№1, 2025, volume 21

Nevus of the sebaceous glands of Jadassohn is a congenital hamartoma, which is of interest to dermatologists with the possibility of benign and malignant degeneration during the patient's life. The article describes rare manifestations of nevus: a case of a cranial nevus with a late onset in adulthood, an extracranial nevus with a large area of distribution, a clinical and dermoscopic description of an advanced malignant cranial nevus. A detailed description of the stages of the course of the nevus, its dermoscopic and pathomorphological characteristics, and approaches to therapy are also given.

The features of the clinical picture and diagnosis of congenital Epidermolysis bullosa in a newborn girl born in a closely related marriage (parents are cousins) are described. Among the features of the clinic, it should be noted the rapid increase in damage to the skin and mucous membranes during the first 10 days of life and the weak ability of damaged tissues to epithelize and heal. Genetic analysis of the blood and skin of a sick child made it possible to clarify the type of congenital hereditary disease, to detail the mutation of the corresponding genes and to clarify the prognosis of the disease.

Objective: to evaluate echocardiographic changes in patients with acute coronary syndrome (ACS) combined with post-COVID syndrome. Material and methods. The study included 118 patients, including 61 men and 57 women with ACS and a post-COVID syndrome. All patients underwent echocardiography on the first day, in addition to coronary angiography and general clinical examination methods. The comparison group consisted of 121 patients with ACS without post-COVID syndrome. Results. In the ACS and post-COVID syndrome group, statistically significant increases in blood pressure (relative risk — RR 2.327, 95% confidence interval — Cl 1.582-2.699), tachycardia (RR 2.067, 95% Cl 1.415-3.730), dyspnea (RR 2.022, 95% Cl 1.495-2.736), weakness (RR 4.077, 95% Cl 2.946-5.643), and insomnia (RR 1.893, 95% Cl 1.519-2.358); p<0,001, were recorded. In the group of patients with ACS and post-COVID syndrome, there was a statistically significant increase in the mean pulmonary artery pressure, dilation of the pulmonary artery diameter, and regurgitation on the mitral valve (p<0,001). The risk of developing left ventricular apex thrombosis (RR 1.785, 95% Cl 1.304-2.444), left ventricular aneurysms (RR 1.736, 95% Cl 1.23-2.443), hypokinesis and akinesis (RR 1.673, 95% Cl 1.275-2.196); p<0,05, was observed more often. Conclusion. Patients who have had ACS combined with post-COVID syndrome show more severe echocardiographic changes compared to patients without post-COVID syndrome.

Objective: to compare the levels of biomarkers of systemic inflammation between groups of patients with paroxysmal and persistent forms of atrial fibrillation (AF). Material and methods. The study included 232 patients diagnosed with AF who underwent the primary procedure of pulmonary vein ablation. The average age was 62 (54;67) years. Patients were divided into two groups: with paroxysmal and persistent forms of AF. Results. As a result of the analysis of the levels of inflammatory markers, no statistically significant differences were found between the groups. For systemic inflammatory response index, 0.8 (0.6; 1.1) vs 0.9 (0.7; 1.1); p=0.077; for systemic inflammation index 361 (276; 509) vs 373 (294; 551); p=0.505; for aggregate inflammation systemic index 170 (122; 255) vs 197 (139; 259); p=0.150; for neutrophils lymphocytes ratio 1.6 (1.3; 2.2) vs 1.8(1.3; 2.3); p=0.428; for platelets lymphocytes ratio 122 (86; 132) vs 107 (91; 130); p= 0.576; for monocytes lymphocytes ratio 0.228 (0.177; 0.291) vs 0.241 (0.2200; 0.301); p=0.262. After statistical correction for the initial clinical characteristics, no differences were also obtained. According to the ROC analysis, no statistically significant threshold values of the levels of the studied markers were found for each form of AF. Conclusion. In this study, there was no difference in the level of "new" biomarkers of systemic inflammation between patients with paroxysmal and persistent forms of AF. Currently, data on the existence of an association between the levels of biomarkers of systemic inflammation and various forms of AF are contradictory, further research in this direction is required.

Objective: to analyze the effectiveness of modern methods of prevention and early treatment of scarring in burned patients, taking into account pathogenetic mechanisms. The methodology of writing a review. The review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology using the eLibrary, PubMed, and Medline databases. The search depth is from 2003 to 2024. Number of sources viewed —1372. The review includes 16 original studies. The most effective and widely used methods of early treatment and prevention of scars in burned patients have been established. Conclusion. The analysis of scientific papers revealed that early excision of granulation tissue and fibrously altered dermis, followed by autodermoplasty with full-layer skin grafts, as well as the complex use of drugs whose mechanism of action is aimed at suppressing the metabolic activity of fibroblasts (glucocorticosteroids, calcium channel blockers), worsening blood supply in the scar, removing excess extracellular matrix, reducing moisture loss from the skin surface, improves the characteristics of the emerging scar tissue.

