Saratov JOURNAL of Medical and Scientific Research

Original article

Prenosological risk criteria for the development of bru-xism in young adults

Year: 2019, volume 15 Issue: №4 Pages: 852-857
Heading: Stomatology Article type: Original article
Authors: Ageeva Yu.V., Klauchek S.V., Sharanovskaya O.V., Shemonaev V.I.
Organization: Volgograd State Medical University
Summary:

The purpose of this study is to assess the dental status of university students to identify the initial risk factors for the development of parafunctional activity of masticatory muscles and bruxism. Material and Methods. Dental examination was conducted in 445 students aged 18 to 25 years. According to the accepted inclusion and exclusion criteria 240 examined person were divided into 2 groups: the first group comprised subjects without revealed functional disorders of the masticatory system (53 persons); the second one —with revealed functional disorders of the masticatory system and damaged dental hard tissues (187 persons). Results. The frequency of detected bruxism cases composed 56%. Hypertony of masticatory muscles is registered in 80.4% cases. Conclusion. Based on the assessment of the students dental status, 43.3% of the examined have prenosological signs of parafunctional activity of the masticatory muscles and functional disorders in the masticatory system, which makes them a risk group for developing bruxism.

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Clinical characteristics of patients with psoriasis according to their somatotype

Year: 2019, volume 15 Issue: №4 Pages: 848-851
Heading: Dermatovenerology Article type: Original article
Authors: Neklyudova V.S., Sherstennikova А.К., Kashutin S.L., Kalmin O.V.
Organization: Penza State University, Northern State Medical University
Summary:

The purpose of the study is to analyze the prevalence and severity of psoriasis according to the patient's somatotype. Material and Methods. The study involved 82 patients (39 women and 43 men) aged 20 to 60 years, suffering from vulgar and exudative psoriasis. The study of the structure of somatotypes of patients with psoriasis was carried out by measuring height-weight ratios, bone diameters and girth sizes, as well as skin-fat folds in accordance with the technique proposed by B. Heath and L. Carter. Individuals belonging to endomorphs, mesomorphs and ectomorphs were distinguished. The prevalence and severity of psoriasis was assessed by the PASI index. Results. The clinical characteristics of patients with psoriasis depending on their somatotype are described. Endomorphic somatotype was observed in 22, mesomorphic — in 37 and ectomorphic — in 23 patients. Conclusion. The results of the study showed that more severe psoriasis, estimated by the PASI index, and exacerbations of dermatosis 2 or more times a year are more common at endomorphs.

Keywords: somatotype, psoriasis
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Dynamics of the neovascular process activity in proliferative diabetic reti-nopathy after panretinal laser coagulation using lasers with different wavelengths

Year: 2019, volume 15 Issue: №4 Pages: 843-847
Heading: Ophtalmology Article type: Original article
Authors: Gatsu M.V., Borzilova Yu.A., Grigoriev S.G.
Organization: North-West State Medical University n.a. I.I. Mechnikov, Department of Neuropathology Assistant Professor, Candidate of Medical Science
Summary:

Purpose: comparative evaluation of the effectiveness of panretinal laser coagulation performed using laser radiation with wavelengths of 532 and 577 nm in the treatment of proliferative diabetic retinopathy. Material and Methods. The study included 32 patients (64 eyes) with stage 1-3 proliferative retinopathy. Patients were divided into two groups by random sampling depending on the wavelength of laser radiation used for PRC (577 nm — group 1, and 532 nm — group 2). The neovascular process activity was assessed by the dynamics of the fluorescence-angiographic picture and the level of vasoproliferative factor in the tear 3, 6 and 12 months after surgery. Results. The conducted studies have shown that laser coagulation performed by both wavelengths is an effective treatment for retinopathy, but gives a delayed effect. After 1-3 months in the first group and 1-6 months in the second one after its implementation, there is an increase in the neovascularization activity and an increase in the VEGF-A level in the lacrimal fluid. In terms of the number and severity of temporary side effects, PRC is the leader using a wavelength of 532 nm, which is eliminated only by 12 months of observation. Conclusion. When using a 577 nm laser, the neovascular process is most quickly stabilized (p<0.05), which makes it possible to consider the use of this wavelength as the most preferable.

