Aim. To study the anatomical and functional varieties of labial frenum and their prevalence in children aged 6–11 years in the territories of the Krasnodar Krai.

Materials and methods. We have studied the prevalence of varieties of labial frenum anomalies in 120 children at the initial and fi nal periods of mixed dentition. A preventive examination of 60 children (1st observation group) and 60 children receiving orthodontic treatment (2nd observation group) at the children’s dental department of the Dental Clinic of the Kuban State Medical University was carried out. The criteria for inclusion in the observation groups were somatically healthy children, living in the city of Krasnodar, and the cities and areas of the Krasnodar Krai. Statistical analysis was performed using the Statistica 6.0 (StatSoft Inc., USA) software. Qualitative data were described using absolute values and percentages. To identify differences in the sign occurrence frequency between the groups under consideration, Fisher’s exact test was used due to the fact that the expected number of observations in the cells of the four-fi eld table was less than fi ve. The obtained value of the exact Fisher’s test p < 0.05 testifi ed to the absence of statistically signifi cant differences.

Results. The prevalence of labial frenum anomalies reached 15% according to routine examination (1st observation group) and 20% — in children with dentoalveolar anomalies who applied for orthodontic treatment (2 observation group). No statistically signifi cant differences were observed between the groups of girls and boys by the prevalence of varieties of labial frenum anomalies (p > 0.05). In the 2nd observation group, labial frenum anomalies were detected 2 or more times more often (p < 0.05) in children living in cities (44.44%) and in the regions of the Krasnodar Krai, than in children living in the city of Krasnodar (21.43%).

Conclusions. Anatomical and functional classifi cation refl ects the main varieties of the labial frenum and allows the indications for surgical intervention to be clarifi ed. An alteration trend of the attachment location of labial frenum to the gingiva was found due to the physiological increase in the dentoalveolar height in the jaw anterior parts during the eruption period of permanent teeth and the formation of their roots. In this regard, it is advisable to plan surgical intervention in the period of late mixed dentition taking into account the anatomical and functional variety of the labial frenum.

Aim. To identify patients with a high risk of precancerous diseases of the colorectal region for colonoscopy assignment in the practice of a district physician.

Materials and methods. 122 patients were surveyed who underwent colonoscopy by the appointment of a district physician at the Municipal Polyclinic No. 3 in Tyumen. All examined patients were divided into two groups according to colonoscopy: with colon polyps — 64 (52.5 %) and without colon polyps — 58 patients (47.5 %).

Results. The mean age of patients in the group with colon polyps was 59.8 ± 4.7 years, in the second group — 58.2 ± 4.8 years. In the group with colon polyps, more patients exhibited a low physical activity and poor nutrition compared to the group without colon polyps. Erosive gastritis and obesity prevailed in patients of the group with colon polyps as compared to the second group. The number of patients who smoked and drank alcohol prevailed in the group with colon polyps, in comparison with the second group. Patients with colon polyps were twice as likely to have a burdened hereditary history of colorectal cancer as those without colon polyps.

Conclusion. Thus, the group of high risk of colon polyps included patients with risk factors: smoking, low physical activity and burdened hereditary history of colon cancer, as well as erosive gastritis in the history.

Aim. To describe the ultrastructural characteristics of the blood-air barrier (BAB) interstitium in fi brous cavernous pulmonary tuberculosis (FCT) in comparison with chronic nonspecifi c lung diseases (CNSLD).

