Vol 18, No 4 (2021)

Imbalance of hormones in a woman's body provokes a number of disorders of the body's functions, which affects her emotional and physical well-being. Purpose - to study the current state of the problem of changes in the musculo-ligamentous apparatus in pregnant women against the background of changes in their hormonal status. Material and methods. A systematic analysis of the main hormonal changes occurring in a woman's body during childbearing, and the results of research by Russian and foreign experts in this area. Results and discussion. It has been established that to date, in Russian and foreign practice, the number of studies that show the correlation between changes in the hormonal background of a pregnant woman and her musculo-ligamentous apparatus is still insignificant and is extremely fragmented. Conclusion. It is concluded that it is necessary to expand the boundaries of experimental studies and conduct a detailed analysis of clinical cases of the onset and exacerbation of musculo-ligamentous pathologies in a situation of a change in the hormonal status of a woman against the background of her pregnancy.

One of the main problems in fixing non-removable orthopedic structures (crowns and bridges) is a violation of the odontopreparation technique. For a strong and reliable fixation of non-removable orthopedic structures, special requirements must be imposed on them in terms of the shape and surface of the support of the processed tooth. These requirements include: parallelism of the walls of the prepared tooth (must be cylindrical); parallelism of the vertical walls of several prepared teeth included in the bridge; smooth continuous gingival ledge [1, 2]. The parallel vertical walls of the prepared teeth provide the most reliable fixation of the prosthetic structure. The parallel walls of adjacent teeth ensure a secure anchoring of bridges. A smooth continuous gingival ridge of the correct shape ensures the tightness of the crown and excludes the penetration of infection between the crown and the tooth. When these three conditions are met in practice, you can be sure that this orthopedic design has the same route of introduction. Based on the analysis of literature data, it should be concluded that the development of odontopreparation methods in order to form the optimal supragingival part of the tooth for further prosthetics is an urgent problem. The development and clinical implementation of dental navigation technologies contribute to the development of methods for monitoring odontopreparations in orthopedic dentistry. The purpose of this article was to analyze the existing methods of odontopreparation and identify the most effective ones among them.

Study objective. The researching of COVID-19 epidemic process features in the Volgograd region during 2020-2021. Materials and methods. The analvsis based on statistical data from the Office of Rospotrebnadzor in the Volgograd Region on the incidence of COVID-19 was carried out. The main research method is epidemiological analysis. Results and discussion. For the period from March 24, 2020 to September 6, 2021, 83 814 cases of SARS-Cov-2 infection were registered in the Volgograd Region, the incidence rate was 3 344.76 per 100 000 population (95 % CI: 3 321,97-3 367,55), case fatality rate - 2,77 %. In the development dynamics of COVID-19 epidemic process in the Volgograd region, three seasonal incidence increases are identified: April - June 2020 (relatively low), September 2020 - February 2021 (high), June 2021 - present (the highest). It is shown that the third rise in the incidence rate is caused by the combined effect of a number of factors - the intensification of seasonal migration, the spread of a new genetic variant of the pathogen ("delta" genovariant, B.1.617.2) and low vaccination coverage of the population. An excess of the regional average incidence rate (3 344,76) was established in 13 districts of the region, the most affected territories are Volgograd (40,3 % of the total number of cases), Volzhsky (15,7 %) and Kamyshinsky district (6,1 %). The distribution of cases by sex revealed the predominance of women (60,3 %) in all age groups, with the exception of 0-18 years old and 70 years and older. The greatest contribution to the incidence of COVID-19 over the entire observation period is made by the age groups 50-59 years (17,7 %) and 60-69 years (17,4 %). During the third wave of incidence, active involvement of the 0-18 age group in the epidemic process and a decrease in the proportion of people 60 and older were established. The clinical picture of the disease is characterized by the prevalence of the mild course of the disease (64,4 %), there is a tendency for the reduction of moderate and asymptomatic forms.

