Background. The dental health is an integral part of a person's well-being. Students of higher educational institutions comprise a health risk group, since they experience extensive physiological changes and personal socialization. The impact of connective tissue dysplasia on dental health is a relevant research task.

Objective. To analyze the correlation between dental pathology and phenotypic signs of connective tissue dysplasia in first-year students.

Methods. A cross-sectional clinical study of the dental health and phenotypic signs of connective tissue dysplasia was conducted as part of routine dental examination of 263 first-year students of KubSMU, aged 18–23. All participants were divided into 2 groups: group 1 – participants with 0-2 signs of connective tissue dysplasia (n = 108); group 2 – participants with 3 or more signs of dysplasia (n = 155). Statistical analysis of the results was carried out using Microsoft Excel 2010 and Statistica 6.0.

Results. Unsatisfactory and poor oral hygiene levels in the group of participants with connective tissue dysplasia outnumber these levels in the control group by 30% and 22%, with very poor level in the second group 2.3 times higher (p ≤ 0.05). The incidence of noncarious tooth pathology in individuals with dysplasia is 26% higher than in the control group. The caries intensity index in group 2 is almost 20% bigger than in the control group. As expected, the group of participants with no signs of dysplasia revealed better periodontal health, namely 51.85% versus 45.81% (p ≤ 0.05). In terms of mucosal pathology, a statistical significant difference between groups 1 and 2 was noted for traumatic injuries (16.35% and 19.35%, respectively). Dentofacial abnormalities were observed more often in individuals with 3 or more phenotypic signs of connective tissue dysplasia.

Conclusion. Higher morbidity rate of caries and noncarious pathology in the group of first-year students with 3 or more phenotypic signs of connective tissue dysplasia, compared to the group with 0–2 phenotypic manifestations of dysplasia, indicated the need to create a database of the dentofacial profiles of students, develop an algorithm for regular medical check-up of students, as well as provide differentiated preventive and therapeutic measures for students with dysplasia.

Background. Relevance of the study is related to the lack of a unified strategy for determining the risk of infectious complications of puerperium. Currently, the specialists use the collected data from studies documenting the main factors of infection in a population or cohorts of postpartum women. However, accuracy of these factors is not established and prognosis could not be personalized. The paper analyzes significant risk factors for the infectious complications associated with cesarean section (C-Section) and develops a model for their prognosis and an individual assessment of the risk of postpartum infection in order to take timely preventive measures.

Objective. To identify predictors of postpartum purulent-inflammatory complications after cesarean section, to evaluate their predictive value, and to develop a statistical model for determining the risk of their occurrence.

Methods. The cohort retrospective study (January 2019 to January 2022) was conducted in four obstetric health facilities of Krasnodar and was focused on analysis of medical records. Anamnestic, clinical and laboratory data of all women after cesarean section delivery were collected. Model: a patient diagnosed with any infection associated with cesarean section within 42 days after delivery — postoperative suture infection, endometritis, peritonitis, thrombophlebitis, sepsis. Infections were grouped to carry out a single risk assessment with an internal validation test and to develop a multifactor logistic regression model. All analyses were conducted using version R 3.2.3 (SPSS Inc., Chicago, IL) and Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD).

Results. Infection associated with cesarean section occurred in 2.50% of women (n = 548; 95% CI 2.6–3.5), suture disruption — in 0.59% (n = 129; 95%, CI 0.41–0.81), endometritis — 1.46% (n = 321; 95%, CI 1.15–1.94), peritonitis — 0.16% (n = 35; 95%, CI 0.11–0.20), thrombophlebitis 0.04% (n = 9; 95%, CI 0.01–0.05), sepsis 0.25% (n = 54; 95%, CI 0.15–0.35). The authors have identified 14 major variables with a high prognostic risk for the development of infectious complications of puerperium. The model differentiated women with and without purulent inflammatory complications of puerperium by internal validation (concordance index = 0.712, 95%, CI 0.672–0.755).

Conclusion. The developed model can be used to accurately predict the risk of infectious complications after abdominal delivery and to identify high-risk patients. It ensures a differentiated approach with a possibility to expand studies and strengthen antibiotic therapy, which promotes reduction of surgical site puerperal infection.

Background. Much controversy surrounds the estimation of anthropometric parameters in multiple newborns. In newborn monochorionic diamniotic twins, these parameters can be affected by specific antenatal complications.

Objectives. To estimate the physical development parameters of preterm monochorionic diamniotic twins according to standards proposed within the INTERGROWTH-21st project, taking specific intrauterine complications into account.