Materials and methods. The fragments of the pericavernal zone and lung tissue were taken for the study at the resection border from the dead or operated for CNSLD persons (n = 163), and the perifocal and boundary zone of lung tissue. 116 CNSLD patients were divided into 3 subgroups:
1) chronic lung abscess (n = 42);
2) bronchiectasis (n = 44);
3) lung cyst (n = 30).
The lung fragments of 30 patients who died from pathology not associated with lung diseases (myocardial infarction, acute cerebrovascular accident) were used as a control group to compare the morphological parameters.
The criteria for inclusion of patients in the study: age from 18 to 65 years, negative clinical and laboratory data on the presence of comorbid pathology (viral hepatitis B, C and HIV). For TEM, lung fragments 1×1×1 mm in size were cut out and fi xed in a 2.5% glutaraldehyde solution in phosphate buffer (pH = 7.2–7.4) and washed in 0.1 M phosphate buffer (pH = 7.4), followed by dehydration in alcohols of an ascending concentration and placing in a mixture of Epon and Araldite resins according to the scheme. Ultrathin sections were made with Reynolds staining. Viewing and photographing preparations was carried out on a PEM-100 transmission electron microscope (Ukraine) (magnifi cation range from ×1000 to ×30 000). 

Results. It was established that changes in BAB components in all groups had similar features in the form of severe interstitial fi brosis, the signs of endothelial cell degeneration and destruction of varying degrees of severity, as well as the heterogeneity of the endothelial and epithelial basement membranes.

Conclusion. Ultrastructural changes in the BAB components of the removed lung part in patients with FCT and chronic nonspecifi c lung diseases are characterised by a polymorphism with prevailing dystrophic and destructive changes in the perifocal zone of infl ammation, and compensatory-adaptive processes on the peripheral, especially at the resection border. 

Aim. Clinical, epidemic and laboratory characterisation of ixodic tick-borne borreliosis in order to improve the early diagnosis of the disease and the timely etiotropic therapy.

Materials and methods. The medical histories of 257 patients with ixodic tick-borne borreliosis treated in the regional infectious diseases hospital in Krasnodar from 2004 to 2018 were analysed. The data of the epidemiological history, the clinical manifestations of the disease, the results of laboratory and instrumental studies, as well as the principles of therapy were analysed.

Results. The incidence of ixodic tick-borne borreliosis in the Krasnodar Krai is characterised by spring-summer seasonality, the predominance among women over 45, and urban residents. The disease has an acute course (85.9%), occurs mainly in the erythema form with little pronounced symptoms of intoxication, a typical ring-shaped erythema, which large dimensions remain longer in women. During the non-erythemic form of the disease, the development of serous meningitis and encephalomeningitis with impaired cerebral blood fl ow as well as the changes in corticocortical relationships were observed. During the sub-acute course, radiculopathy and polyneuropathy, as well as diffuse changes of the myocardium with conduction disturbance and the development of atrioventricular block, arthralgia and arthritis/arthrosis were registered. The increase in LDH, CPK and transaminase was observed for all forms of the disease.

Conclusion. In connection with the formation of a natural ixodic tick-borne borreliosis focus on the territory of the Krasnodar Krai, it is necessary to exclude this disease in patients with the signs of fever, weakness, and erythema at the site of tick suction. The tendency of ixodic tickborne borreliosis to the long course with the development of multiorgan pathology causes the need for follow-up observation of recovered patients both by an infectious disease specialist and narrow specialists (a neurologist, rheumatologist or cardiologist).

Aim. To compare the results of surgical treatment using bipolar hemostasis and traditional ligation of ligaments and blood vessels in vaginal hysterectomy.

Material and methods. Fifty patients with benign uterine disease underwent vaginal hysterectomy using electrosurgery (n = 29) or conventional suture ligation (n = 21 controls).

Results. Postoperative pain (especially on the fi rst day) was decreased in the electrosurgery group (5.50 ± 1.43 VAS points) as compared to the control group (7.64 ± 0.58 points), p < 0.001. Intraoperative blood loss was signifi cantly lower in electrosurgery group (82.86 ± 22.58 ml) than in the control group (226.36 ± 129.12 ml), p < 0.001. Operating time was signifi cantly shorter in the main group than in the controls (65.36 ± 20.9 min vs. 86.59 ± 40.19 min, p < 0.05). On average, 2.75 ± 1.11 suture packages were used with bipolar coagulation, 6.00 ± 1.93 in the controls (p < 0.001). Hospital stay was similar for both groups. Adverse event rates did not differ signifi cantly.

