Background. A dynamic cross-layer visualisation of skin, its vascular structure in various anatomical facets during treatment in different age cohorts holds both scientific and practical value.

Objectives. A semiotic study of skin, facial, neck and hand soft tissues using high-resolution ultrasound in women of different age cohorts.

Methods. A total of 63 women aged between 22 and 59 years were enrolled. The study was designed with two comparison cohorts. The inclusion criteria were: women aged 22-59 years with no evident somatic or acute dermatological pathology not having aesthetic procedures for at least one month prior to the ultrasound examination of skin, facial, neck and hand soft tissues. The cohorts separated by age. Cohort 1 included 32 women aged 22-44 years (young), and cohort 2 — 31 women aged 45-59 years (middle-aged). High-resolution ultrasound (US) was performed in B-mode, colour Doppler and microV imaging.

Results. A maximal dermal thickness was facial middle-third in both cohorts, averaging to 1.87 ± 0.35 mm in the young and 1.57 ± 0.23 — in middle-aged cohort (p <0.0001). A minimal dermal thickness in both cohorts was periorbital (1.16 ± 0.15 mm in the 22-44-year and 0.95 ± 0.12 — in 45-59-year cohort) and in dorsal hand surface (0.89 ± 0.13 and 0.9 ± 0.16 mm, respectively, p <0.0001). The dermal thickness in face and neck diminished with age due to a thinning papillary layer. An adequate dermal vascularisation rate was greater in the young cohort (p = 0.038).

Conclusion. Ultrasound is effective in the diagnosis of skin, facial, neck and hand soft tissues at the planning and further control of safe injection and hardware aesthetic procedures, allowing a real-time thickness assessment of epidermis, dermis and its layers, vessels, subcutaneous fat and mimic muscles in norm and during complications.

Background. The variety of polishing systems and tools available for finishing direct composite restorations may perplex the dentist.

Objectives. An effect evaluation in one- and multi-step composite polishing tools using model specimens of GC Gradia Direct and 3M ESPE Filtek Ultimate restoratives.

Methods. The prepared specimens of GC Gradia Direct and 3M ESPE Filtek Ultimate restorative composites were exposed in laboratory to the Kenda Maximus, Dentsply PoGo, Kagayaki RoundFlex, Shofu Super-Snap, Kagayaki Ensmart Pin, EVE Composoft polishing systems and Daiyamondo Kagayaki paste. The polishing systems distinguished by brand, technical and performance characters.

Surface microgeometry in all 16 samples was estimated in the Laboratory of Optical Metrology, Institute of Design and Technology for Scientific Instrument Engineering, Novosibirsk, using a MNP-1 light interferometric nanoprofile microscope and at the shared core facilities of the Research and Education Centre “Nanomaterial Diagnostics and Properties” of Kuban State University, Krasnodar, using a JEOL JSM-7500F scanning electron microscope.

Results. Optical profilometry and scanning electron microscopy were used to estimate surface roughness in 16 specimens exposed to polishing for one minute. The polishing tools Kenda Maximus, Dentsply PoGo, Kagayaki RoundFlex, Shofu Super-Snap, Kagayaki Ensmart Pin, EVE Composoft, as well as Daiyamondo Kagayaki paste used in instrumental polishing, revealed a varied performance. Optical profilometry exhibited the GC Gradia Direct and Filtek Ultimate specimens to possess the lowest average roughness in two cases: 1) after multi-step polishing with Kagayaki Ensmart Pin tools with Daiyamondo Kagayaki paste (average roughness corresponded to Sa — 0.214 pm in GC Gradia Direct and Sa — 0.248 pm — in Filtek Ultimate), 2) in application of the Kenda Maximus monopolishing tool (roughness values of Sa — 0.211 and Sa — 0.242 pm, respectively). Surface roughness after multi-step machining with EVE Composoft silicone polishers was average Sa — 0.579 and Sa — 0.549 pm in both samples and was reported the highest. Scanning electron microscopy confirmed the optical profilometry estimates.

Conclusion. The assay showed that the specimen machining with a sole Kenda Maximus diamond abrasive tool and several Kagayaki Ensmart Pin silicone polishing heads followed by a Daiyamondo Kagayaki diamond abrasive paste application produced very similar surface roughness values, which were graded the lowest with GC Gradia Direct and 3M ESPE Filtek Ultimate composite samples using scanning electron microscopy and optical profilometry.

