2022, volume 18

Objective: clinical substantiation of the periodicity of professional oral hygiene at the stages of prosthetics on dental implants. Material and methods. In the process of dynamic clinical observation during the year for 45 patients in the process of prosthetics on dental implants, hygienic and periodontal indices were used: index Green J. C, Vermillion J.R. — OHI-S; Hygiene index of supraconstruction — IGs ' gingivitis index — Gl (Loe H., Silness J.); Muhlemann — Cowell index; papillary-marginal-alveolar index — RMA in Parma modification. Results. The period after pre-implantation oral debridement until the completion of permanent prosthetics on implants is accompanied by a deterioration in hygienic parameters at the end of the osseointegration period, when the opening of implants and fixation of gum formers or abutments is indicated; at the end of the use of temporary polymer prostheses before the completion of permanent prosthetics. The OHI-S index, equal to 3.9 when applying for prosthetics, varies at different stages during the year before and after professional hygiene from 1.6 to 0.4. Conclusion. The stages of prosthetics on implants, coinciding with the deterioration of oral hygiene, should be accompanied by professional hygiene, which, from the installation of implants to the completion of the final prosthesis, should be carried out three times: before installing implants, before fixing gum formers or abutments, before fixing permanent prostheses.

Objective: development and evaluation of the clinical effectiveness of the technology of immediate sequential bilateral cataract surgery (ISBCS). Material and methods. The work was carried out in two stages. As part of the first stage, a literary analysis of the traditional algorithm for conducting ISBCS was carried out, as a result of which a modified algorithm for conducting surgical intervention (molSBCS) was developed. During the second stage, 130 patients (mean age 58.4±1.8 years) with uncomplicated binocular cataract were under observation. Patients were divided into two groups of equal age and visual condition —the main group (67 people, 134 eyes), who underwent molSBCS, and the control group (63 people, 126 eyes), who (21-28 days after the first operation) underwent surgery on the second eye (delayed sequential bilateral cataract surgery, DSBCS). Results. The analysis of traditional provisions served as the basis for improving the technology of ISBCS by including a long (at least 60 minutes) break between operations with a comprehensive examination of the patient in the algorithm of surgical intervention. The data obtained indicate a similar clinical efficacy of molSBCS and DSBCS. Conclusion. The molSBCS can be considered as an effective and safe method of surgical treatment of cataracts, which is especially important for patients with visually stressful work.

The article presents a case of pregnancy in a patient with a transplanted kidney. Pregnancy management of this patient presented certain difficulties: dynamic supervision of related specialists was required. The peculiarity of the case is due to the rare occurrence and presence of a complication — pyelonephritis of the graft. The practical significance of this clinical case lies in the peculiarities of pregnancy management of a patient with a transplanted kidney, the correct tactics of both conservative and surgical treatment for successful delivery and preservation of the life of the mother and child.

Objective: to evaluate the local and integral parameters of the mucociliary clearance (MCC) of the nasal cavity in the postoperative period in patients with foreign bodies in the maxillary sinus using various methods of surgical approach to the maxillary sinus. Material and methods. The study performed in 90 patients with foreign bodies in the maxillary sinus and 60 healthy individuals. To evaluate MCC, we used the technique of high-speed digital video recording of the microscopic picture of the specimen and saccharin test; computed tomography (CT) data. Results. Local MCC in the rhinological healthy individuals in our study was 10.84±3.80 Hz. There is a linear correlation of the local MCC and the saccharin test with inverse mean strength (r=-0.64). Local MCC depend on the type of surgical approach; the saccharin test do not reflect the nature of the surgical injury and quickly normalized. The degree of pathological changes in the area of the ostiomeatal complex on the computed tomogram, correlates with the local MCC before and after surgery. Conclusion. The measured indicator of local MCC characterizes the processes in the area of the ostiomeatal complex and correlates with CT; the values of local MCC due to surgical trauma decrease for up to 3-5 months. The saccharin test is not a method for determining the osteomeatal complex function and cannot be used as a diagnostic criteria. The method of investigation of local MCC can be used as a criterion for choosing surgical access to the maxillary sinus.

Objective: to consider the clinical experience of duplex sonography in the diagnosis of brachiocephalic arterial pathology and to summarize the reference values of ultrasound markers of cerebrovascular disease (CVD). A systematic search of the scientific literature was performed in the PubMed, ProQuest Dissertations & Theses Global, and ProQuest Ebook Central databases from 1983 to the present, and included 47 relevant sources. The following search terms were formulated: "vascular neurology", "noninvasive diagnostics of CVD", "duplex sonography of head and neck vessels", "stenoocclusive lesions of cerebral arteries". Duplex scanning is an integral part of the diagnostic algorithm of screening and expert evaluation of pathological changes in CVD, which contributes to the personalization of diagnosis and treatment, significantly improving the results of primary and secondary prevention of ischemic events.

Objective: to analyze of genetic mutations in patients suffering from Parkinson's disease. To achieve this objective, domestic articles and dissertations were studied, as well as foreign literary sources placed in scientific databases such as PubMed and Medscape. The list of references consists of 25 scientific researchs published from 2015 to 2022. In a result of generalization and systematization of the data, it was found that mutations in different gene loci lead to different clinical phenotypes of Parkinson's disease, which can help predict the course of the disease. It was also determined that the mutation in the GBA gene is the most common genetic defect in the Russian population. Determination of genetic mutations that cause Parkinson's disease in real clinical practice will allow diagnosis and treatment of the disease at the premotor stage, especially in people with a burdened family history.

