卷 19, 编号 3 (2022)

Medical errors in dentistry are a complex problem. There is no unambiguous and comprehensive definition of this concept. The article examines the existing classifications of medical errors, discusses their advantages and disadvantages. Possible alternative classifications of medical errors for objective and subjective reasons, for medical and non-medical factors influencing diagnosis and treatment, according to the severity of the harm done to the patient are considered. Medicine is developing, so the term "medical error" requires not just a modern view, but also official recognition as a problem. It is necessary to supplement and clarify it, for ease of use in official medical documents.

In the Volgograd region, a large number of febrile patients are registered annually in the summer. Most often, such patients are diagnosed with West Nile fever, however, the clinical manifestations of this disease are similar to the symptoms of other arbovirus fevers, for exampLe, Usutu, Sindbis, Ukuniemi. On the territory of the VoLgograd region, the circuLation of West Nile and Crimea-Congo hemorrhagic fever viruses has been established. In addition, other arboviruses, pathogenic for humans, apparentLy circuLate in the region, the fuLL species composition of which has not yet been estabLished. The existence of a number of arboviruses in the region is due to the possibiLity of a systematic introduction of pathogens by migratory birds, the presence of certain types of reservoirs and carriers here. In different years, antigens of the Sindbis virus, the California serogroup (Inko, Tyaginya virus), Batai, Ukuniemi viruses, and specific antibodies to them were detected in the field material, which indicates the presence of these pathogens in the region. The review provides a potential spectrum of arboviruses pathogenic for humans circulating in the Volgograd Region, as well as its abiotic (climate, bird migration pathways) and biotic factors (carriers, reservoirs).

The article provides research data devoted to the study of an actual scientific problem of human physiology – the identification of sex differences in human cerebral hemodynamics during the solving cognitive tasks. Cognitive activity was modeled using a two-colored Schulte – Gorbov test, cerebral hemodynamics was assessed by the method of rheoencephalography, registering it in the fronto-mastoidal and occipito-mastoidal leads on the left and right. The obtained data indicate that the hemodynamic supply of brain activity in subjects of different sexes during the solution of cognitive tasks differs significantly. In particular, it was found that when the Schulte – Gorbov test was performed in male subjects, hemodynamic changes were observed in the occipital region mainly on the right, while in females – in the occipital region both: on the left and on the right.

The purpose of our study is to study changes in the parameters of visual evoked potentials to a flash under the influence of speleotherapy. Material and research methods. The study involved 23 2nd year students of VSMU (18-21 years old, 9 boys and 14 girls). The course of speleotherapy consisted of 10 sessions of 60 minutes each and was carried out in a stationary ground speleochamber at a temperature of 18-22 °C. The study was conducted in compliance with the basic bioethical rules. Before the start of speleotherapy, on the 3rd, on the 10th day of speleotherapy, visual evoked potentials (vEP) were registered on the right and left for a flash using the neuromyoanalyzer NMA-4-01 "Neuromian". The analysis of the data obtained was carried out using the Excel 16 version and IBM SPSS Statistics 26 programs. It was found that flash VEP is an important diagnostic method that allows not only to solve such diverse tasks as detecting the presence of vision, assessing the degree of preservation of the visual functions of the peripheral visual field, and determining the speed of the visual signal and the efficiency of its processing, but also to assess the degree of influence of non-drug methods of treatment on the human body, the work of its regulatory mechanisms, in particular, the central nervous system. The course of speleotherapy improves the speed of the visual signal, the speed of primary processing of information and the speed of analysis of visual information. Moreover, the mechanism of this improvement occurs according to Hans Selye's theory of stress: through the "emergency" stage on the third day of speleotherapy to the stage of stable adaptation on the 10th day of speleotherapy.

