2024, volume 20

Objective: to evaluate the value of tuberculosis preventive treatment (PTT) in children with tuberculosis infection. Material and methods. As part of a continuous study, a cohort of 200 children from 1 to 17 years old taken for clinical observation in group VI A (positive test result with the recombinant tuberculosis allergen [ATR]) was analyzed. All children underwent additional examination methods to exclude the local form of tuberculosis: physical examination, laboratory clinical and biochemical tests of blood and urine, multislice computed tomography of the chest organs and, according to clinical recommendations, PTT was proposed, which the parents of 65 children refused. Study groups: 1 — those with no family contact with a patient with tuberculosis (ТВ) (n=70): 2 — those with contact with a patient with ТВ (n=65), in group 3 included children whose parents refused PTT, despite the presence of indications (n=65), incl. 14 children were from Tl lesions. Children group 1 and 2 received PTT. Control over the PTT was carried out on the "Yandex.Teleconference". Results. As a result of comparison of the three groups, reliable data were obtained on the effectiveness of PTT according to the criteria of preventing the disease and reducing the results of the ATR test. A significantly high percentage of sick children in group 3 was established, compared with children from group 1 (p=0.008; x2=18.6). When assessing the dynamics of the results of immunodiagnostic tests in children of the group 1 who received PTT, a decrease in the test with ATR was significantly more often observed compared to children without PTT(p=0.001; x2=17.2). It is worth noting that children had satisfactory tolerability of the drugs; no adverse events were observed in patients with daily video recording. Conclusion. A conclusion was made about the need for preventive work with parents of children who refused preventive treatment to increase their level of adherence, the need to evaluate the effectiveness of PTT courses using primary and additional criteria, including the importance of controlled PTT.

Objective: Assessment of the characteristics of the microelement composition of the hair of children with type 1 diabetes mellitus (T1DM) to develop recommendations for diet correction. Material and methods. The study involved children with T1 DM (n=28) and practically healthy children from the comparison group (n=56) aged 3-5 years living in the Omsk region. The elemental composition of hair was analyzed by atomic emission and mass spectrometry with inductively coupled argon plasma. The research materials were subjected to statistical processing using nonpara-metric criteria. Results. The elemental profile of hair of children with T1 DM has been determined. Significant differences were found in the amounts of microelements in hair: lower values of beryllium (p=0.0001), chromium (p=0.003), lithium (p=0.005), vanadium (p=0.005), selenium (p=0.043), and large amounts of cuprum (p=0.025), phosphorus (p=0.001) in the hair of children with diabetes in comparison with the group of practically healthy ones. In the group of children with T1DM, there was a smaller proportion of people with insufficient magnesium (p=0.003), phosphorus (p=0.001), and cuprum (p=0.001). The severity of mineral metabolism disorders (MMD) was less in the group of children with T1DM: 53.6% of children were classified as having no MMD or having minor MMD. Conclusions. The elemental composition of the hair of children with T1DM was characterized by higher amounts of phosphorus and cuprum, lower content of chromium, selenium, beryllium, lithium and vanadium. The proportion of children with insufficient supply of magnesium, phosphorus, cuprum was higher in the comparison group. The degree of MMD in the group of children with T1 DM was generally less.

Objective: to identify indicators of arterial stiffness that change after COronaVlrus Disease-2019 (COVID-19). Material and methods. Included were 112 people examined before and after the start of the new coronavirus infection (NCI) pandemic: healthy individuals (groups "H" and "H/COVID +") and patients with arterial hypertension (AH) (groups "AH" and "AH/COVID+"). An isolated comparative study was carried out in groups of healthy people and patients with hypertension. Results. Individuals in the "H/COVID+" group had higher levels of non-high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and more low values of high-density lipoprotein cholesterol (p=0.038; p=0.032; p=0.006) when compared with group "H". According to ABPM data, between the "AH" and "AH/Covid+" groups it was revealed difference at night level of reflected wave transit time (RWTT). An increase in cardio-ankle vascular index (L-/CAVI.,) in healthy persons and subjects with AH (p=0.001; p=0.004). In patients "H/COVID+" group higher values of pulse wave velocity in the aorta (PVW), elastic arteries type (R/L - PVW) and biological age (p=0.001; p=0.005; p=0.001) were registered. Conclusion. In healthy individuals who have had COVID-19, lipid profile abnormalities were noted, as well as an increase in L-/CAVI., when compared with the group of those who were not ill. In patients with AH after COVID-19, a negative change in the majority of indicators of arterial stiffness was noted.

Objective: selection of optimal biological wound coverings for the treatment of patients with borderline burns. Material and methods. The results of treatment of 30 patients aged 28-58 years were analyzed. All patients were diagnosed with second degree burn wounds of varying localization and area from 5 to 20% (according to International Classification of Diseases 10th Revision). Of these, 13 (43%) patients in group I (age 48 [39; 54] years) underwent surgical removal of necrosis, and ChitoPran® biological wound dressings were applied to the wounds. The remaining 17 (56%) patients in group II (age 42 [28; 58] years) also underwent early surgical treatment, but the grafts were covered with synthetic Voskopran™ wound coverings. Results. In group I, where the biological wound coating ChitoPran® was used, the epithelialization period was 10 (9.0; 10.0) days. In group II, where the synthetic wound coating Voskopran™ was used, the epithelialization period was 12 (11.0; 13.0) days (p=0.031). The data obtained show that biological wound coatings ChitoPran® demonstrate an advantage in accelerating the timing of wound epithelization compared with synthetic wound coatings Voskopran™. In group I, the duration of hospitalization was 10.5 (10.0; 11.0) days, for group II — 11.5 (10.0; 12.0) days (p=0.048). Conclusion. A comparative assessment of the effectiveness of biological wound coverings in the treatment of patients with borderline burns showed that, in contrast to the synthetic wound covering Voskopran™, the use of the biological wound covering ChitoPran® provides favorable conditions for regeneration, due to which the period of epithelization of wounds was reduced by an average of 1-2 days, and hospitalization time is on average up to 2 days.

