Vol 20, No 3 (2023)

The article presents the methods and their options of telemedicine and remote electrocardiographic (ECG) monitoring. The purpose of the work is to acquaint general practitioners, functional diagnostics physicians and healthcare organizers with the prospects and possible difficulties in introducing digital technologies into everyday practice. The state of the problem today in the world and in our country is shown. The review is made in two parts. In the first part, general methods of remote monitoring of indicators of the human body are described. In the second part, the remote transmission of the cardiogram, the possibilities and prospects of remote ECG monitoring are presented.

The purpose of this article is to give a brief overview of the manifestations in the oral cavity of systemic diseases in patients, such as diabetes mellitus, cirrhosis of the liver, peptic ulcer of the stomach and duodenum, iron deficiency anemia, based on domestic and foreign literature data for the last 10 years. The review will focus on diseases affecting the oral mucosa and salivary glands, since these tissues are of the greatest interest to practicing dentists of all profiles. Pathological processes that occur in the human body due to systemic diseases are often manifested through changes in the mucous membrane or organs of the oral cavity and in most cases are the first clinical signs of metabolic disorders, especially in diseases of the digestive, endocrine, hematopoietic systems. The degree of manifestation of somatic pathologies in the oral cavity is directly dependent on the severity of the disease, since the physiological processes in the body acquire a pathological character. This article will be useful for practicing dentists of all specialties, for the formation of clinical thinking.

Non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of ventricular arrhythmias and cardiac conduction disorders, especially in patients with type 2 diabetes mellitus (DM2). The association between NAFLD and an increased risk of atrial fibrillation (AF) does not depend on common cardiometabolic risk factors and traditional AF risk factors. Structural, electrical and vegetative remodeling of the heart, characteristic of NAFLD, is a potential cause of its arrhythmogenic damage.

The aim of the work was to identify factors of genetic and phenotypic conditionality of a person^’s propensity for risky behavior. The study involved 300 people, men and women aged 18–25, residents of 6 regions of the Russian Federation. Psychological status of the study participants by evaluating the indicators of the Freiburg multifactorial personality questionnaire, character accentuations, suggestibility, frustration, irritability and resentment, adventurousness, behavior and social activity. The functional status was assessed by the level of general non-specific reactivity of the organism. Genetic research was carried out by PCR. Investigate the genotypes of polymorphisms rs6923492 (GRM1), rs6280 (DRD3), rs1851048 (CACNA2D3), rs2562456 (ZNF). As a result of the study, the systematic organization of genetic and phenotypic mechanisms for the formation of a person’s propensity for risky behavior is substantiated. As a result of the performed studies, the systematic organization of genetic and phenotypic mechanisms of the individual formation of a person’s propensity for risky behavior is substantiated. The predisposition to risk behavior in men and women is due to the SNP rs1851048 (CACNA2D3), as well as increased levels of irritability, neuroticism, reactive aggressiveness, emotional lability, resentment, and the severity of cardiotype A.

The results of 269 cases of performing of cataract phacoemulsification with IOL implantation (PHACO) and microinvasive nonpenetrating deep sclerectomy (MNPDS) at various stages have been analyzed. The main group included patients who underwent PHACO, followed by MNPDS – 64 persons, 65 eyes. The group was divided into a subgroup based on the date of the second intervention. 1 subgroup – patients who underwent MNPDS 1 month after PHACO (30 cases); 2 subgroup – 3 months after PHACO (35 cases). The control group included patients who underwent MNPDS followed by PHACO – 196 persons, 204 eyes. Patients of the main group showed a significant decrease in intraocular pressure after each stage of treatment. in the control group, intraocular pressure decreased after the first stage of treatment, but increased 6 months after surgery. In primary open-angle glaucoma associated with cataract, the most persistent hypotensive effect is observed when the first stage of cataract phacoemulsification is performed, and the second stage is antiglaucoma surgical intervention.

