№2, 2023, volume 19

Objective: to assess the possible effect of excess body weight on the results of surgical treatment of osteoarthritis of the ankle. Material and methods. 134 patients with moderate to advanced ankle osteoarthritis who underwent supramallear osteotomy or ankle arthrodesis. Patients were divided into 4 groups according to Body Mass Index: A) underweight (BMI<18.5 kg/m2), B) normal weight (18.530 kg/m2). All patients were followed up for more than 6 months. All patients were evaluated physically, as well as by VAS (Visual Analog Scale) and AOFAS (American Orthopaedic Foot and Ankle Society). Results. The AOFAS and VAS at 3 months and 6 months after surgery were significantly better in all four groups compared to the preoperative scores. A comparison of the preoperative AOFAS and VAS scores showed no significant difference between the four groups (p=0.505, p=0.779). A comparison of the AOFAS and VAS 6 months after surgery revealed no significant difference between the four groups (p=0.313, p=0.711). Conclusions. For the middle and late stages of osteoarthritis, regardless of the level of the patient's Body Mass Index, supramalleolar osteotomy, as well as ankle arthrodesis, showed the greatest effectiveness. During the early rehabilitation period, an increase in Body Mass Index had no negative effect on pain and functional recovery after ankle surgery.

Objective: to determine the species composition of pathogens of acute odontogenic inflammatory processes of the jaws in children, to determine the sensitivity and resistance of the isolated microflora to antibiotics of various groups, as well as to determine the dependence of the characteristics of the clinical course of the disease on the type of dominant pathogen. Material and methods. The analysis of the results of microbiological methods for the study of exudate from purulent odontogenic foci of 900 children, due to periostitis and osteomyelitis of the jaws, was carried out. Results. In 65.6% of cases, the causative agent was Pyogenic streptococcus or group A beta-hemolytic streptococcus (BHSA) ith a high level of sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactams (91 %) and the highest percentage of resistance to macrolides (41%). Streptococcus viridans (6.1%), Streptococcus pneumoniae (4.3%) and others were also isolated; mixed microflora (14.3%). The syndrome of endogenous intoxication of the body was manifested in 56% of cases by fever, in 38% by leukocytosis, in 57.4% by accelerated ESR. There was no statistically significant difference in the degree of endogenous intoxication in groups with different types of streptococcus. Conclusions. The cause of the inflammatory process of the jaws in 65.6% of cases was BHSA with a high level of sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactams (91 %).

Objective: to compare the characteristics of the periodontal condition in three categories of patients: smokers of electronic cigarettes, smokers of tobacco heating systems and non-smokers, taking into account age and gender. Material and methods. A comprehensive analysis of 1754 patient-smoker records was carried out: 1122 — electronic cigarettes (ES), 632 —tobacco heating systems (SNT). Data from 566 non-smokers were used as a control group (GC). Patients of all groups were divided into subgroups depending on age and gender. The clinical condition of the periodontium was assessed by dental indices and indicators. Statistical data analysis was performed using Microsoft Excel and Statistica 64 ver. 20.0 programs. Results. Gingivitis prevailed in the groups of persons with ES, SNT and GS. The frequency of gingivitis in the ES group decreases with age, while in the SNT group it increases. Among HS patients, gingivitis was recorded in all age groups. The frequency of acute periodontitis was highest in patients of the ES and SNT groups aged 35-39 years. In the Civil Code — at the age of 30-34 years. The frequency of gingivitis and acute periodontitis in persons of the SNT and ES group is more pronounced in women. In GS, these figures are almost equal. The frequency of registration of chronic localized periodontitis in persons of the SNT group is more pronounced in women, in the ES group these figures are higher in men. The frequency of registration of chronic general periodontitis in persons of all groups is more pronounced in women. Conclusion. The results of the study proved that the use of ES and SNT is a negative factor causing the occurrence of periodontal diseases.

Objective: to analyze the clinical effectiveness of apparatus rehabilitation in patients with maxillofacial pathology. Review writing methodology. The review of 15 publications is given in the article, where the results of research work of the employees of the Department of Dentistry of Surgical and Maxillofacial Surgery of V. I. Razumovsky Saratov State Medical University in the development of rehabilitation methods for patients with maxillofacial pathology during the period of thirty years (from 1995 to 2022) are presented. Employees of the Department of Dentistry of Surgical and Maxillofacial Surgery have substantiated the use of apparatus rehabilitation methods in the treatment of patients with the most widespread maxillofacial pathology. Conclusion. With the participation of staff of the Department of Dentistry of Surgical and Maxillofacial Surgery were created apparatus rehabilitation for physiotherapy, which meet the requirements of our time, which showed high efficiency in treating patients with the most common in the practice of the doctor's pathology of maxillofacial region. Patents for apparatus rehabilitation and methods of treatment of patients with head and neck diseases were received.