Methods. The anthropometric data were analyzed in 148 pairs of newborn monochorionic diamniotic twins, who were divided into three groups according to the presence of specific intrauterine complications: Group I (n = 56 pairs) — twin-to-twin transfusion syndrome (TTTS); Group II (n = 38 pairs) — selective intrauterine growth restriction (sIUGR); Group III (n = 58 pairs) — absence of the above-mentioned specific complications. The obtained data were statistically processed on a personal computer via variation statistics methods using Microsoft Excel spreadsheets (Microsoft, USA) and an online service available at https://medstatistic.ru.

Results. Newborns with sIUGR (37–100.0%) and 26 (49.1%) donors fell into the category of newborns light for gestational age. Disharmonious (3–10th percentile) and markedly disharmonious (below the 3rd percentile) physical development at birth was most commonly observed in newborns with sIUGR and, to a lesser extent, in donors (OR — 9.2; 95% CI — 3.2–24.3; p < 0.05), which was noted only occasionally in monochorionic twins from other groups. A combined decrease in the values of birth centiles for head circumference, body weight, and body length was found in 13 (35.1%) newborns with sIUGR and in 12 (22.6%) donors, which may mark the severity of antenatal complications and the development of neurological deficit.

Conclusion. Monochorionic diamniotic twins include newborns having greater and lower body weights. In the newborn having a lower birth weight, specific complications associated with monochorionic multiple pregnancy result in body weight and length deficit, disharmonious development due to the lack of nourishment (22.6% in the TTTS group and 73.0% in the sIUGR group), as well as delayed head circumference growth in 56.8% of newborns with sIUGR.

Background. The relevance of alimentary-constitutional obesity, especially its severe forms, is associated with a number of metabolic disorders, subsequently leading to serious chronic noncommunicable diseases.

Objective. To identify factors that increase the risk of severe alimentary-constitutional obesity and metabolic disorders.

Methods. A follow-up group of 426 patients aged 18 to 65 years was formed among those seeking help from an endocrinologist for overweight or obesity. The diagnosis of alimentary-constitutional obesity was confirmed at the initial examination in the outpatient clinic setting. Depending on the severity of obesity and the type of fat deposition according to anthropometric data (body mass index, waist circumference), the study participants were ratified into two study groups. The research was conducted between 2010 and 2017 in outpatient settings and was based on a cross-sectional comparative study. In order to assess the risk of severe obesity and factors associated with it, the authors studied medical history data, results of physical examination, including blood pressure level, laboratory examination with analysis of carbohydrate, fat metabolism and liver function, assessed eating behaviour, and performed diagnosis of anxiety-depressive disorder. Statistical analysis of the results was carried out using Statistica 10 (StatSoft, USA).

Results. Women are more likely to see an endocrinologist with less severe obesity than men. Severe obesity risk is higher in middle-aged and elderly people, as well as in hereditary tainted patients and those having a history of obesity for more than 10 years. Severe obesity itself is a significant risk for metabolic events, with a 4-fold higher risk of hyperglycaemia and hypercholesterolaemia (due to very low density lipoproteins) and a 5-fold higher risk of hyperinsulinaemia and insulin resistance.

Conclusion. Analysis of severe obesity risks has shown that earlier personal commitment to a healthy lifestyle is essential for weight loss and subsequent improvement of metabolic parameters, particularly in men and those aged 45 years or older.

Background. Prostate cancer is a frequently diagnosed malignant disease in men. At present transrectal ultrasound is the most common technique for imaging the gland. Traditionally, a combination of grayscale and Doppler modes is used. In order to make transrectal ultrasound of the prostate more informative, the contrast-enhanced techniques are recommended to apply. Contrast-enhanced ultrasound can provide quantitative assessment, which, in turn, increases the objectivity of the results obtained.

Objective. To evaluate potential of contrast-enhanced transrectal ultrasound for differential diagnosis of focal pathology of the prostate.

Methods. A single-center retrospective comparative study of contrast-enhanced transrectal ultrasound of the prostate gland in 66 patients was carried out at the Republican Clinical Oncological Dispansery, the Republic of Tatarstan. The inclusion criteria was the presence of focal pathology in the peripheral zone of the prostate gland. The median age of patients was 67. The following quantitative perfusion parameters were analyzed: time to peak, peak intensity, descending time, area under the curve and an additional index calculated for each of the specified parameters. The resulting enhancement curves were also analyzed by measuring enhancement angles (β) and washout angles (α). SPSS 13.0 (IBM SPSS Statistics, USA) was used for data analysis.