The experiment was carried out on 6 isolated donor (cadaver) eyes, penetrating keratoplasty was performed with intrastromal ring implantation according to the proposed method.When modeling the technology we proposed, we obtained patterns identical to those given, we observed a complete cut of the cornea without the formation of tissue bridges and adhesions. The developed new femtosecond laser cutting patterns made it possible to implant the intrastromal ring into the residual corneal stroma of the recipient without the need for additional fixation.

In modern plastic surgery of soft tissues of the oral cavity, there is a wide variety of ways to close recessions of the gingival margin and increase the keratinized gum zone, but only a few of them give a well-predicted and effective result. So, one of the most popular techniques is the tunneling technique using a de-epithelized free gingival graft. The prevalence of this method is primarily due to its minimally invasive nature, which allows for accelerated regeneration of the gingival margin and reduces the likelihood of postoperative complications. The analysis of 20 clinical cases of closure of recessions of the gingival margin of the teeth on the upper and lower jaws according to the Miller classification of class I and II, subclasses A and B and the Francesco Cairo classification – type 1 and type 2 with the use of tunnel technology according to Zuhr. The high efficiency of this method of closing recessions has been revealed, including in terms of achieving an optimal long-term forecast and aesthetic result.

Literature data and own observations indicate that the risk of periodontal complications at various stages of dental prosthetics is associated with the clinical and functional state of the periodontal complex. After basic therapy in patients with chronic generalized periodontitis (CGP), an analysis of the clinical and morphofunctional state of the periodontium was performed. Cell differentiation index (CDI) and inflammatory-destructive (VDI) index, as well as the degree of microbial contamination (CIGP) were determined. The clinical condition of the periodontium of patients was assessed using periodontal and hygienic indices. The results of monitoring (3, 7, 14 and 21 days after surgical debridement of periodontal pockets) showed that the relief of the inflammatory process in the periodontium is observed as early as 14 days, according to the PMA – 10,3 ± 1,2 index (p₂ < 0,05). The data of a cytological study of smears-imprints of the marginal epithelium of the periodontium indicate that the stabilization of inflammation and the reparative process in the integumentary epithelium becomes pronounced after 14 days, and the values of CDI (630,6 ± 1,1) and VDI (3,5 ± 1,2) reach the limits of the norm only by 21 days after curettage of periodontal pocket. Thus, in order to minimize the risk of periodontal complications, when planning the timing and scope of prosthodontic treatment for patients with CGP, it is recommended to use, among other things, a cytomorphological method that reflects an objective picture of the periodontal condition

A special place is given to the priority areas in pediatrics to improve the basics of medical supervision of patients with recurrent bronchopulmonary pathology, in particular recurrent bronchitis. Among the reasons that often determine the onset of the disease, its subsequent course, and sometimes the outcome, an important role is given to infection, including herpesvirus.

Background: The operation of ligation of the fistulous tract in the intersphincter space (LIFT) is widely used in the world for transsphincter pararectal fistulas (TSPF). However, the frequency of fistula recurrence still cannot satisfy coloproctologists and dictates the need to modify the LIFT operation method in order to increase its reliability and safety.

The aim: To present the modified LIFT technique and the results of its clinical application in the treatment of TSPF.

Materials and methods: The LIFT operation modified by us (RF Patent No. 2686949) was performed in 40 patients with TSPF. The outcomes of the operation were evaluated according to the frequency of complications and recurrences of the fistula.

Results: A distinctive feature of the developed modification of the LIFT operation method is the maximum elimination of the possibility of developing a "complete" recurrence of the fistula, since even if the bandaged and removed through the skin incision in the projection of the intersphincteric groove of the proximal stump of the fistulous tract, only a "small" recurrence can form, which is not dangerous and easy eliminate. All 40 patients did not have "complete" relapses within 9 to 18 months; "Small" recurrences in the posterior localization of fistulas developed in 2 (5 %) patients, in whom the fistula was dissected into the lumen of the rectum at the second stage, recovery occurred.