Resume. Mandibular prognathia is a common pathology of the development of the dentition, related to genetic disorders. A characteristic feature of mandibular prognathia is the overlap of the upper incisors by the lower incisors. Despite the fact that distal prognathia is more common than mandibular (mesial) prognathia, the latter affects all age categories of people. The causes of this pathology can be divided into two groups: endogenous and exogenous. Clinically, this is manifested by a violation of the aesthetic appearance of the face, due to a change in its configuration, the appearance of pronounced nasolabial folds. The purpose - of the study was to assess the teleradiological parameters of facial tissues in patients after orthodontic treatment for mandibular prognathia. Materials and methods. The collection and analysis of clinical material was carried out on the basis of the Samara City Clinical Dental Clinic No. 1, Samara, in the period from 2018 to 2022. The study involved 88 patients with removable and permanent dentition. When detecting mandibular prognathia, clinical functional tests proposed by Ilyina-Markosyan were used. Conclusion. Analysis of the results of the treatment of patients suffering from mandibular prognathia demonstrated a stable improvement in the clinical picture, which is confirmed by the results of teleroentgenography.

The lack of information on the relationship between the indicators of micro, macronutrient and dental status of adolescents living in Yamal was the basis for analyzing these indicators. A comprehensive dental examination of 112 adolescents aged 12 and 15 years, from among the indigenous peoples living in the territory of the Yamalo-Nenets Autonomous District, an assessment of the actual nutrition and elemental composition of blood serum was carried out. The analysis of the data showed that the prevalence of dental caries among the examined exceeds 99 %. The CPI index ranged from 4,6-7,7. The imbalance of micro- and macroelements involved in ontogenesis and providing the processes of remineralization of hard tooth tissues was revealed. Correction of the elemental status should be included in the complex of therapeutic and preventive measures that increase caries resistance.

Resume. Intra-abdominal hypertension (IBH) in patients with sterile pancreatic necrosis (SP) leads to the formation of abdominal compartment syndrome (ACS) in 6-8 96. The most vulnerable in this regard are patients with cardiac and pulmonary comorbidity (CLC). Difficulties in predicting the development of ACS in most cases do not allow making a timely decision on surgical decompression, which leads to delayed surgical treatment and associated high mortality. Objective: to develop and conduct a clinical evaluation of a method for determining indications for preventive minimally invasive surgical decompression in IBH in patients with SP with cardiac and pulmonary comorbidity. Materials and methods. Prospective cohort studies were performed in 84 patients with sterile pancreatic necrosis with CLC, of which 40 patients were in the main group and 44 in the comparison group. Results and discussion. IBH I-II art. was formed in the main group in 32 (80 %) patients, in the comparison group in 34 (77 %). In 10 (29,4 %) patients from group for comparison, ACS developed, while in all 5 (5/22 - 22,7 %) patients with IBH of the first art., it was not possible to diagnose the syndrome in vivo. Categorically, it became possible to verify ACS only in 5 (5/12 - 41,6 %) patients with type II IBH, however, delayed surgical decompression in 60 % (3 out of 5) cases led to mortality. In the main group of patients with SP with CLC, the developed method for determining indications for preventive surgical decompression in IBH I-II art., allowed to prevent the development of ACS in 34 % (11 out of 32) patients, to reduce the number of intraoperative complications by 43 %, and the minimally invasive variant of operations reduced the number of early postoperative complications by 75 %. Conclusions. The developed method for determining indications for preventive minimally invasive surgical decompression in patients with SP with CLC allowed to reduce the mortality associated with an increase in intra-abdominal pressure by more than 2 times, and the overall mortality by 5,5 %.

Resume. Objective. Conduct a systematic analysis of the results of domestic and foreign clinical studies on changes in the functions of the musculoskeletal system of a pregnant woman and, based on our own research, study the relationship between pregnancy and disorders of the musculoskeletal system in women. Methods. The study included a survey conducted among 102 women during pregnancy and 18 women in the postpartum period. The following parameters were also determined: body weight before pregnancy and at the moment, woman's height glucose and blood pressure levels, hemoglobin values. the length and width of the foot, the range of motion in the joints of the limbs of pregnant women were measured in order to identify signs of joint hypermobility. All measurements of the foot were made using a stopometer and caliper with the calculation of the podometry index. Statistical analysis of the obtained data was carried out using the IBM SPSS Statistics 23 program. Results. During pregnancy, women are concerned about pain of various localization: in the back, neck, legs, spasms of the muscles of the legs. There is a change in anthropometric parameters and the index of podometry, in particular, an increase in the foot by 1-2 sizes, due to a decrease in the arches of the feet under the influence of hormonal changes, with the development or progression of the existing combined flat feet. In pregnant women using insoles, the absence of flattening of the arches of the feet and a decrease in pain in the spine and extremities are determined. Conclusion. The analysis confirmed that women during pregnancy are at high risk of developing disorders of the musculoskeletal system. The results of the study showed that changes in the arches of the foot lead to abnormal kinematics of the joints of the lower limb and spine during pregnancy and, if not corrected, persist in the postpartum period.