Conclusions. Bipolar coagulation with the TissueSeal Plus proved to be more effi cient or identical to traditional suture ligation. Intraoperative blood loss, postoperative pain and the duration of the operation were less, while the complications were identical for both groups. In addition, bipolar coagulation was easier to use and cost effective. These fi ndings prove the feasibility and effectiveness of the use of electrosurgical techniques to perform hysterectomy and its further study

Aim. To analyse the effi ciency of osteoplastic material application in order to reduce the resorption level after tooth extraction in the preimplantation period according to the data of cone beam computed tomography.

Materials and methods. The study involved 80 patients who were divided into 4 equal groups depending on the preservation material used. The fi rst group was treated with Cerabone (Botiss, Germany) xenomaterial based on natural bovine bone. Plasma enriched with PRGF growth factors obtained by the BTI Endoret (Spain) technology was used for the patients of the second group. The third group consisted of patients who underwent a socket preservation of the extracted tooth with a powdered autologous dentin matrix (ADM) obtained from their own tooth. In the fourth group, bone-plastic material based on hydroxyapatite with Collapan-L lincomycin hydrochloride (Intermedapatit, Russia) was used to prevent socket resorption. All patients had a cone beam computed tomography of the maxillofacial region before the extraction and 3 months after the preservation in order to evaluate the level of bone resorption. After the installation of dental implants, a comparative assessment of the bone resorption level in the vertical and horizontal directions before tooth extraction and in the preimplantation period was carried out.

Results. The smallest level of vertical bone resorption after socket preservation was observed in group 1 (Cerabone) and group 3 (ADM). The median value of the socket resorption level in group 1 was 0.7 mm (8.54 %) in the vertical direction and 0.5 mm (9.45 %) in horizontal measurement as compared to the level of bone tissue before tooth extraction. Similar indicators were observed in the group using an autologous dentin matrix. The vertical decrease in the socket bone tissue was 0.61 mm (7.75 %), horizontal — 0.51 mm (6.2 %). The level of bone resorption was signifi cantly higher using two other materials.

Conclusions. The use of three-dimensional radiation research methods allows a comprehensive assessment of the bone tissue volume to be carried out, which in turn determines the choice of the dental implant size, the need for further bone-plastic surgery to increase the width/height of the alveolar ridge. The use of cone beam computed tomography showed that the most optimal results can be obtained by introducing Cerabone material into the socket of the extracted tooth, as well as using the innovative method of preservation with the patient’s own powdered tooth (ADM).

Aim. To study neurological disorders in rats when modeling purulent bacterial meningitis (PBM) on the example of pneumococcal meningitis under experimental conditions.

Materials and methods. Pneumococcal meningitis was modeled by injecting a suspension containing Streptococcus pneumoniae at a concentration of 5×109 CFU/ml into the subarachnoid space. The degree of neurological disorders was determined by clinical assessment of rat health status, the degree of neurological defi cit, specifi c strength, “Infrared activity monitor”, “Object recognition task” tests.

Results. When modeling pneumococcal meningitis in rats, the sum of points of clinical assessment of their health in the 1st day after modeling the pathology is 34.2 % less than the initial, on the 5th — less than 3.4 %, on the 8th day returns to the primary indicator, 5 points. The maximum degree of severity of neurological defi cit was observed in the fi rst four days after meningitis modeling; it was in the 1st day 34 % less than the same indicator in the group of intact animals, on the 2nd day 32.7 % less, on the 3rd day — 30.7 % and on the 4th day — 30.1 %. In the meningitis group on day 10, the distribution of neurological defi cit by severity was as follows: mild — 32 %, medium — 20 %, severe — 16 %, without residual neurological defi cit — 32 %. The specifi c strength of rats in the group of meningitis on the 1st, 5th and 10th day after the development of the pathology was 48.7, 64, and 67.4 % of the baseline specifi c strength. In relation to intact animals, the index of recognition of short-term memory in rats of the meningitis group is 2.3 times greater, and the index of recognition of long-term memory is 1.7 times greater.

