk of healthy children mothers a background level of the p-defensin 2 is detected (209,6 pg/ml). In the case of mild AD the concentration of p-defensin 2 was lower (HBD-2 -166,3 pg/ml. In breastmilk of mothers whose children had moderate AD the level of p-defensin-2 concentration was significantly lower than in the first group (HBD-2 - 71,2 pg/ml). Thus we can make a conclusion that the decrease of the p-defensin-2 concentration in the breastmilk can be one of prognostic criteria of more severe AD in infants and young children.