Results. The combination of “angle ß ≥69.5°+ angle α≤69.5°” with sensitivity of 92.7%, specificity 80.0% proved to be the most informative. The sensitivity and specificity of the obtained threshold values “enhancement angle ß≥69.5°” comprised 73.2% and 60.0%, respectively, “washout angle α≤69.5°” — 63.4% and 56.0%, respectively. According to the analysis of perfusion quantitative parameters the test “peak intensity ≥ 34.1 dB” with sensitivity of 75.6%, specificity of 84.0% has the most informative value in the diagnosis of prostate cancer.

Conclusion. Quantitative analysis of contrast-enhanced transrectal ultrasound of the prostate gland provides objectification of the study, and the use of threshold values increases the informativity in the differential diagnosis of focal lesions of the prostate gland.

Background. Parkinson's disease is a neurodegenerative disorder that leads to severe disability, especially in its advanced stages. Medical care should be performed in accordance with modern clinical recommendations and standards. Assessment of the quality of medical care in the Russian Federation is carried out via examination of medical documentation by insurance experts regarding compliance with Russian standards and other regulatory documents.

Objective. To study the predictors for unfavorable course of Parkinson's disease based on routine examinations of the quality of medical care.

Methods. The cohort retrospective study included 7,264 examinations of the medical care quality of 1,754 patients with Parkinson's disease for the period from 2011 to 2018 in the Russian Federation. The study focused on two indicators: presence/absence of disease progression and determination/aggravation of a degree of disability or maintenance of the previous social and professional activity. The obtained data were used to develop diagnostic tables with prognostic factors of Parkinson's disease according to A. Wald. Statistical analysis of the results was carried out using Statistica 13 (StatSoft, USA). Results. Diagnostic tables have been developed to determine the prognostic factors affecting the progression of Parkinson's disease and, accordingly, decreasing the degree of social and/ or professional activity and to assess the diagnostic factors when the risk of the disease aggravation will be more than 95%.

Conclusion. The greatest progression of Parkinson's disease (p < 0.05) was observed in the cases of poor collection of complaints, history and clinical evaluation of the patient's condition, inadequate prescription or absence of prescription of levodopa when indicated, as well as defects in the correction of additional disorders. The likelihood of social disadaptation in patients with Parkinson's disease (p < 0.05) was found to be greater in the cases of poor collection of complaints and history, neurological examination and clinical evaluation of the patient's condition as well as inadequate prescription or absence of prescription of levodopa when indicated.

Background. Among the damaging factors affecting the mucociliary system of the nasal cavity, surgical wound is of particular relevance in the practice of an otorhinolaryngologist. The clinical assessment of regeneration of the mucociliary system is associated with certain diffi culties, since the intravital morphological examination of the nasal mucosa in patients is traumatic. Therefore, the development of animal models of experimental rhinitis is considered to be highly relevant in order to study the dynamics of mucociliary pathomorphological changes and assess the epithelium regeneration.

Objectives. To evaluate the developed model of experimental rhinitis in laboratory rats by studying clinical, morphological and biochemical changes in the infl ammatory process.

Methods. The experimental rhinitis model was developed and tested on 60 mature male Wistar rats. All animals were randomized into two groups: experimental group #1 (n = 30) — rats in which experimental rhinitis modeling was performed and group #2 (n = 30) — control, intact animals. In the course of the experiment, the authors examined the content of CRP in blood, evaluated the differential blood cell count, and studied a morphology of the nasal septum mucosa in 2, 5, 10 days after the injury to assess the dynamics of the infl ammatory process in rats of both groups. Statistical analysis of the study results was carried out by means of Statistica 8.0 (StatSoft Inc., USA).

Results. After injury, the rats from group #1 developed acute rhinitis, which was clinically manifested by the release of mucous or mucopurulent secretion from the nostrils, sneezing and scratching the nose. An increase in CRP, band and segmented neutrophils, and a decrease in lymphocytes were observed in blood of the rats from group #1 in comparison with the control group. Microscopic analysis of changes in the nasal septum mucosa showed that the acute phase of exudative infl ammation developed on the second day: vascular congestion, edema, neutrophilic infl ammatory infi ltration of the submucosal membrane were observed against the background of foci of epithelial necrosis. The proportion of lymphocytes and macrophages in the infl ammatory infi ltrate increased by the fi fth day, initial signs of restoration of epithelial tissue — the formation of an undifferentiated regenerating epithelium — appeared by the tenth day.

Conclusion. The results of the study show that an adequate experimental model of acute rhinitis in laboratory animals have been obtained. An acute infl ammatory process is characterized by clinical manifestations and changes in blood parameters. Particular destructive and reparative-proliferative changes develop in the mucous membrane of the nasal septum of experimental animals as a result of a surgical wound.