Background. Among cardiovascular diseases, valve pathology of various aetiology comprises a primary factor of chronic heart failure. Mitral valve diseases afflict over half of all patients with acquired heart defects. Today’s long-term outcomes of mitral valve replacement are not quite satisfactory, which urges the invention of novel vales. Such a modern artificial valve is the nationally developed bivalve full-flow MedInzh-ST prothesis.

Objectives. Assessment of advantages of the novel MedInzh-ST full-flow mechanical valve vs. MedInzh-2 model in analyses of short-term postoperative outcomes.

Methods. Over a five-year period, 116 patients underwent indicated mitral replacement with MedInzh valves. The full-flow MedInzh-ST was implanted in 55 patients, and MedInzh-2 — in 61. All patients had transthoracic echocardiography for structural and functional heart and implant control prior to surgery and discharge from hospital. Clinical and echocardiographic analyses were performed in the early postoperative period.

Results. The choice of valve model had no effect on the rates of postoperative complications and hospital mortality. All lethal cases were not associated with the valve malfunction. All patients with predominant mitral stenosis revealed the reliably lower peak and mean transmitral pressure gradient and pulmonary artery systolic pressure, irrespective of the valve model. The novel full-flow valve implantation significantly more often associated with a reduced right ventricle size. All patients with predominant insufficiency were observed to reduce mitral regurgitation and the left ventricular size upon defect correction. Patients with full-flow protheses significantly more often had a reduced end-systolic dimension.

Conclusion. The MedInzh-ST full-flow mechanical valve satisfies the modern requirements for efficacy and safety. Mitral stenosis correction with full-flow valves is shown to exert a greater effect on reverse right ventricular remodelling compared to the classical model.

Background. Anxiety-depressive disorders (ADD) afflict almost half of patients with arterial hypertension (AH). AH aggravation by psychoemotional disorders causes a more severe illness and rapid target organ injury, particularly, the increased arterial stiffness and central aortic pressure (CAP). However, the prospects of combined antihypertensive-antidepressant treatments in AH-ADD patients remain largely unexplored.

Objectives. The effect assessment in combined antihypertensive-psychocorrective therapy on circadian blood pressure (BP), vascular stiffness and CAP, anxiety and depression in women with AH and ADD.

Methods. The study enrolled 60 AH-ADD women randomised between two cohorts. Cohort 1 received a fixed combination of valsartan and hydrochlorothiazide, bisoprolol and sertraline antidepressant; cohort 2 only had same combined AH therapy. Past 24 weeks of trial, all patients had a general clinical examination and daily blood pressure monitoring (DBPM) with BpLab Vasotens (Petr Telegin Ltd., Russia) and control of daily BP, CAP and vascular stiffness. The psychometric HADS and CES-D scales were used along with psychiatric counselling.

Results. Past four weeks of treatment, the target blood pressure (TBP) was revealed in 60 and 36.7% patients, and in 90 and 66.6% — past eight weeks in cohorts 1 and 2, respectively. Cohort 1 vs. 2 required a lower valsartan dose to attain TBP. Past six months, both cohorts showed improved main DBPM values reflecting vascular stiffness and CAP. However, a statistical decrease in nocturnal central and peripheral BP, as well as improved BP variability and vascular stiffness were registered at antidepressant use. A normalised daily BP profile was significantly more frequent in cohort 1. In addition, sertraline had a significant ADD-reductive impact.

Conclusion. An antidepressant-combined conventional AH therapy in AH-ADD women facilitated a faster TBP achievement at lower AH agent doses and the significantly improved DBPM (nocturnal specifically), arterial stiffness and CAP values. A sertraline treatment improved the psychoemotional patient state.

Background. Wounds of various aetiology are among the most frequent traumatic injuries. A prospective route to improve treatment of this nosology is the development of novel or advancement of the already on-stage dressing materials.

Objectives. A comparative experimental assay of novel chitosan-based wound dressings in the healing of soft tissue wounds of different genesis using ultrasound to control biodegradation of the developed dosage form.