Conclusion. The dynamics of neurological disorders in rats in the simulation of PBM can be determined using the methods of assessing behavioural and cognitive status. In rats, when modeling pneumococcal meningitis, neurological disorders are maximally expressed on the 1st day of the disease. Then there is a distinct positive dynamic up to 5 days of the disease. From 6 to 10 days positive dynamics is present, but insignifi cant.

Aim. To study the cardioprotective effect of levorotatory ethylmethylhydroxypyridine malate enantiomer in combination with rosuvastatin on the model of doxorubicin cardiomyopathy.

Material and methods. The research was conducted using 80 Langendorff perfused Wistar rat hearts (OOO “Kardioprotekt”, Saint-Petersburg) after a 3-day simulation of doxorubicin cardiomyopathy. The selection criteria for the evaluation of cardioprotective effect in the administration of ethylmethylhydroxypyridine derivatives and their combination with rosuvastatin were the indicators of left ventricular contractility, Tension-Time Index (t TTI), the diameter of cardiomyocytes.

Results. During the experiment, it was found that the introduction of doxorubicin has a cardiotoxic effect, manifested through a decrease in the left ventricle contractility by 30–45% and an increase in the t TTI index by 4 times (“diastolic defect”). The introduction of a racemic mixture of ethylmethylhydroxypyridine malate at a dose of 93 mg/kg prevents the reduction of the left ventricle contractility and prevents the development of a “diastolic defect”, restraining the increase in the t TTI index by 32%, while the ethylmethylhydroxypyridine enantiomer at a dose of 93 mg/kg is more effective and its positive effect increases in combination with rosuvastatin at a dose of 0.4 mg/kg.

Conclusion. The use of oxypyridine derivatives at doses of 50 mg/kg and 93 mg/kg, as well as their combination with rosuvastatin prevented the development of a “diastolic defect”. The highest effi ciency was revealed for the use of a combination of levorotatory ethylmethylhydroxypyridine malate enantiomer at a dose of 93 mg/kg with rosuvastatin at a dose of 0.4 mg/kg.

Aim. To establish signifi cant factors infl uencing the discrepancy of lifetime and postmortem diagnoses and to offer a technique of comparison of diagnoses when carrying out the clinical and anatomical analysis of a lethal outcome.

Material and methods. The material for the study was 1420 acts of forensic examination of corpses recorded at the Bureau of forensic medical examination of the Moscow region during the 2014–2018 period. We studied the cases of deaths in hospitals of medical organisations with fi nal clinical diagnoses of the initial causes of death from diseases of the circulatory system (1085), respiratory diseases (157), digestive system (178). An analytical comparison of nosological forms of diseases in all headings of the fi nal clinical and forensic diagnoses was carried out. The frequency of occurrence of objective and subjective causes of discrepancy of diagnoses was determined. The most signifi cant factors of erroneous formulation of the fi nal clinical diagnosis, which create risks in the formation of divergence of diagnoses, were established. The causes of divergence of diagnoses relevant to the choice of inadequate treatment and the onset of death were established. Absolute (abs) values were calculated for qualitative variables and relative (%) frequencies. The frequency comparison was carried out using Fisher’s two-way exact criterion. Risk ratios with 95 % bilateral confi dence intervals for risk ratios were calculated to identify the factors causing the highest level of divergence. Statistically signifi cant differences were considered when the probability of error of the fi rst kind was less than 5 % (p < 0.05). Data processing was carried out using the Excel 2016 (Microsoft, USA) and IBM SPSS Statistics 25 (IBM, USA) software.