Background. An analysis of published results on the chemical structure, pharmacodynamics and pharmacokinetics of hepatoprotective agents, as well as their practical application, shows that a holistic view on the pharmacology of hepatoprotective agents is yet to be developed. Thus, the relationship between antioxidant activity and the effectiveness of reducing hepatocyte cytolysis remains unclear. Another difficult question concerns indications for the application of hepatoprotectors, selection of a particular drug and treatment duration.

Objectives. To investigate the effects of hepatoprotective agents with different mechanisms of action on the indicators of oxidative metabolism in the blood of patients with alcoholic hepatitis.

Methods. Four groups of patients were involved in the study. The 1st group consisted of relatively healthy male patients (n = 15). The remaining groups (10 individuals in each) were represented by patients with moderate alcoholic hepatitis. Patients of the 2nd group received remaxol; patients of the 3rd group received ademetionine; patients of the 4th group received ursodeoxycholic acid. Prior to and following treatment, the indicators of cytolysis and oxidative stress in blood were determined. Statistical data processing was carried out using the StatPlus v 7 (AnalystSoft Inc.) software package.

Results. According to the observed changes in the cytolytic syndrome marker enzymes, all three hepatoprotectors under study expressed comparable efficacy. After treatment according to any of the applied schemes, the ALT and AST activity in the blood plasma decreased by 56–68% and 75–81%, respectively, compared to their initial values. In comparison with the control group, the total antioxidant activity of the blood plasma decreased by 20–27%; the content of TBA-reactive products in the erythrocyte suspension increased by 61–87%. The remaxol, ademethionine or ursodeoxycholic acid therapy led to a partial normalization of the abovementioned parameters without significant differences between the experimental groups. The concentration of reduced glutathione in the erythrocyte suspension and the content of thiol groups in the blood plasma of patients were reduced in comparison with the control group by 16% and 26%, respectively. After therapy, these indicators also increased by 12–15%, although no predominant effect of either of the studied hepatoprotectors was revealed.

Conclusion. The conducted comparative study indicated the absence of a specific antioxidant effect among the pharmacological mechanisms of action of remaxol, ademethionine and ursodeoxycholic acid. In this regard, further research should be carried out to investigate the effect of hepatoprotective drugs on pathobiochemical changes and to analyse a relationship between the antioxidant effect and the efficacy of reducing the level of hepatocyte cytolysis.

Background. Inflammatory bowel diseases — Crohn’s disease and ulcerative colitis — are chronic gastrointestinal diseases affecting young people of working age. An alternative to basic therapy (5-aminosalicylic acid) for inflammatory bowel disease is the use of ozone, which has anti-inflammatory, immunomodulatory, antibacterial properties and no side effects in therapeutic concentrations. Objective. To perform clinical and morphological analysis of efficacy of intraperitoneal ozone application in experimental colitis.

Methods. The study was conducted on 73 male Wistar rats weighing 200-250 g. The animals were divided into four groups by simple randomization. Check studies were performed on the second, fourth and sixth days. Oxazolone-induced colitis was simulated in two stages using a 3%-alcohol oxazolone solution. Ozone-acid mixture was obtained on “UOTA-60-01” unit (“Medozone”, Russia). Rectal suppositories with 5-aminosalicylic acid were prepared on the basis of rectal suppositories “Salofalk”. Clinical status was assessed daily according to the disease activity index (DAI) scale. Morphological evaluation of colon lesion tissue fragments was carried out using a PrimoStar microscope (CarlZeiss, Germany). Colon tissue damage was assessed using tissue damage index (TDI). Statistical analysis was conducted with SPSS Statistics 19 (IBM, USA).

Results. Clinical and morphological picture of the large intestine lesion in oxazolone-induced colitis on days 2, 4 and 6 is consistent with the changes typical of inflammatory bowel disease in humans. Daily intraperitoneal insufflation of ozone at a dose of 0.05 mg/kg in oxazolone-induced colitis leads to partial restoration of DAI, reduction in neutrophils, eosinophils, histiocytes, and fibroblasts in the lesion, as well as to a decrease in ulcerous defect diameter and TDI. The effects of intraperitoneal insufflations of ozone in oxazolone-induced colitis as compared to rectal suppositories with 50 mg of 5-aminosalicylic acid every 12 hours were less marked for the DAI index on day 4; for the number of eosinophils, plasma cells, histiocytes — on day 2, 4 and 6; for lymphocytes — on day 6.

Conclusion. Clinical and morphological picture of the large intestine lesion in ozone-induced colitis correlates with the changes typical of inflammatory bowel disease in humans. The positive effect of ozone in ozone-induced colitis was driven by its anti-inflammatory properties through the activation of Nrf2 and by its antioxidant properties through the inhibition of Keap1.