The effectiveness of the developed original two-stage method of surgical treatment of epithelial coccygeal passage (positive decision on the issue of the Russian Federation patent for invention under application № 2021127105) was studied by comparing the resuLts of using the impLemented new method with the use of traditionaL methods. 60 patients were included in the study, forming 3 comparable clinical observation groups. Comparative analysis of the final results, the number of earLy and Long-term postoperative compLications reveaLed reLiabLe advantages of the deveLoped technoLogy, consisting in reducing the proportion of postoperative complications, recurrences of sacrococcygeal fistulas, reducing the duration of treatment and hospitaL stay.

Since ischemic stroke is an extremely common and dangerous pathology, it is important to use drugs with neuroprotective activity. The depth and degree of brain damage due to ischemia are reflected in its bioelectrical activity. This makes it possible to use the electrocorticography or intracranial electroencephalography (EEG) as a tool for evaluating the effectiveness of neuroprotective therapy. In the present study the neuroprotective properties of the experimental compound RU-1205 and the kappa-opioid agonist butorphanol were analyzed. The neuroprotective effect of the substances was assessed by measuring the extent of the neurological deficit and the changes in bioelectrical activity of the ischemic brain of rats. Compound RU-1205 (10 mg/kg, i.v.) as well as the reference drug butorphanol (2,5 mg/kg, i.v.) restored to normal neurological status and power of the EEG signal in delta and theta frequency bands.

The article discusses the presentation of the features of cerebellar remodeling after traumatic brain injury (TBI) in the highlands. The experiment was carried out on 106 outbred male rats weighing 210-290 g in compliance with the rules of laboratory practice. In high-altitude conditions, in contrast to low-altitude conditions, significant changes occur in the cerebellum, namely, changes in the membrane potential of cells, ectopia of Purkinje cells, pronounced changes in molecular and granular layers.

The aim of the work was to identify the links between indicators of functional and psychophysiological status with psychological characteristics that determine the risk of developing chemical addictions in men and women. The study was carried out with the participation of 309 people, 137 men and 172 women aged 18-30, students of state universities in Volgograd, Samara and Arkhangelsk. The level of consumption of legal psychoactive substances was assessed based on the results of a retrospective self-assessment by respondents of the frequency of alcohol intake and tobacco smoking experience. The psychological status of the study participants was determined by evaluating the indicators of the Freiburg multifactorial personality questionnaire, adventurousness and social destructiveness. The psychophysiological status of the subjects was assessed according to standard electroencephalography indicators. The functional status was characterized by analyzing the level of general nonspecific reactivity of the organism. As a result of the performed research, the systematic manifestation of functional, psychophysiological and psychological prerequisites for the individual formation of a person's propensity to consume legal psychoactive substances is substantiated. The combination of a high level of general nonspecific reactivity of the organism with low values of the alpha rhythm amplitude and pronounced adventurousness, both in men and women in the follicular or luteal phases of the ovarian-menstrual cycle, is a prognostic criterion for the risk of alcohol and tobacco addiction. Comprehensive accounting of phenotypic indicators of a person's predisposition to the demand for psychoactive substances is able to optimize the system of health-saving support for students.

The article presents a comparative analysis of the combined risk of progression of chronic kidney disease (CKD) and the development of cardiovascular complications (CVD) in patients with arterial hypertension (AH) and AH patients in combination with type 2 diabetes meUitus (DM) using software tools. It is proposed to use the "HeartCare" Internet resource developed by the authors, which presents the main methods for determining cardiovascular and combined risk in various groups of patients. It was noted that among persons with AH and DM type 2, patients with high and very high combined risk were statistically significantly more likely to be identified in comparison with patients with "isolated" hypertension (55,2 vs 17,1 % in the main and control groups, respectively). The "HeartCare" resource allows you to evaluate personal risks in dynamics.