Methods. Soft tissue wounds were modelled in experimental animals, conventional and lineage male rats, 275 (± 25) g body weight, and male rabbits, 2,900 (± 150) g weight, using a proprietary methodology (Patent on invention RU No. 2703709 dated 23 August, 2018).

Two wound dressing samples selected as most promising and applicable in large-volume soft tissue aseptic wounds were tested in the final step of experiment. Ultrasound imaging of the model wound area during the sample material biodegradation was used to control the wound process in more detail. At all steps of experiment, animal models were handled in compliance with GOST 33044-2014 “Principles of Good Laboratory Practice”.

Histomorphological assays were carried out with common protocols. Variation statistics was used for the data analysis, including the mean (M) and standard mean error (± m) estimation. The level of statistical significance was p < 0.05.

Results. The animal assays and comprehensive evaluation of the obtained data revealed a high healing efficacy of chitosan-based wound coatings. The analyses of wound dressing samples have confirmed their predesigned properties: scaffold stability, capillarity, biodegradability and matrix capacities for the carried drug delivery.

Additionally, ultrasound was proved effective to estimate dynamics of the coated wound healing and biopolymer biodegradation processes.

Conclusion. The developed chitosan-based wound dressings exhibited efficacy in an experimental model of the soft tissues wound process.

The use of ultrasound to study dynamics of the wound process and coating biodegradation provided an adequate congruence between the imaging and tissue histomorphology data, as well as the structure and properties of coating material.

Background. Pancreatic malignancies pose a challenging medical and social problem. The assessment of oncology care requires an in-depth analysis of morbidity and lethality. At a relatively improved prevalence and lethality in other-locale malignancies, pancreatic cancer remains a disappointing situation. Medical statistics in pancreatic malignancy can be used for the specialty care prediction and implementation of measures to advance diagnostic algorithms and population screening.

Objectives. An assessment of the pancreatic malignancy incidence and mortality in the adult population of Russian Federation over a six-year period.

Methods. A retrospective descriptive cohort trial included statistical data on morbidity and mortality in pancreatic cancer patients (C 25.0-C 25.9) according to the ICD of 10th edition. A comparison cohort sampled patients with all-locale neoplasms (C00-C96) according to the ICD of 10^th edition, excluding nosologies C25.0-C25.9. Information was sourced in the Federal Statistical Abstracts for the period of 2014-2019. Inclusion criteria: the study cohort included pancreatic cancer patients diagnosed at the age of 18 years on, and comparison cohort — malignancy patients diagnosed with at 18 years on. The main study indicator were the pancreatic cancer morbidity and mortality figures in Russia.

Results. Pancreatic cancer was shown to co-increase main morbidity figures in 2014-2019 compared to malignant neoplasms of other localities. Other-locale malignancies decreased mortality over the study period, which was not the case with pancreatic cancer. The period exhibits more frequent morphologically verified diagnoses and higher population numbers registered with specialty dispensaries. Registered pancreatic cancer figures are significantly higher in the female population. The proportion of advanced pancreatic malignancies at primary diagnosis exceeds that of early stages.

Conclusion. The findings expose a demand for improving the system of early pancreatic cancer detection via intensifying preventive measures to capture the patient’s predisposition and screening techniques for early disease diagnosis. An active outpatient surveillance is prerequisite to an effective population involvement in dispensary screening.

Background. Infertility is becoming ever more pressing a problem by year in Russia and worldwide. Tubal-peritoneal infertility is most frequent, with the prevalence of 42.5-80.5% in various estimates. Echohysterosalpingography is considered the today’s “gold standard” in tubal-peritoneal infertility diagnosis in women. This method is known to possess a series of limitations and adverse consequences due to painful sensations during and after check-ups that psychologically afflict women.

Objectives. An overview of current methods for inspecting fallopian tubes in reproductively impaired patients to inform promising diagnostic research.

Methods. Publications were mined and analysed in the PubMed, eLibrary, Web of Science, Cochrane Library and Cyberleninka electronic databases. The query terms were: echohysterosalpingography [эхогистеросальпингография], echohysterography [эхогистерография], infertility [бесплодие], pregnancy planning [планирование беременности], fallopian patency [проходимость маточных труб], ultrasonic diagnosis [ультразвуковая диагностика], submucous myomatous node [субмукозный миоматозный узел], incompetent uterine scar [несостоятельный рубец на матке], niche [ниша]. The topic selected was female infertility, particularly, the use of echohysterosalpingography in fallopian diagnosis in reproductively impaired women.