Objective: to conduct a comparative analysis of the parameters of the optic nerve head, retinal ganglion cells and microcirculation parameters in patients with primary open-angle glaucoma (POAG) of various stages in achieving the target intraocular pressure using the method of optical coherence angiotomography. Material and methods. 87 patients (87 eyes) with POAG were examined. Group 1 — 26 patients (26 eyes) with stage I POAG, group 2 — 19 patients (19 eyes) with stage II glaucoma, group 3 — 24 patients (24 eyes) with stage III glaucoma. Group 4 (control group) — 18 patients (36 eyes) without signs of glaucoma. Optical coherence tomography was performed on patients, angio-OCT scans 6.4x6.4 of the macula and optic nerve head were used. Results. The thickness of the nerve fiber layer (RNFL) was 94.00±10.54 urn in patients with stage I POAG, 48.00±1.00 urn and 41.00±1.73 urn in patients with stage II and III POAG, respectively, moreover, a more sensitive indicator is the RNFL in the lower peri-papillary zone (Inf RNFL). The thickness of the layer of retinal ganglion cells (RGCs) in patients with stage I POAG was 96.33±4.62 urn, with II — 70.33±1.53 urn, with III — 64.33±11.93 urn. The density of blood vessels in the area of the optic disc differed from the norm in patients with stages II and III of POAG (42.23±4.95 and 35.10±1.80, respectively). Conclusion. In patients with different stages of POAG, the greatest differences were found in RNFL in the lower segment, the area of the neuroretinal rim, the values of focal and global GCS loss, and the density of the vascular bed in the lower half of the peripapillary zone.

Objective: to present current data on the efficacy and safety of phakic intraocular lenses in keratoconus to correct ametropia in patients with stabilized keratoconus. Methods. The PubMed and Google Academy databases were used to search for articles. Queries were formulated taking into account the main topic of the review; the main key search phrases were: "phakic intraocular lenses", "keratoconus" in Russian and English. These keywords were used to find 72 articles. A total of 26 literature references published between 2003 and 2021 were used in this review. Conclusion. The studies presented so far indicate sufficient predictability and efficacy of the above technique. However, there are certain difficulties and possible side effects associated with this method. One of the main problems in the use of phakic intraocular lenses in patients with keratoconus is the difficulty in calculating the lens power, especially the toric component.

Laser keratomileusis in situ (LASIK) is the most common refractive surgery in young patients, the goal of which is to provide high distance vision without the use of glasses. One of the topical aspects of assessing the clinical effectiveness of LASIK is the dynamics of the accommodative function of the eye, which is a professionally significant function of the visual analyzer in patients with visually stressful work (VSW). Three clinical cases are presented, reflecting various states of accommodation (normal, habitual excessive tension of accommodation, asthenic form of accommodative asthenopia), diagnosed (based on the method of objective accommodation and the "quality of life" questionnaire "Computer visual syndrome — 22" in patients with VSW before LASIK. It was determined that that LASIK for various degrees of myopia in patients with VSW requires a comprehensive consideration from the standpoint of diagnosis and (or) correction of accommodative asthenopia based on a personalized approach that takes into account the main types of asthenopia. Correct diagnostics provides adequate treatment from the standpoint of choosing both the actual method (physical factor) and the required optical, amplitude and time parameters of exposure.

Objective: to compare the effectiveness of new method of sensory fusion recovery in patients with personalized adjustment of the frequency of alternation of liquid crystal glasses (LCG) compared with the empirical selection of the frequency of alternation. Material and methods. The study included 39 patients with concomitant convergent strabismus with orthotropy and no sensory fusion after surgical treatment of strabismus, who were prescribed LCG. The glasses were programmed empirically at 2 Hz in 21 patients (empiric group), in 18 patients — using the developed formula for calculating the frequency of alternation of LCG (calculated group). The compared groups did not differ in gender, age, visual acuity, and other characteristics. Results. Recovery of sensory fusion occurred more often with LCG in calculated group (16 patients, 88.9%) than in empiric group (9 patients, 42.9%), the difference is highly reliable (p=0.001). Conclusions. Anew method for personalized selection of the frequency of alternating LCG using video oculography is more efficient than empirical programming for sensory fusion restoration in children after surgery for concomitant convergent strabismus.