2021, volume 17

Sleep apnea in adolescence is a frequent and at the same time underestimated pathology, the consequences of which can lead to cardiovascular dysfunction, cognitive and metabolic disorders. The task of an orthodontist is to recognize and reduce the risk of developing the obstructive sleep apnea syndrome (OSAS) in a timely manner. The purpose of this study was to collect theoretical data on OSAS, its effect on the body of adolescents, methods of diagnosis and treatment, as well as to identify problems of diagnosing OSAS in early adolescence. The literature review was conducted using the PubMed search engine in the Scopus and Medline electronic databases. The literature review was conducted using the PubMed search engine in the Scopus and Medline electronic databases from 2010 to 2021, 47 literature sources were analyzed. As a result of the analysis of the literature data, it was revealed that the reduction in the size of the oral cavity, mediated by the narrowing of the dentition, negatively affects the respiratory function of the body, exacerbating the syndrome of obstructive sleep apnea. Orthodontic care is focused on the treatment of dental anomalies and pathology of the development of the facial skeleton. The expansion of the jaws, aimed at increasing the volume of the airways, is an integral part of the treatment and prevention of OSAS.

Objective: to assess the dynamics of changes in the morphofunctional parameters of the macular zone in patients with diabetic macular edema (DME) with intravitreal dexamethasone implant (IVD) in vitrectomized eyes and eyes with a native vitreous (NV). Material and methods. The study involved 60 patients (60 eyes) divided into two groups with a diagnosis of diabetic retinopathy, DME. Group 1 — patients with NV, group 2 — with vitrectomized eyes. The best corrected visual acuity (BCVA), optical coherence tomography (ОСТ), ОСТ angiography and microperimetry were evaluated before, 1, 3 and 6 months after IVD. Results. In both groups, an increase in the average BCVA after IVD up to 3 months of monitoring (p<0.01); exponential decrease in central retinal thickness from 1 to 3 months (p<0,01), and an increase by 6 months (p<0.05); an increase in total vascular density during 6 months of monitoring (p<0.05); the average photosensitivity (PS) increased in group 1 — up to 3 months, and returned to the initial parameters by 6 months (p<0.05); in group 2 — up to 6 months (p<0.05); Parameter К (the number of points with PS below 24 dB) decreased in group 1 to 3 months (p<0.05) and returned to baseline by 6 months; in group 2 — during the entire observation period (p<0.01). Conclusion. IVD in DME may significantly improve the morphofunctional parameters of the macular zone in the eyes with both NV and vitrectomized eyes. The maximum effect of the drug was observed on the 3rd month of monitoring.

Objective is to assess the effectiveness of the inclusion of rhythmic transcranial stimulation (rTMS) in the treatment of climacteric (CS) and postovarectomy syndromes (POES). Material and Methods. 95 women with POES (main group IA(n=48), comparison IB (n=47)) and 135 women with CS (main IIA(n=68), comparison IIB (n=67)) were included. All patients underwent menopausal hormone therapy (MHT), in the main groups — in combination with rTMS. Results. The average age of patients with POES is 47.9±2.2, with CS — 53.6±3.5 years (p=0.042). The duration of menopause was 2.8±0.6 years. On the scales of physical and psychological components of health in the main groups IA, IIA showed higher values after 3, 6 months of therapy compared to the same parameters in the comparison groups IB, IIB. The dynamics of the decrease in the values of psychoemotional and neurovegetative disorders of the modified menopausal index in the main groups IA, MA after 3 months was more pronounced compared to the same parameters in the comparison groups IB, IIB. The ratio of the chances of normalization of the clinical picture by 6 months for the main group lAand comparison group IB is 2.5 with 95% Cl [1.05-6.16], and for the main group IIAand comparison group IIB — 7.6 with 95% Cl [3.05-19.05]. Conclusion. The inclusion in the treatment of CS and POES along with MGT rTMS improves the quality of life, improves immediate and long-term results.

The increasing number of implantation failures even with application of reproductive technologies makes scientific society look for new ways to assess the state of the internal genitals in terms of the readiness of female body for implantation. Echographic assessment of the uterus and ovaries allows us to study in detail a number of prognostic markers of the probability of pregnancy. The purpose of the review is to present new data illustrating modern achievements in ultrasound diagnostics, when describing the characteristic changes in the internal genitals of women during the implantation window, to summarize the information obtained for the convenience of its use by obstetricians-gynecologists and reproductologists when reading ultrasound reports. The analysis of 47 publications from domestic and foreign sources of literature on the given topic, published over the period of 1995-2021, has been carried out. Electronic databases e-Library, PubMed, SCOPUS, and Web of Science have been used to search for articles. The authors have identified the main conditions of ultrasound examination (USE) (from the 19th to the 23d day of the menstrual cycle) and the main echographic markers which characterize the function of the corpus luteum, the state of the endometrium, as well as the perfusion of the uterus and endometrium based on the measurement of resistance indices in the uterine, basal, spiral arteries during a possible successful implantation.

Objective: to evaluate the pros and cons of assisted and robot-assisted functional endoscopic interventions and the possibilities of their use in rhinosinus surgery. The work is devoted to the review of methods of assisting in endoscopic rhinosurgery from 1983 to 2020 based on the materials of foreign scientific databases PubMed, ResearchGate. A total of 48 sources were studied. A brief history of the development of endoscopic rhinosurgery, bimanual endoscopic technique and its main disadvantages are presented, literature data on passive and active (robotic) devices holding the endoscope are presented. Based on the studied literature, it may be concluded that the existing commercial and experimental robotic devices of various designs have a number of serious disadvantages that prevent their wide distribution and introduction into the practice of rhinosurgery.