Conclusions: The modification of the LIFT operation method proposed by us is a reproducible, accessible to coloproctologists, a safe and effective method of operation. Having a sphincter-preserving character character, the modified LIFT method makes it possible to avoid a "complete" recurrence of a fistula with a high probability, and with a low frequency of a "small" recurrence of a fistula, it makes it possible to safely eliminate a "small" recurrence of a fistula at the second stage, even on an outpatient clinic.

The effect of 30-day dark deprivation (light-dark cycle 24/0 h, artificial illumination 300 Lux) and 14-day correction with melatonin on the endometrium of the uterus was studied in an experiment on mongrel females of 4 months of age. It was found that 30-day dark deprivation leads to hyperplastic processes of the endometrium: an increase in the number of uterine glands (by 18.9 % p < 0.05), thickening of the endometrium (by 12.5 %, p < 0.05). Morphometric characteristics of the endometrium: single-layer columnar epithelium of the endometrium and uterine glands were corrected by administration of exogenous melatonin for 14 days.

Objective: to study the prevalence of vitamin D level disorders in therapeutic patients and the features of their correction.

Materials and methods: 322 patients who applied for medical help in the field of therapy (rheumatology and cardiology) were examined. Methods: clinical, laboratory (study of the level of vitamin D in the blood), statistical.

Results: it was found that among patients with a therapeutic profile, vitamin D concentration disorders (deficiency and insufficiency) occur in 72,7 % of the surveyed. There is a high prevalence of risk factors for osteoporosis in the examined patients: female sex prevails (81 %), age – average age was (53,6 ± 14,3) years, drug use (50 % take proton pump inhibitors, 21,4 % take glucocorticoids). When comparing the proportion of people with impaired vitamin D levels in comparison with the data of previous years, there was a decrease in the proportion of people with vitamin D deficiency and an increase in the proportion of people with vitamin D deficiency. Among people with a vitamin D level of 30–100 ng/ml, daily use of vitamin D preparations in dosages exceeding the recommended consumption levels was noted.

Conclusion: based on the data obtained, the prevalence of vitamin D deficiency and insufficiency remains high. However, recently there has been a trend towards a decrease in the proportion of people with vitamin D deficiency and an increase in the proportion of people with vitamin D deficiency. In this connection, it is necessary to inform the population about the recommended adequate levels of vitamin D in blood serum and safe dosages of vitamin D preparations for daily intake.

The article presents the results of studies of structural changes in the lungs that occur during inhalation exposure to lead phthalate in an experiment on rats. The identified morphological disorders lead to the development of chronic inflammatory processes and indicate the toxicity, fibrinogenicity of lead phthalate and its ability to cause allergization of the body.

Objective: conduct a comparative study of methods for the modernization of mesh prostheses as a matrix for the cultivation of fibroblasts.

Materials and methods: In the experiment conditions, polycaprolactone substance was applied to the surface of mesh hernioendoprostheses according to the original method proposed by V.V. Bereshchenko and a team of co-authors (2019). The polyvinylidene fluoride "Uniflex Standard" prosthesis (Lintex LLC, St. Petersburg, Russia) was chosen as the object of study. After applying the polymer, low-temperature plasma treatment was performed with the characteristics: frequency – 5 kHz, pulse voltage – 10 kV, power density – 2 W/cm², exposure time – 5 minutes. After that, the samples were sterilized using X-ray radiation with a power of 150 kV and an exposure of 3 min. The application of cells was carried out by introducing samples into a DMEM medium with fibroblast culture for 5 days. The obtained samples were studied using scanning electron microscopy. Statistical processing was performed using the nonparametric Mann-Whitney test in the Statistica 10 program (Dell Software Company, Round Rock, Texas, United States of America).

Results: The data obtained indicate the successful attachment of fibroblasts to the surface of modified hernioprostheses.