Objective: to analyze the anthropometric features of the prosthetic bed and masticatory muscles in patients with complete secondary adentia for planning orthopedic treatment. Material and methods. 63 people participated in the examination, who, according to the inclusion/exclusion criteria, were divided into two groups: the first (n=30) — control, the second (n=33) — patients with complete secondary adentia. Ultrasound examination was used to study the structural features of the chewing muscles and prosthetic bed, and the results were compared with a group of healthy individuals. Results. In patients with complete secondary adentia, atrophy of the prosthetic bed mucosa is noted, the average blood flow rate was 9.7±0.8%, which is 2.4 times less than in the control group of 23.4±1.9% (p<0,001). A statistical difference was obtained in determining the area of the chewing muscles at rest and tension — 69.8±2.8%, which is 15.7% less than in the group of healthy people — 80.8±1.8% (p=0.03). The thickness of the prosthetic bed varied from 0.3 mm to 0.5 mm, depending on the location, so the thickness of the prosthetic bed in the anterior part was 0.363±0.01 mm, in the lateral — 0.354±0.01 mm. A2.2-fold decrease in this parameter relative to the control group indicated atrophy of the prosthetic bed mucosa (p=0.03). Conclusion. In patients with complete secondary adentia, there is a decrease in the thickness of the masticatory muscles and prosthetic bed due to the development of atrophic processes of muscle tissue against the background of a decrease in the rate of local blood flow against the background of stagnation.

Objective: to determine the pathogenetic role of tissue expression of tumor necrosis factor a (TNF-a), interleukins (IL) 1(3 and IL-6 in the development of the clinical and morphologic diversity of chronic apical periodontitis. Material and methods. The study involved 94 patients with apical periodontitis. Clinical, radiographic, and morphological data were used. Lesion samples were taken during apicoectomy, and pulp tissues were taken from removed molars for cytokine analysis. Results. The levels of IL-1 b and IL-6 significantly differed between the symptomatic, asymptomatic, and control groups. IL-1 b in the symptomatic group was 22.03±3.21 pg/ml, in the asymptomatic group it was 14.17±3.34 pg/ml (p<0.001), there was no IL-6 in the control group. 26.38±5.09 pg/ml (symptomatic) versus 12.32±2.61 pg/ml (asymptomatic; p<0.001). TNF-a was detected in 23 cases of periodontitis without intergroup differences. In radicular cysts, IL-1 b is higher than in granulomas(p<0.001). Correlation of IL-1 band IL-6: Rs=0.32(p=0.043) and Rs=0.44 (p=0.026). Conclusion. The key role of IL-1 p and IL-6 in the development of clinical and morphological diversity of chronic apical periodontitis was confirmed. IL-1 (3 level >15 pg/mL distinguishes symptomatic from latent lesions, and its concentration >18 pg/mL in radicular cysts is a marker for the choice of treatment tactics. IL-6 correlates with bone resorption, justifying the use of its inhibitors in refractory forms. The results formed the basis of a protocol for periapical fluid testing for early stratification of patients to reduce the risk of unnecessary tooth extraction.

Objective: to evaluate the possibility of using the technology of step-by-step formation of the foveal intact fragment and the superior inverted fragment of the internal limiting membrane in surgery for traumatic macular hole of the retina. Material and methods. 7 patients (7 eyes) with traumatic macular hole as a result of severe contusion of the eyeball, including 5 with complicated traumatic macular hole, 2 with uncomplicated. Preoperative best corrected visual acuity (BCVA) ranged from 0.03 to 0.12, minimal macular hole diameter ranged from 230 to 512 urn. All patients were operated on using a modification of the surgical technique. The observation period is up to 1 year. Results. Closure of the traumatic macular hole occurred in all patients. In all treated patients, over a period of up to 3-6 months, there was a gradual increase in visual acuity (up to 0.5-0.7), the limitation of which in some cases (up to 0.05-0.2) was associated with the severity of the consequences of the contusion on the neuroreceptorthe apparatus of the eye and the combination of lesions. Conclusion. The proposed technology can be successfully used in surgery for traumatic macular hole, especially with combined contusion damage to the posterior pole of the eyeball, because it allows for surgical intervention without long-term postoperative tamponade of the vitreal cavity with gas or silicone oil.

Objective: to determine the effectiveness of rinsing the nasal cavity with a large volume of mineral-vegetable isotonic solution using an individual device in the postoperative period in patients with severe chronic rhi-nosinusitis with polyps and compare the results of the study with the effectiveness of copious instillation of the same solution into the nasal cavity. Material and methods. The study included 45 people aged 28-49 years after endoscopic pansinusotomy In the postoperative period, 2 groups were identified: in group 1 (n=33), the nasal cavity was rinsed using an individual device with a mineral-vegetable isotonic solution (recipe No. 1) with a volume of 240 ml and a temperature of 36 °C 2 times a day. In group 2 (n=12)— copious instillation of the same solution (20 ml in each half of the nose) was performed 4 times a day. The effectiveness of nasal breathing was evaluated according to the Visual Analog Scale and the Sino-Nasal Outcome Test 22 questionnaire and the degree of crust formation on days 5-6, 14. Results. In group 1, the effectiveness of nasal breathing was significantly higherthan in group 2 on days 5-6 and 14 of follow-up according to Visual Analog Scale (p=0.001 and p=0.04, respectively), the Sino-Nasal Outcome Test 22 (p=0.002 and p=0.004) and the condition of the nasal mucosa. Conclusion. Rinsing the nasal cavity with an individual device with a solution of the composition (recipe No. 1) is effective for improving nasal breathing in the postoperative period, reduces cortical formation, and normalizes healing. With heavy instillation, these indicators were worse.