In order to investigate the role of prenatal sufficiency of 25-hydroxyvitamin D3 (25(OH)D3) in the postnatal development of infants, a dynamic assessment of physical (PD) and neuropsychic development (NPD) was carried out in comparison with the level of 25(OH)D3 in umbilical cord blood in newborns, upon reaching 40 weeks of post-conceptual age (PCA); at 3, 6 and 12 months of corrected age (CA). Materials and Methods: A prospective observational study of 118 children born between 24 and 41 weeks of gestational age was carried out, of which 52 were premature (group 1) and 66 were term infants (group 2). Evaluation of 25(OH)D3 level in cord blood serum was carried out. using an immunochemical analyzer UniCel DxI600 Beckmancoulter, USA. To assess PD indicators (body weight, height, head circumference), the Intergrowth-21st nonparametric method was selected using an online postnatal growth calculator. NPD was assessed according to the CAT/CLAMS and Zhurba -Mastyukova's scales. Comparing the developmental age with the actual age, the developmental coefficient was calculated as a percentage, the value of which >75 % indicated that the NPD corresponded to the actual or corrected age of the child. Research results and discussion: The median of the 25(OH)D3 indicator in the 1st group was 17,63 ng/l, 95 % CI / Q1-Q3: 10,07-21,39; in group 2 - 23,76 ng/l, 95 % CI / Q1-Q3: 17,2-39,34 (p < 0,001). Severe deficiency of 25(OH)D3 (below 10 ng/ml) was observed more often in premature infants (25 %) and only in 9,1% of term infants (p = 0,03). A direct statistical dependence of the growth rates in both full-term and premature infants in compare of 25(OH)D3 in cord blood after they reach 12 months of CA (p = 0,049, p = 0,036, respectively) was proved. In the group of premature infants a statistically significant relationship between speech developmental disorders (coefficient of speech development CAT/CLAMS <75 %) and low 25(OH)D3 status in umbilical cord blood was found (p = 0,034). The threshold value of 25(OH)D3 in umbilical cord blood at the cut-off point, which corresponded to the highest value of the Youden index, was 15,33 ng/ml. When the value of 25(OH)D3 in the umbilical cord blood was higher or equal to this value, the gradation of the speech development coefficient was predicted to be >75 % in compare of the age norm. The sensitivity and specificity of the method were 75,3 and 55 %, respectively. Conclusions: In order to produce preventive measures it is necessary to continue further study of low vitamin D prenatal supply influence on PD and NPD in the near and long-term prognosis in children.

Today a study aimed at the role of various neurotrophic factors in the implementation of a stress response and their influence on the functioning of the central and peripheral nervous system is of particular interest. Nerve growth factor (NGF) which belongs to a special group of polypeptide regulators has the most expressed neurospecificity. It has been established that this factor has a neuroprotective effect which is realized due to its ability to induce the induction of antiapoptotic proteins and inhibition of proapoptotic ones, thereby affecting the survival rate, as well as the differentiation of individual populations of peripheral neurons. Currently neuropeptide drugs with a wide spectrum of biological activity are considered as the leading stress protectors. Glyproline neuropeptides with proven versatile pharmacological activity, namely neuroprotective, anti-inflammatory, regenerative, immunotropic, etc., attract particular attention. Objective: to study the effect of glyprolines on the level of nerve growth (NGF) in the blood serum of white rats under conditions of "social" stress. Materials and methods. The study was carried out on 90 white non-linear male rats for 6 months. The experimental model of "social" stress was formed as a result of sensory contact for 20 days, followed by the formation of aggressive and submissive types of behavior. Glyproline compounds Thr-Lys-Pro-Arg-Pro-Gly-Pro (Selank), Pro-Gly-Pro and Pro-Gly-Pro-Leu were injected intraperitoneally at a dose of 100 pg/kg/day from the 1st day of stress exposure by the course 20 days. The level of NGF in the blood serum of white rats was assessed by the enzyme-linked immunosorbent assay using an ELISA Kit for NGF (USA). Results. Exposure to "social stress" led to a decrease in the level of nerve growth factor which probably has a cause-and-effect relationship with a decrease in neurogenetic processes. The observed restoration of the NGF level under the influence of glyprolines Thr-Lys-Pro-Arg-Pro-Gly-Pro (Selank), Pro-Gly-Pro and Pro-Gly-Pro-Leu indicates their stress and neuroprotective activity.

Cataract surgery is one of the most frequently performed ophthalmic surgical interventions. Cataract extraction technologies are being improved every year. The methods differ in technical features and implantable intraocular lenses. The choosing of the treatment method also depends on many factors. This paper analyzes the patient's choice of treatment method from the point of view of the "Theory of Generations", developed in 1991 by economist N. Howe and historian V. Strauss, based on retrospective material. The study showed that according to this classification, representatives of Generation X and "baby boomers" choose high-tech interventions more often than others.