Objective: to assess the informativity of the use of the rapid cytological method in the study of sentinel lymph nodes in patients with breast cancer. Material and methods. The study involved 46 patients from 30 to 85 years old with verified breast cancer. On the eve of the operation, about 150-200 MBq of the 99 mTc-Nanotope radiopharma-ceutical was peritumorally injected into the parenchyma of the affected mammary gland. After 1.5-2 hours, lymphos-cintigraphy was performed, followed by SPECT/CT, in which sentinel lymph nodes are zualized. The next day after the administration of the radiopharmaceutical, during surgery, sentinel lymph nodes were found using a g-detector. Further, the surgeon removed the node (or nodes) and sent them for express cytological examination. To check the informativity of this method, a comparison was made with the "gold standard" of morphological diagnostics — with histological examination of postoperative material. Results. An express cytological study revealed the presence of metastases in the sentinel lymph nodes in 12 patients, which significantly influenced the further tactics. It was found that the cytological method of the study is not inferior to the histological one, the sensitivity and specificity of the method is 100%. When comparing the results of rapid cytological and planned histological studies, there were no discrepancies in diagnoses by the state of the lymph nodes. Conclusion. Rapid cytological examination of sentinel limphatic nodes informative method for sentinel lymph node detection in breast cancer patients.

We have presented a clinical case of successful restoration of the frontal group of teeth by the method of aesthetic restoration using the universal nanogibrid composite. The experience of applying direct restoration allows us to ensure high quality restoration of carious teeth, aesthetics of the dentition with minimal time costs — 1 day. Compared to the manufacture of ceramic structures, the time spent on the manufacture of structures is 7 days. The applied method is economically more favorable by an average of 50% compared to the last specified method.

Objective: to determine the effect of membrane peeling on the dynamics of retinal inner layers anatomy changes after surgery for retinal detachment with macular hole. Material and methods. Patients of group 1 (20 patients, 20 eyes) underwent surgical treatment with repair of the rupture using an inverted flap of the internal limiting membrane. Patients of group 2 (20 patients, 20 eyes) did not undergo hole blocking during the first stage of surgery. All patients underwent optical coherence tomography to assess the condition of the inner layers of the retina. Results. One day after surgery, in patients of group 1, the thickness of retinal tissue in the parafoveal zone was 128.2±11.6 nm. In patients of group 2 it was 102.7±6.4 nm (p=0.041). These values remained until the silicone oil was removed. When comparing the indicator of the volume of retinal tissue in the parafoveal zone, there is a decrease in the indicator in patients who underwent membrane peeling, the indicator was 0.645±0.041 mm3, compared with the data of patients of the 1st group, where it was at the level of 0.787±0.52 mm3 (p=0.047). In the temporal quadrant, the difference in indicators persisted until one year after surgery. Conclusion. Membrane peeling leads to damage to the retinal tissue, local defects which can persist up to a year. The outer layers of the retina are damaged throughout the entire area of the macula due to the impact on the supporting plates of the Muller cells and the nerve fiber layer.

This rare clinical case demonstrates the treatment of paralytic mydriasis caused by taking a herbal drug, Atropa belladonna, which is extremely rare in the treatment of diseases today, using sequential implantation of an intraocular lens (IOL) and an artificial iris with simultaneous correction of refractive errors. The patient took Atropa belladonna extract for 5 years to prevent exacerbation of gastric ulcer according to the scheme 2 times a year (spring, autumn) for 2 weeks, 5-7 drops 3 times a day with meals. The uniqueness is explained by the fact that paralytic mydriasis arose as a result of long-term drug exposure. Analysis of the state of the iris stroma showed the impossibility of performing suture plasty of the pupil. In addition, patients with this pathology have been denied treatment in other medical institutions for decades.

Objective: to evaluate the efficacy of the stentless endoscopic technique for congenital choanal atresia in infants. Material and methods. Subjects: 51 infants younger than 1 year of age undergoing the stentless choanoplasty procedure. Main group: 27 children who underwent surgery for the first time Comparison group: 24 children who experienced relapse after traditional stent-tube choanoplasty. To assess results, endoscopic examinations and saturation levels were used. The quality of life was evaluated using the Qualite de vie du Nourisson questionnaire for children between 3 and 12 months of age. Parents of 45 children were involved: 25 from the main group and 20 from the comparison group. Results. An endoscopic examination of the nasal cavity/nasopharynx in 50 patients showed no signs of restenosis over a 1- to 2-year follow-up period. The saturation level increased from 98.4±2.4% in the main group to 99.4±1.0% (p=0.001) in the comparison group; in the latter, it increased from 93.5±4.7 to 99.0±1.0% (p<0.001). The assessment of the quality of life after surgery using the stentless approach in the main group showed an increase from 14.4±0.4 points to 15.3±1.8 (p=0.056); points, while in the comparison group the increase was from 14.0±0.4 points to 15.6±1.0 points (p<0.001). Conclusion. Based on the results of this study, we can conclude that the endoscopic, stentless, nasal approach to surgical treatment of congenital choanal atresia in infants is more effective than traditional choanoplastic techniques with stent tubes.

The article presents the history of the formation and development of the leading department of the pedi-atric faculty of Saratov State Medical University named after V. I. Razumovsky. The path of formation of the scientific school of pediatric gastroenterology is traced. The main directions of educational, scientific and medical work of the staff of the department are highlighted.