Vol 2, No 4 (2022)

Spontaneous pneumothorax (PT) is a rare complication of coronavirus pneumonia.

Recent publications suggested that the occurrence and pneumothorax in coronavirus pneumonia is associated with the frequent use of invasive ventilation (IVV) and noninvasive ventilation (NIVV). At the same time, there are an increasing number of reports on the development of this pathological condition in patients in the absence of respiratory support.

The purpose of clinical observation was to study potential predisposing factors to PT, as well as to determine the association with changes in laboratory data and clinical manifestations.

Materials and methods. We analyzed one case of spontaneous pneumothorax in a patient against the background of coronavirus pneumonia, who was not on artificial ventilation. Clinical, laboratory and radiological data were analyzed.

Results. PT appearance in a patient was accompanied by the worsening of respiratory failure symptoms and general state deterioration; also we revealed the interrelation between the development of this complication and LDH peak.

Conclusion. The main cause of spontaneous pneumomediastinum and pneumothorax is probably severe alveolar damage. Further studies of potential markers of PT development in coronavirus pneumonia, as well as determination of mechanisms of this complication development are necessary

The article is devoted to human dirofilariosis. The incidence of dirofilariosis has been increasing in recent years. Endemic areas in Russia are expanding from Krasnodar region, Rostov region to Krasnoyarsk region, Khabarovsk and Kamchatka. Objective: to analyze the efficacy of conservative and surgical treatment of human dirofilariosis.

Material and methods: the clinical case is the most interesting, because human dirofilariosis is a rare enough phenomenon, so there is no generally accepted scheme of diagnostics and treatment of this disease. Human dirofilariosis has a variety of clinical manifestations, which makes it difficult to diagnose and choose the tactics of patient management. Most cases of dirofilariosis are ocular dirofilariosis with lesions of the visual organ, its appendages and orbital cavity. There were studied the peculiarities of etiology, epidemiology, clinic and diagnostics of human dirofilariosis pathogen - Dirofilaria repens, the interaction of ophthalmologist, infectious disease doctor, maxillofacial surgeon, possible schemes of conservative therapy: meglumine acridonacetate, albendazole, diethylcarbamazine, lidocaine.

Results: it was found that the diagnosis of dirofilariosis in humans is difficult due to the lack of specific laboratory and instrumental diagnostic methods. Conservative therapy, for the most part, is not effective in the treatment of human dirophylyariasis.

Conclusion: It is necessary to raise the awareness of practicing physicians about the peculiarities of diagnosis, clinic and treatment of human dirofilariosis. If an area of skin or mucosa suspicious for localization of dirophylyariasis is found the way to immobilize the parasite can be superficial anesthesia with a tampon with 2% lidocaine. The best way to treat human dirophilariosis is surgical extraction.

An important problem in modern medicine is a special differentiated approach to children with autism spectrum disorders. Autism spectrum disorder (ASD) is a special mental development disorder characterized by impaired stereotypical behavior and problems with social interaction with other people. Self-care skills in children with this disorder are poorly developed, children are dependent on sugary foods, and there is also impaired sensory integration.  All this leads to poor oral hygiene. The high rates of dental disease in these patients require finding the most effective methods of treatment and prevention. Special programs based on clinical manifestations and behavior modification have been developed for children with ASD to adapt to dental appointments and oral hygiene education. In addition to traditional hygiene education, modern techniques involving the use of electronic devices are increasingly being introduced. The pediatric dentist must teach oral hygiene to patients with ASD to prevent dental caries and periodontal disease, using new technology and virtual reality devices. At the same time it is necessary to find an individual approach to each child, so it is important to pay attention to the adaptation of children with ASD. Various effective programs have been created to gradually introduce children into the comfortable environment of dental appointments. Unfortunately, not all children can get accustomed to the dental procedures and the dentist has to resort to the use of sedation or general anesthesia. Studies show that anesthesia in children with autism improves the quality of reception and reduces psycho-emotional excitability, therefore improving the adaptation of patients and the likelihood of exacerbation of the disease is less.

In connection with the above, the purpose of this literature review is to present current information about methods of children's adaptation to dental appointments, prevention and treatment of oral diseases.

The work of art is able to touch us and, at the same time, to carry out shaking and collapse of habitual worldview and all because the truth is hidden in it. Involved in the world created by artistic creation, we can no longer return to our former selves and must make every effort to find another self.

Immanuel Kant distinguishes between morals and morality. He writes about human morals as being subject to all kinds of spoilage, and about morality as a law that is within us, the presence of which we feel in the form of the dictates of duty. Duty is not a sensual attraction, it is above all sensual, because sensual attraction only advises, but duty commands and in following pure duty, we remain faithful to our own dignity as a being endowed with reason, and thus able to rise above self-love.