Purpose: evaluate the effectiveness of surgical treatment of recurrent operated macular rupture. Material and Methods. The study included 10 patients (10 eyes) with recurrent macular rupture. In 8 out of 10 cases, the macular hole was closed using the inverted internal limiting membrane (ILM) flap technique; in 2 cases — using mechanical convergence of the edges of the rupture. Preoperative vision varied from 0.05 to 0.1-0.2. According to optical coherent tomography, the average rupture diameter ranged from 600 to 800 urn and in one case was 1144 urn. Results. In all cases, an anatomical result was obtained. During ILM application, the most effective anatomical result was obtained in 5 cases with preservation of the neuroepithelium; in 2 cases the retina in the fovea was thinned. In these cases, there was an improvement in visual functions 1-3 months after the surgery. In 3 cases, there was an incomplete closure of the macular hole. In 1 case, the defect remained at the level of ellipsoid zone of retinal photoreceptors; in 2 cases, there was a deformation of the retinal fovea with the destruction of photoreceptor ellipsoid zone. Visual functions remained unchanged. Conclusion. The use of the described inverted ILM flap technique in surgery of recurrent operated macular rupture serves to increase the effectiveness of treatment.

The complexity of the visual analyzer organization is an incentive for the search and improvement of its diagnostic methods, which allow us to assess visual perception and the effectiveness of processing information obtained as a result of the visual pathway. The review considers in detail the methods of studying the central departments of the visual analyzer, which presumably are crucial in the processes of neuroadaptation. A review of Russian and English-language scientific medical literature was carried out using databases of medical and biological publications: PubMed, Russian scientific electronic libraries Elibrary and Ciberleninka; the electronic library of dissertations and abstracts disserCat; the archives of the journals: Bulletin of the Russian Military Medical Academy; Aerospace and Environmental Medicine; Sensory Systems Journal; Annals of the Russian Academy of Medical Sciences; Russian Ophthalmological Journal; Russian Journal of Clinical Ophthalmology; Ophthalmology in Russia; Russian Journal of Physiology and others. The last search query was dated April 14, 2021. On the issue under study, 63 medical publications were selected, of which 47 works (1965-2021) were identified as the most informative publications that meet the purpose of the review.

The review analyzes available data and identifies problems in the diagnosis of amblyopia. Many authors come to the opinion that traditional methods for detecting amblyopia are insufficient and it is necessary to search for other objective methods, considering that the new methods presented in the literature do not have objective confirmation of their effectiveness. The following databases were used to search for information: eLIBRARY, Scopus, Google Academy PubMed. The analysis of 50 sources of literature on the topic of amblyopia for a period of no more than 15 years was carried out, 30 sources dated 2008-2021 were selected for the literary review.

Purpose: to evaluate by microperimetry and ОСТ the morphofunctional parameters of the retina during recombinant prourokinase subretinal introduction followed by pneumodislocation in comparison with anti-VEGF therapy in the long term for patients with submacular hemorrhage. Material and Methods. Depending on the surgical treatment choice, patients were divided into two groups. In the 1st group 11 patients (11 eyes) received anti-VEGF therapy; in the 2nd group 9 patients (9 eyes) underwent standard 25G vitrectomy with subretinal injection of 0.2-0.3 ml of prourokinase solution and airtamponade of 70% of the vitreous volume and introduction of anti-VEGF drugs 14 days afterthe operation. Results. In patients of the 2nd group, successful dislocation of the clot was achieved in 89% of cases; depression of the central retinal thickness was revealed by 4 times; the height of chorioidal neovascularization decreased by 2.8 times based on an improvement in visual functions by 10 times; the number of loci corresponding to areas of absolute scotoma decreased by 4.7 times, while the general photosensitivity of the retina increased by 12.6. Conclusion. The assessment of the retinal morphofunctional parameters demonstrates an increase in visual acuity due to favorable anatomical outcome and the subsequent maintenance of the achieved parameters in the long term in patients with submacular hemorrhage after subretinal injection of prourokinase and pneumodislocation followed by anti-VEGF therapy.

Purpose: to assess the dynamics of changes in visual functions by Fundus microperimetry (FMP) at various times of observation after vitrectomy using silicone oil tamponade (SOT) for macula-off reghmatogenous retinal detachment (RRD). Material and Methods. The duration of primary macula-off RRD in the group I was up to 13 days (10 eyes); in the group II — from 14 to 30 days (10 eyes). Contralateral eyes without ophthalmological pathology represented the control group. All patients underwent FMP on the 3rd, 30th, and 90th days after SOT and on the 30th day after removal of the silicone oil (SO). Results. There was a tendency to an increase in the maximum corrected visual acuity (MCVA) for periods up to 90 days in the group I and up to the 30th day in the group II. After a SO removal the MCVA index was 0.48±0.11, which exceeded the data on the 90th day by 1.92 times (p=0.002), and the data on the 3rd day by 2.8 times (p<0,001). In the group II the MCVA value was 0.28±0.16, which exceeded the data on the 90th day by 1.47 times (p=0.12) and the data on the 3rd day by 2 times (p=0.05). After the SOT removal in the group II in the 1st zone was detected a decrease in the light sensitivity (LS) parameter by 1.33 times (p=0.05), in comparison with the data on the 90th day, associated with a shift in the fixation point. In the group I the MCVA index had a strong positive correlation with the LS in the 1st zone (r=0.73) and the average value of the LS (r=0.66). In the group II, the moderate positive correlation was demonstrated, both between the MCVA and the SP in the 1st zone (r=0.55), and the average value of the LS (r=0.51). Conclusion. In cases with RRD using SOT revealed different dynamics in the MCVA, LS and fixation parameters, depending on the duration of RRD.