The SARS-CoV 2 virus infects lung tissue, blood vessels of the heart, brain (GM), peripheral and central nervous system. There is a decrease in immunity, and with damage to the kidneys, spleen, liver and pancreas, a syndrome of multiple organ failure occurs. With the defeat of the paranasal sinuses, the development of frontal sinusitis, sphenoid-itis, ethmoiditis is possible, followed by powerful necrosis of the tissues of the head and neck, the development of an abscess of the brain. The author considers her own clinical observation of patient M., 42 years old, with a diagnosis: "BM abscess in the basal parts of the frontal lobes. Ischemic stroke in the basin of the left middle cerebral artery (MCA). Novel coronavirus infection U07.1 COVID-19, severe form. Community-acquired bilateral polysegmental viral-bacterial pneumonia. Bilateral frontal sinusitis, ethmoiditis, right-sided sinusitis, right-sided sphenoiditis. This clinical case draws attention to the fact that the combination of this pathology led to formidable complications: thrombosis of the right internal carotid artery (ICA); mucormycosis of the nasal bones, thrombosis of the cavernous sinus. Peripheral nervous system lesions in the form of multiple cranial polyneuropathy were stated. Ischemic stroke in the territory of the left MCA. The presented observation will be a definite contribution to the accumulation of data and will help in organizing basic and additional studies in neurological patients with a new coronavirus infection U07.1 COVID-19.

The SARS-CoV-2 virus in U07.1 COVID-19 affects the lung tissue, blood vessels of the heart, brain and lower extremities. Against the background of a nowel coronavirus infection, cases of damage to the peripheral nervous system (PNS) have become more frequent. The article presents five clinical cases (3 men and 2 women) of the development of polyneuropathies, when patients developed tetraparesis after an average of 14 days, and the distribution of clinical variants resembles those in classical Guillain — Barre syndrome (GBS), confirming the predominance of acute inflammatory demyelinating polyneuropathy and sensorimotor syndrome. The typological characteristics of PNS lesion in patients with GBS against the background of U07.1 COVID-19 are described. Attention should be paid to the massive release of cytokines in COVID-19, which contributes to the strengthening of the dysimmune process underlying GBS. The effectiveness of the applied plasmapheresis in complex treatment indicates a postinfectious immune-mediated mechanism of GBS development. The considered variants of PNS lesion in patients with GBS clearly demonstrate the difficulties that arise in the diagnosis of PNS lesion in the conditions of departments for patients with U07.1 COVID-19. The article discusses the necessary and optimal both basic and additional laboratory and instrumental research methods. Unfortunately, not all departments are equipped with modern diagnostic equipment necessary for the timely and earliest diagnosis of neurological complications in patients with U07.1 COVID-19.

Objective: to analyze the frequency of occurrence and structure of comorbid disorders in patients with rare episodic, frequent episodic and chronic migraine without aura. Material and methods. Outpatient records of 159 patients with migraine without aura were analyzed: 52 with rare episodic migraine (REM), 54 with frequent episodic migraine (FEM), 53 with chronic migraine (CM). All patients underwent a clinical and psychological examination with an assessment of the state of the temporomandibular joint, frontal, occipital muscles, neck muscles (pericranial muscles) and chewing muscles with an emphasis on the pterygoid muscles. All patients were consulted by a clinical psychologist. Results. Additional headache symptoms have been identified in various forms of migraine. In the structure of comorbid conditions, the following were noted more often than others: disorder of pericranial muscles (REM 59.6%, FEM 72.2%, CM 90.5%), dysfunction of the temporomandibular joint (REM 21.1%, FEM 22.2%, CM 54.7%), anxiety-depressive disorders (REM 26.9%, FEM 35.2%, CM 58.5%), insomnia (FEM 22.2%, CM 39.6%). With CM, there is a high percentage of medication-overuse headache (73.6%). Conclusion. Comorbid disorders occur with varying frequency depending on the form of migraine. Among comorbid disorders, muscle dysfunction, dysfunction of the temporomandibular joint, anxiety and depressive disorders, and sleep disorders predominate.

Infantile cerebral palsy is one of the most common causes of persistent disability in childhood. The main method of treatment of motor disorders in this pathology is physical rehabilitation. Objective: a comparative analysis of the effectiveness of the use of kinesiotherapy methods for various forms of infantile cerebral palsy The analysis of scientific articles in public databases was carried out: MEDLINE® (Ovid), AMED, Embase, CINAHL и АРА PsyclNFO®, published in the period 1985-2021. The following keywords and phrases were used in the search: "kinesiotherapy", "infantile cerebral palsy". A total of 102 articles were analyzed. The review includes 17 scientific papers according to the methods of kinesiotherapy used and methods for evaluating their clinical effectiveness. The results of the system analysis demonstrate the positive effects of kinesiotherapy in the rehabilitation and habilitation of children with various forms of infantile cerebral palsy. As factors that increase the effectiveness of kinesiotherapy, group forms of training in the form of a game should be noted.