Results. The study found that the discrepancy between the lifetime diagnosis criteria of reliability, etiopathogenetic and timeliness are the most signifi cant factors affecting the discrepancy of diagnoses under the heading “underlying disease”. The causes of divergence of diagnoses, which are of the greatest importance for the choice of inadequate treatment and the formation of a lethal outcome, were revealed. On the basis of the obtained data, a method for comparing the in vivo and postmortem diagnoses during the clinical and anatomical analysis of the lethal outcome was developed.

Conclusion. Incorrect clinical diagnosis is important in the onset of death only if the erroneous diagnosis is due to insuffi cient examination of the patient, the lack of clinical data, the severity of the condition and the short duration of stay, which does not allow the underlying disease and fatal complication to be determined and adequate medical measures to be carried out. The proposed method for comparing the in vivo and postmortem diagnoses allows a correct, reliable and convincing clinical and anatomical analysis of the case of death in the hospital to be performed.

Aim. Experimental evaluation of the effect of some cryoprotectors on crystallogenic properties of mice blood serum at intraperitoneal administration.

Material and methods. The experiment was performed on 40 adult white line mice divided into 4 equal groups. Animals from the control (fi rst) group received a single intraperitoneal injection of saline (0.5 ml agent/animal), animals of the second-fourth groups — 3 % solution of glycerin, dimethyl sulphoxide and trombocryodmac (N, N-dimethylacetamide), respectively, in the same quantity.

Results. It is shown that single intraperitoneal introduction of cryoprotectants (solutions of glycerin, dimethyl sulphoxide and trombocryodmac) has a systemic effect on the mouse organism, which is manifested through the changes of crystallogenic properties of blood serum. 3% solution of glycerin, dimethyl sulphoxide and trombocryodmac have multidirectional infl uence on crystallogenic properties of mouse blood serum. The most pronounced physiological effect was established for dimethyl sulphoxide.

Conclusion. Our studies demonstrate the presence of systemic effects in cryopreservative substances. It was confi rmed by the changes of crystallogenic properties of mice blood serum under intraperitoneal administration of cryopreservatives.

Aim: to present a clinical case of amiodarone-induced hypothyroidism in a patient with paroxysmal atrial fi brillation.

Results. Before taking amiodarone, the patient suffered from subclinical hypothyroidism. The level of thyroid stimulating hormone (TSH) was 6.2 mIU/L, thyroxine (T4) — 9.2 pmol/L. Against the background of taking amiodarone in a maintenance dose of 200 mg per day 5 days a week with a break of 2 days, clinically severe hypothyroidism developed with a TSH level of more than 16 mIU/L. An electrocardiogram (ECG) recorded sinus bradycardia with a heart rate (HR) of 37 beats per minute. Paroxysms of atrial fi brillation have stopped. According to the daily ECG monitoring recorded throughout the sinus rhythm with maximum heart rate of 92 beats/min., minimum of 35 beats/min. The circadian rhythm profi le was correct. No pauses were detected for more than two seconds. Transient atrioventricular block was of 1 degree (during sleep). Ectopic activity was represented by supraventricular extrasystoles 112 per day: 107 single, 1 pair, 1 group. Ventricular extrasystoles: 55 per day: polymorphic, solitary. No diagnostically signifi cant elevation or depression of the ST segment was detected. After the abolition of amiodarone, thyroid function was recovered. Levothyroxine was not prescribed. However, paroxysms of atrial fi brillation began to occur again. For the prevention of paroxysms, sotalol 160 mg per day was prescribed.

Conclusion. Thus, the development of clinically pronounced amiodarone-induced hypothyroidism has contributed to the existing thyroid dysfunction in the patient. The assessment of the thyroid gland function and its further monitoring in the process of taking the drug is prescribed. Amiodarone therapy is performed in case of ineffectiveness of other antiarrhythmic drugs and, as a rule, is not used for primary prescription.