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Determination of the projection of the front sinus in the preoperative period

Year: 2019, volume 15 Issue: №4 Pages: 839-842
Heading: Otolaryngology Article type: Original article
Authors: Kuchmin V.N., Mareev O.V., Mareev G.O., Aleshkina O.Yu., Afonina O.I.
Organization: Saratov State Medical University
Summary:

Objective: to create an easy-to-use method for determining the parameters of the frontal sinus in the preoperative period for more effective and safe surgical treatment of the patient. Material and Methods. An algorithm for obtaining parametric projections of the frontal sinus, based on computed tomography of the head. Results. A parametric model of the frontal sinus with indication of its boundaries, wall thickness and depth was constructed on the basis of high-resolution computer tomograms. Using reference points and data of computer tomograms, a stencil of the frontal sinus was formed with its subsequent fixation on the front surface of the forehead, which can be a guide when choosing the optimal place for trepanation in surgical practice. Conclusion. The proposed method allows in the absence of expensive equipment, minimal costs and the need for personnel training to obtain an accurate parametric projection of the frontal sinus, containing the necessary information about the thickness of its walls and depth.

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Comorbidity in patients with acute coronary syndrome in real (everyday) clinical practice

Year: 2019, volume 15 Issue: №3 Pages: 821-825
Heading: Cardiology Article type: Original article
Authors: Furman N.V., Dolotovskaya P.V., Malinova L.I., Reshetko O.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study was to assess prevalence of comorbidity in the population of patients with acute coronary syndrome in Saratov region. Material and Methods. Inpatient and outpatient records of 484 patients with acute coronary syndrome (ACS) were analysed (64% of them residents of Saratov). Cases of cardiac and non-cardiac comorbidity were evaluated, Charlson Comorbidity Index (CCI) was calculated. Results. Only 20.5% of patients were without cardiac or non-cardiac comorbidity. Comorbid non-cardiac diseases were observed in 37.5% of patients (the most common diseases of the digestive system — 43% of all cases of non-cardiac comorbidity). Comorbid cardiovascular diseases were detected in 76.9% of patients, among the most common ones were arterial hypertension (88.4% of all cases of non-cardiac comorbidity) and documented hypercholesterolemia 42.2%). A correlation was found between the CCI and an unfavorable hospital outcome (0.227, P<0.0001). Conclusion. Patients with ACS in the vast majority of cases have at least one concomitant disease (cardiovascular or non- cardiac) that can significantly affect their prognosis. To determine individual prognosis for ACS patients with concomitant diseases, it is advisable to calculate the Charlson comorbidity index.

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Drug treatment of stable coronary artery disease in the context of guidelines on myocardium revascularization

Year: 2019, volume 15 Issue: №3 Pages: 812-817
Heading: Cardiology Article type: Original article
Authors: Posnenkova О.М., Genkal E.N., Popova Yu.V., Kiselev A.R., Gridnev V.I.
Organization: Saratov State Medical University
Summary:

Purpose: to assess the quality of medical treatment in patients with stable coronary artery disease (CAD) based on 2018 European guidelines on coronary revascularization (ESC 2018) and 2017 Appropriate Use Criteria (AUC 2017) using the data from Russian multicenter registry. Material and Methods. The data from 1531 patients with stable CAD (mean age 61.7±9.8 yrs, 76% men) were studied. The source of data was Russian multicenter registry of hypertension, CAD and chronic heart failure. Administration of optimal medical therapy (OMT) in terms of ESC 2018, maximal antiischemic therapy (MAT) in terms of AUC 2017 and agreement with both criteria were evaluated. OMT included at least one antiischemic drug + antiplatelet agent + statin + short acting nitrate + RAAS blocker in patients with hypertension, diabetes and heart failure. MAT included at least two antiischemic grugs. Correspondence with these criteria was determined in the groups of patients who underwent coronary revascularization and who received only medical treatment. The criteria were also determined in the groups of patients, for whom invasive treatment were indicated primarily, for whom it could be delayed and among patients who did not need revascularization according to ESC 2018 and AUC 2017 Results. In patients treated conservatively (n=924) OMT was administered in 18% of cases, in the group of revascularization — in 9% of cases (p<0.001). MAT was also administered significantly more frequently in the group of medical treatment (34% vs 24% in the group of revascularization, p=0.001). Medical treatment met ESC 2018 and AUC 2017 criteria in the groups with and without intervention in 7 and 3% of cases correspondingly (p<0.001). Conclusion. The data of Russian multicenter registry have shown that medical treatment of stable CAD fit with European and American clinical guidelines on myocardium revascularization in only insignificant part of patients independently from selected treatment strategy.

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Peculiarities of psychoemotional status and myocardium's response to heliogeomagnetic disturbances under emotional load in volunteers residing in the middle latitudes

Year: 2019, volume 15 Issue: №3 Pages: 806-812
Heading: Cardiology Article type: Original article
Authors: Parshina S.S., Kodochigova A.l., Samsonov S.N., Afanasyeva T.N., Petrova V.D., Petrova P.G., Strekalovskaya A.A., Manykina V.I., Kasimov O.V., Tokayeva L.K., Komzin K.V., Ramazanova Z.G.
Organization: Clinical Hospital "RZD-Medicine", Saratov, North-Eastern Federal University n. a. M.K. Ammosov, Saratov State Medical University, Yu. G. Shafer Institute of Cosmophysical Research and Aeronomy of the Siberian Branch of the Russian Academy of Sciences
Summary:

The purpose of the study is to evaluate psychoemotional features of volunteers residing in the middle latitudes and the impact of emotional stress on the synchronization status of the myocardium and heliogeomagnetic disturbances. Material and Methods. In the course of 60 days volunteers (31 people) were daily assessed concerning the state of the myocardium according to the coefficient of symmetry of the T-wave (CST) in the phase portrait of ECG at rest, after emotional stress, and after rest. Geomagnetic activity was assessed with the help of global planetary index of geomagnetic activity (Kp- index), while psychoemotional state of volunteers — with the help of questionnaires and projective techniques. Results. Personality characteristics of volunteers residing in the middle latitudes include optimism and friendliness, combined with a reduction of adaptability when building stress coping behavior against the background of polar intrapsychic tendencies. Emotional stress causes transient change in the synchronization state of the myocardium and heliogeomagnetic disturbances (CST-Kp). 3 types of violations of CST-Kp synchronization were identified. We were the first to describe the phenomenon of CST-Kp synchronization inversion: the increase of myocardium tension after geomagnetic disturbance reduction. Conclusion. Emotional stress in volunteers residing in the middle latitudes against the background of their characteristic of reduced psycho-emotional adaptation, leads to blockage of myocardium's reaction to weak geomagnetic disturbances and may contribute to the emergence of sensitivity to powerful geomagnetic disturbances.

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Terahertz therapy at frequencies of the molecular spectrum of nitric oxide: results and prospects of clinical use

Year: 2019, volume 15 Issue: №3 Pages: 800-806
Heading: Cardiology Article type: Original article
Authors: Parshina S.S., Afanasyeva T.N., Vodolagin A.V., Petrova V.D., Ushakov V.Yu., Kaplanova T.l., Potapova M.V., Ramazanova Z.G.
Organization: Saratov State Medical University, Clinical Hospital "RZD-Medicine", Saratov
Summary:

The purpose of the study is to summarize the results of clinical use of terahertz therapy at molecular spectrum of nitric oxide frequencies (150,176... 150,664 GHz) (THZ-therapy-NO) in cardiology, to identify general regularities and peculiarities of terahertz therapy influence. Material and Methods. We examined 312 patients with angina pectoris (150 patients with unstable angina pectoris, and 162 patients with stable angina of III-IV f. to.). Results. Antianginal effect of THZ-therapy-NO does not depend on the form of angina, sex, age, mode of exposure, hypocoagulation effect of smoking. We identified 2 types of effects of THZ-therapy-NO on hemostasis and blood rheology: active antithrombotic and protective (prevents the development of hypercoagulation shifts against the standard drug treatment). Procoagulant hemostasis is most sensitive to terahertz exposure. Reducing the duration of course exposure leads to expansion of antithrombotic effect by increasing the activity of natural anticoagulants (antithrombin III). Conclusion. Antianginal effect of THZ-therapy-NO does not depend on its hypocoagulation action. Irradiation mode "3/15" is optimal for patients with angina. Mode "2/5" does not have its own antithrombotic effect, therefore it is suitable for patients with angina with a tendency to hypocoagulation. Smoking does not affect the efficiency of the THZ-therapy-NO.

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Assessment of system's adaptive reserves by indicators of heart rate variability in young men at the initial stages of university education

Year: 2019, volume 15 Issue: №3 Pages: 796-800
Heading: Cardiology Article type: Original article
Authors: Olenko E.S., Fomina Е.М., Kirichuk V.F., Kodochigova A.l., Yupatov V.D., Konovalova A.A.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to assess the activity index of regulatory systems and mechanisms of neurohumoral regulation of heart activity in healthy young men at the initial stage of university education. Material and Methods. We studied the activity index of regulatory systems (PARS) and features of the mechanisms of neurohumoral regulation of cardiac activity on a sample of 150 young men [19.0 (18.0; 19.0) years old], based on the analysis of heart rate variability. Results. 40.0% (n=60) of young men had a satisfactory state of adaptive reserves of the body, 23.3% (n=35) were in a state of low functional stress, 24.7% (n=37) had poor adaptation, and 12.0% (n=18) failed to adapt. Conclusion. In male students with satisfactory, tense, and unsatisfactory adaptation, as disadaptation increases, the total effect of all levels of regulation on the heart rate increases with an increase in the effect on the cardiac activity of the parasym-pathetic division of the ANS and a decrease in the activity of cerebral subcortical structures responsible for adaptation, against the background of an increase in psychoemotional stress. In healthy male students, the disruption of systems' adaptive reserves is often accompanied by the total decrease in all levels of regulation with a predominance of sympathetic influences on the heart rhythm and is less frequently associated with a sharp increase in all levels of regulation and the predominance of parasympathetic division of the ANS for the CVS.

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Prospective study of patients with old myocardial infarction: influence of presence or absence of type 2 diabetes mellitus on adherence to treatment

Year: 2019, volume 15 Issue: №3 Pages: 791-796
Heading: Cardiology Article type: Original article
Authors: Naumova Е.А., Bulaeva Yu.V., Semenova O.N.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to conduct a prospective study of patients with old myocardial infarction with the presence or absence of type 2 diabetes mellitus and to identify factors associated on adherence to therapy. Material and Methods. 80 hospitalized patients with old myocardial infarction were included into the study: group one with type 2 diabetes mellitus (50%), group two — without it (50%). Standard clinical, laboratory and instrumental examination, calculation of metabolic indices were performed. 6 months discharge by phone viewed the continuation and regularity of therapy, end points. Results. The results of a study regarding adherence to therapy were evaluated over the phone 6 months after discharge from hospital; factors associated with continuation of therapy are presented. Conclusion. Patients with old myocardial infarction and diabetes mellitus are more adherents to treatment. Increased waist circumference, patient satisfaction with therapy, low rate of re-hospitalization and positive emotional evaluation of aspects of the therapy are factors is associated with high adherence to therapy.

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