In the context of the coronavirus infection (COVID-19) pandemic, there is an acute problem of timely provision of high-quality medical care to the population, which determines the relevance of the introduction of telemedicine technologies in dentistry. Telemedicine technologies in the mode of delayed consultations were carried out for 6 months in the treatment of 15 patients with diseases of the oral mucosa in the «doctor-doctor» segment. As a result of the remote consultations, confirmation of the diagnosis and the prescribed treatment was obtained in 14 clinical cases (94%), in one case one of the methods of laboratory examination was recommended. The advantages of telemedicine technologies were identified: availability, cost-effectiveness, the possibility of developing a comprehensive plan for examining and treating a patient as a result of the interaction of doctors.

Aim: to study the relationship between the severity of visceral obesity and the condition of the main arteries in patients with chronic heart failure (CHF) with obesity. Materials and methods. 116 patients with CHF of stage I -IIA of functional class I -III (FC) aged 40 to 65 years were included. All patients were divided into 3 comparable groups: group 1 included patients with CHF with normal body weight (n = 34), group 2 - overweight CHF (n = 40), group 3 - CHF and 1 - 2 degree obesity (n = 42). There were no differences in severity, CHF FC and NT-proBNP levels between the study groups. A clinical examination was performed, indicators of visceral obesity and adipokine status were evaluated. Arterial stiffness was assessed by measuring the pulse wave propagation velocity (CWPV) through the vessels of muscular (CWPVm) and elastic (CWPVe) types. Results. A high percentage of visceral obesity was found: 17.6 % among people with normal BMI, 70 % among overweight people and 100 % among obese people. A statistically significant increase in CWPVe was found in patients with CHF and obesity in comparison with patients with CHF and normal body weight (10,5 [8,9; 11,6] vs 8,5 [7,5; 8,4] m/s). CWPVe > 10 m/s was significantly more common among overweight or obese patients compared to patients with normal body weight (62,4 and 83,2 % vs 37,5 %, respectively). There was a significant decrease in the concentration of adiponectin and an increase in the level of leptin from group 1 to group 3. The correlation analysis showed the presence of reliable relationships between the parameters characterizing the elasticity of the vascular wall and the severity of visceral obesity, as well as laboratory markers of obesity. Conclusion. The data obtained indicate a negative effect of visceral obesity, hyperleptinemia and hypoadiponectinemia on the condition of the main arteries in patients with CHF.

Changes in the state of the body's regulatory systems by the parameters of cutaneous conductivity and heart rate variability in a healthy adult under the influence of speleoclimatotherapy have been studied. It was revealed that the change in the activity of the body's regulatory systems in terms of the parameters of cutaneous conductivity and heart rate variability in an adult healthy person under the influence of speleoclimatotherapy depends on the sex of the subjects. In girls and boys, different mechanisms of the response of the regulatory systems of the body to the action of air ions are observed. At the same time, in both boys and girls, the central mechanisms of regulation do not participate in response to the speleoclimatic effect, the mechanism of action is determined by the work of internal physiological systems (intrasystem mechanisms) and the autonomic nervous system.

Injuries to the anterior cruciate ligament of the knee joint, while remaining one of its most common types of injury, cause restriction of physical activity in people leading an active lifestyle, due to the occurrence of biomechanical disorders. The generally accepted approach of surgical correction is aimed at replacing the lost structure in order to approach the motor norm of the preserved elements of the joint. The presented publication reflects the results of arthroscopic surgical reconstruction of the anterior cruciate ligament with an autograft from the patellar ligament by anatomical and transtibial methods. The main methods of diagnosing tears of the anterior cruciate ligament were clinical and instrumental studies, including manual testing, radiography, magnetic resonance imaging, hardware arthrometry. A total of 134 patients with long-standing damage to the anterior cruciate ligament and chronic anterior instability of the knee joint were treated, which were divided into two groups according to the method of plastic surgery. Complete recovery of the level of physical activity and return to sports were observed in the majority of patients of both clinical groups.