Results. The review covers 52 sources of the total 118 analysed. Current published evidence and its review identify a notable success of imaging techniques in the fallopian tube diagnosis in women with reproductive problems. The continually developing echohysterosalpingography technique is considered more promising for routine use. Techniques gain more value in analyses of implantation failures. The main challenges in current radiodiagnosis and monitoring of fallopian lesions at a background therapy are the inspection standardisation, disease classification, imaging diagnostic accuracy and prognostic value evaluation in patients with reproductive loss and infertility.

Conclusion. The prospective routes of research comprise the definition of optimal check-up terms, echohysterography and echohysterosalpingography diagnostic criteria descriptiveness, improving prognosis in the carrying of pregnancy and treatment efficacy control. A timely and accurate diagnosis of uterus and fallopian tubes is of paramount importance to sustain the women’s reproductive health.

Background. The choice of sealant is an important dentist’s decision with a long-term influence on treatment. Knowledge of the properties and characters of each material is key to the optimal endosealer selection on individual basis.

Objectives. A comparison of endodontic sealants based on epoxy resins, calcium hydroxide, zinc oxide eugenol and bioceramics.

Methods. Publications were mined in the PubMed and Google Scholar electronic databases to cover the four sealer groups (epoxy, calcium hydroxide, zinc oxide eugenol and bioceramics) over years 2014-2021, including selected relevant sources within 2002-2013; 73 articles were considered for review, regardless of the study design or language. Content and descriptive analyses were used as research tools. Meta-analysis was not used due to a high evidence heterogeneity.

Results. The dental market currently offers a variety of sealant groups. Endodontic sealants based on epoxy resins, zinc oxide eugenol, calcium hydroxide and bioceramics are the most common. The review identifies no ideal material for the root canal filling.

Conclusion. Manifold studies demonstrate the pros and cons in each endodontic sealant group with respect to variant criteria. Depending on clinical situation, the practitioner can opt for the material property to identify the endosealer.

Background. Splenic artery pseudoaneurysm is a rare complication of acute and chronic pancreatitis caused by an arterial wall lesion with aggressive pancreatic enzymes and followed by arrosive bleeding into pseudocyst lumen and the formation of a dense fibrous capsule prone to growth.

Clinical Case Description. Patient M., 61 yo, was emergently admitted to Territorial Clinical Hospital No. 2 with a preliminary diagnosis: Chronic pancreatitis, incomplete remission. Pancreatic pseudocyst. Condition after endoscopic papillosphincterotomy, pancreatic duct stenting. Gastrointestinal haemorrhage. The patient complained of moderate persistent belting upper abdominal and left subcostal pain, nausea, general weakness, black liquid stool over last five days. Pancreonecrosis in history. Pseudocyst formation in two months, endoscopic papillosphincterotomy and pancreatic stenting in hospital, the aforementioned complaints appeared past three months. Moderate anaemia (haemoglobin 73 g/L, erythrocyte count 2.8 x 1012), hyperamylasaemia (amylase 170 U/L), no other pathology in general and biochemic blood panels. The patient was rendered urgent oesophagogastroduodenoscopy for large duodenal papilla, with no evident bleeding detected. Abdominal CT angiography revealed a haemorrhagic mass connected with splenic artery lumen in the projection of pancreatic tail. The patient was transferred to an interventional radiology room for coil embolisation of splenic artery. The postoperative period was benign, and the patient discharged on day 3 after surgery for outpatient surgical patronage. Definite clinical diagnosis: Chronic pancreatitis, incomplete remission. Splenic artery pseudoaneurysm with haemorrhage into pancreatic pseudocyst. Condition after endoscopic papillosphincterotomy, pancreatic duct stenting.

Conclusion. Splenic artery pseudoaneurysm with haemorrhage into pancreatic pseudocyst is reluctant to early diagnosis due to a lacking definite clinical picture and tractable only at an interdisciplinary institution disposing with a rich diagnostic toolkit and sufficiently qualified medical personnel. Endovascular treatment is overall most effective and enables a reliable aneurysm isolation from the splenic artery basin.