The article is devoted to an urgent problem – the study of the epidemic manifestations of the new coronavirus infection COVID-19 during the fourth wave of the rise in the incidence, which began in January 2022 in the Volgograd region.

Materials and methods: We used the official statistical data of the Office of Rospotrebnadzor for the Volgograd Region on the incidence of COVID-19 and the results of SARS-CoV-2 genomic RNA sequencing. The main research method is epidemiological analysis. We analyzed the period from the beginning of the next increase in the incidence, coinciding with the almost complete replacement of other variants of SARS-CoV-2 by “omicron” (since January 16, 2022), until the decrease and stabilization of the incidence rates on March 30, 2022. Comparison of the epidemiological process indicators was carried out with the period before the appearance of the omicron genovariant (as of December 30, 2021).

Results and discussion: Since mid-January 2022, there has been a sharp rise in the incidence of COVID-19 in the region up to 2,222 cases per day by mid-February and a subsequent decrease in incidence rates by the end of March. It has been established that the next wave of coronavirus infection is associated both with an increase in interpersonal contacts on holidays and the subsequent introduction of the infection into work and educational teams, and with the change of the SARS-CoV-2 genovariant to “omicron”. During 2.5 months of the fourth wave, 76,717 people fell ill with coronavirus, which is 36.6 % of the total number of cases registered over the entire observation period. Moreover, the proportion of cases in the age category up to 18 years has significantly increased (by 13.1 %). During the analyzed period, the proportion of cases with a mild course increased by 18.3 % (up to 88.6 %), and the percentage of cases of moderate severity decreased by 10.1% (up to 10.5 %), a severe course decreased by 4.1% (to 0.7 %), asymptomatic also decreased by 4.06 % and accounted for 0.14 % of the total number of detected cases of COVID-19. The share of pneumonia in the total morbidity for 2.5 months decreased by 16.8 % (to 1.6 %). In most cases, the treatment took place on an outpatient basis. The percentage of patients requiring hospitalization decreased to 18.5 %. There is a downward trend in the mortality rate from 4.3 % before the rise in incidence to 3.2 % as of March 30, 2022.

Conclusions: In the Volgograd region, from January 14, 2022, another rise in the incidence of COVID-19 was registered with the maximum indicators for the entire observation period in February. The omicron genovariant, which has become dominant, has a higher contagiousness and is actively spreading in children’s groups. The disease is characterized by a milder clinical course in the form of acute respiratory viral infections, bronchitis, and a decrease in the proportion of deaths.

When examining patients in clinical dental practice, especially in cases of total occlusion reconstruction, the most important thing is to diagnose the condition of human masticatory muscles, in particular, to determine their bioelectric activity and contraction strength. The accuracy of the diagnosis depends on the correctness of the diagnosis and subsequent treatment. After analyzing the diagnostic devices used to study the condition of human masticatory muscles, we found out that today there are no those that can provide comprehensive diagnostic procedures. Therefore, we have developed an author’s device that can be used for gnathodynamometry and electromyography of human masticatory muscles, as well as training with BOS therapy. In this work, a large-scale study of diagnostic devices was conducted, followed by a survey of 100 relatively healthy volunteers aged 18–35 years. The effectiveness of diagnostic devices was determined clinically and statistically. According to the results of the study, the following data were obtained: the highest number of points was scored by the "EMG-BOS AND GDM-BOS, EMG AND GDM APPARATUS" developed by us – 85.83 points. The adaptive electromyograph "Synapsis" scored less – 82.24 points, and the electronic gnathodynamometer "Vizir-E1000" (Russia) – only 79.47 points.

A clinical case of long-term treatment and observation of a patient with a diagnosis of «Wilson – Konovalov’s disease» is presented. This rare hereditary disease belongs to storage diseases and is associated with impaired copper metabolism. The article considers the course of the disease, analyzes the data of laboratory and instrumental studies conducted on the patient in various clinics. It is emphasized that during 25 years of dynamic observation and treatment, it is possible to prevent the development of liver cirrhosis in the patient.