Objective: to study the effect of treatment on the dynamics of antibodies to thyroid hormones in patients with rheumatoid arthritis with thyroid involvement. Methods: 27 people were selected with a diagnosis of rheumatoid arthritis, with a different cjndition of thyroid gland, tread with basic therapy (methotrexate or leflunomide). The patients were divided into three groups, depending on additional anti-inflammatory therapy: group 1 - NSAIDs, group 2 - NSAIDs and glucjcjrticoids (GC), group 3 - NSAIDs, GC and plasmapheresis (7, 15 and 5 patients, respectively). Concentrations of TSH, T3 and T4 were measured using ELISA, antibodies to T3 and T4 - by indirect ELISA using antigens immobilized on magnetic polyacrylamide beads. Marker levels were measured at admission to the hospital and at the time of discharge. Results. By the end of hospitalization of RA patients with autothyroid pathology in the hospital, there was a significant decrease in the content of antibodies in the blood to thyroid hormones. The level of antibodies to thyroid hormones in RA patients with concomitant autothyroid pathology demonstrated significant differences between the indicators before and after treatment in patients in the third group. The levels of antibodies to thyroid hormones in subgroup No. 3 after treatment significantly decreased by 75 % from the initial values. The other two subgroups also showed reductions in antibody levels, but these were not statistically significant. Conclusion. Thus, the basic therapy of RA, as well as additional methods of reducing RA activity using NSAIDs, GC, plasmapheresis, can affect the levels of thyroid hormones in patients with thyroid lesions. The most pronounced effect on the concentration of antibodies to thyroid hormones was found in patients who received a course of plasmapheresis in addition to other methods of treatment. T4 level after treatment was proportionally reduced in patients of all three groups, while remaining within the normal range. For T3, there were no distinct dynamics after treatment. The results obtained indicate a predominantly autoimmune genesis of thyroid lesions in RA.

The paper presents the results of assessing the regulatory and adaptive capabilities in terms of the parameters of cardiorespiratory synchronism in 24 men 45-56 years old with prostate cancer (stages I-II) before and after HIFU treatment. It was found that after treatment, the regulatory adaptive capabilities increase. This is due to an increase in the synchronization range and a decrease in the duration of the development of synchronization at the minimum border of the range.

In researches on the posterities of rats been born from rats of females who received adeprofen substance during pregnancy (a new analogue of the purine nucleoside adenosine) at a dose of 150 mg/kg (15 times the therapeutic dose), it is not established differences with the control by body weight increase, but at it, a noting statistically significant advance of ear otlipanie, eye opening and sensory-motor reflexes maturation, such as: formation of "negative geotaxis,"pupil reflex, "visual stimulus-induced cliff avoidance," and "turning over in free fall". In behavioral activity, in the posterities of the study group of rats of 20-day age there was an activation of horizontal mobility, inspection of minks and acts of grooming, and in the same rats at 1,5 months age there were no differences with control. The conducted researches allow to make the conclusion about absence is influence of adeprofen substance on the development of posterity rats, registered in the postnatal period. The noted changes in separate parameters of physical development and formation of sensory-motor reflexes did not go beyond the physiological norm.

Using a set of excitation/emission wavelengths characteristic of fluorescent advanced glycation end-products (AGEs), the fluorescence intensities of glycated albumin and hydrolyzed diabetic rat tail tendons were compared. The following excitation/emission wavelengths were used: 335/385 nm, 345/405 nm, 370/440 nm, 379/463 nm and 440/520 nm. The ability of 1-benzyl-1,4-dihydronicotinamide (a fluorophore) to interfere with fluorescence of AGEs was studied. It was shown that glycated albumin and hydrolyzed tendons of diabetic animals have nearly identical values of fluorescence at all wavelengths. At the same time, 1-benzyl-1,4-dihydronicotinamide, which was added into the samples of glycated albumin to bring the interference (the addition was carried out after the end of glycation reaction), interfere only at the excitation/emission wavelengths of 370/440 nm and 379/463 nm. Thus, the advantage of the use of entire set of the wavelengths (simultaneously) for AGEs detection was confirmed. We believe that the usage of the entire set of wavelengths may reduce the risk of interference-induced errors in detection of fluorescent AGEs.

The incidence of arterial thrombosis in patients with COVID-19 is about 11 %. Currently, the pathogenesis of these complications has not been fully studied. Purpose: present the course of COVID-19 Associated thrombosis of the left iliac artery on a clinical example. Material and methods. Patient with Covid-19 developed thrombosis the iliac artery. Results. A clinical example demonstrates that a patient with risk factors - coronary heart disease, type 2 diabetes mellitus, obesity, smoking, against the background of a new coronavirus infection, an iliac artery thromboembolism developed. Conservative treatment of thrombosis with antithrombotic drugs was not successful. In this connection, the patient was hospitalized in a socialized medical institution, where a thromboectomy was performed from the iliac, femoral, popliteal artery on the right. The patient's condition improved during the therapy. However, on the 3rd day, a pneumonia clinic developed, which was the reason for transferring him to a covid hospital. Despite the etiotropic and antithrombotic therapy, repeated arterial thrombosis of the vessels of the lower limb progressed, which required surgical intervention (amputation of the lower leg). The cause of death of the patient was a progressive multiple organ. A clinical example shows that the pathogenesis of thrombosis in COVID-19 has not been fully studied (not established), and treatment regimens with antithrombotic drugs require further revision.