[Assessment of the condition of organs and tissues of the oral cavity in people with dentition defects against the background of metabolic syndrome]. / Otsenka sostoyaniya organov i tkanei rta u lits s defektami zubnykh ryadov na fone metabolicheskogo sindroma.

OBJECTIVE: The aim of the study is comparative analysis of the condition of oral organs and tissues in people with metabolic syndrome (MS) of varying severity before orthopedic dental rehabilitation based on dental implants. MATERIAL AND METHODS: 255 patients (151 women and 104 men) aged from 35 to 65 years were examined. 3 groups were formed: 2 study groups and a comparison group. Groups 1 and 2 included individuals with excess body weight and MS. The control group consisted of 88 people without MS. An index assessment of the condition of the periodontium and tissue structures of the alveolar bone (according to cone-beam computed tomography), microcirculation in the gingival mucosa was carried out using laser Doppler flowmetry. RESULTS: The analysis of the periodontal condition indicators showed that in all groups of patients with MS, periodontal pathology occurred, the value of which was significantly higher than in patients of the control group (p <0.05). The analysis of bone tissue according to CBCT data showed that the most favorable conditions (type 1 and type 2 of bone according to Misch) for dental implantation are found in people without MS, respectively 3.5% and 35.1% of cases. The intensity of blood flow (σ) was 21.2% lower in group 1 and 48% in group 2, compared with the control group. Vasomotor activity (Kv) was 13.2% lower in the first group and 35% lower in the second group. A decrease in amplitudes in the area of all rhythms in the LDF gram was found: low-frequency - by 15.6%, high-frequency - by 16.9%, pulse - by 3.6%. CONCLUSION: Changes occurring in the organs and tissues of the mouth against the background of MS of varying severity lead to a decrease in tissue perfusion with blood and blood flow activity, a local decrease in bone density, and as a result, pathological changes in periodontal tissues. Before performing dental rehabilitation, it is necessary to take into account all the risks of possible complications caused by the general condition of organs and systems of people with MS.

[Evaluation of the efficacy and safety of a combination drug containing ambroxol, guaifenesin, and levosalbutamol versus a fixed-dose combination of bromhexine/guaifenesin/salbutamol in the treatment of productive cough in adult patients with acute bronchitis].

AIM: To evaluate the efficacy and safety of a combination drug containing ambroxol, guaifenesin, and levosalbutamol, oral solution, versus Ascoril Expectorant, syrup (combination of bromhexine, guaifenesin, and salbutamol) in the treatment of productive cough in adult patients with acute bronchitis. MATERIALS AND METHODS: This open-label, randomized, phase III study included patients with acute bronchitis who had a productive cough with difficulty in sputum expectoration. 244 patients were randomized in a 1:1 ratio and received 10 mL of the study drug or reference drug 3 times daily for 2 weeks. After 7 and 14 days of treatment, the physician evaluated patient's subjective complaints and the efficacy of therapy. The primary endpoint was the proportion of patients with high and very high efficacy. RESULTS: The primary endpoint was reached by 70 (0.5738) patients in the study drug group and 54 (0.4426) in the reference drug group (p=0.04). The intergroup difference was 0.1311 [95% confidence interval: 0.0057; 0.2566]. The lower limit of the 95% confidence interval was above zero, which confirms the superiority of therapy with the study drug over therapy with Ascoril Expectorant. The proportion of patients with a 1-point total score reduction and with complete resolution of all symptoms according to the Modified Cough Relief and Sputum Expectoration Questionnaire after 7 and 14 days was numerically higher in the study drug group versus the reference drug group. There were no statistically significant differences between the groups in the incidence of adverse events. CONCLUSION: The efficacy of a new combination drug containing ambroxol, guaifenesin, and levosalbutamol in the treatment of productive cough in adult patients with acute bronchitis is superior to the efficacy of Ascoril Expectorant. The safety profiles of the study drug and the reference drug were comparable.

THE DIFFICULTIES OF DIFFERENTIAL DIAGNOSIS OF EDEMATOUS AND ANEMIC SYNDROMES IN AN EDERLY PATIENT WITH ATYPICAL COURSE OF COELIAC DISEASE.

OBJECTIVE: Analysis of the complexities of diagnosis of atypical celiac disease in elderly patients. KEY POINTS: A clinical observation of the patient 63 years with atypical form of celiac disease, have flowed mainly from edematous and anemic syndrome. High titers of antibodies to gliadin, tissue transglutaminase, histological changes of the mucous membrane of the small intestine (Marsh II), the presence DQA1*0501 of the alleles have confirmed diagnosis. Against the background of strict gluten-free diet and a half years I have come persistent clinical remission with normalization of serum indicators. CONCLUSION: Inclusion in the plan of diagnostic screening for celiac disease in patients \'vith edematous and anemic syndrome possible to establish the correct diagnosis and to reduce the risk of complications (including malignancies) in this patient.

[Status of the myocardium and heart valves in funnel chest]. / Sostoianie miokarda i klapannogo apparata serdtsa pri kilevodnoi deformatsii grudnoi kletki.

Examinations of 70 patients with keeled deformation of the chest (KDC) have revealed signs of connective tissue dysplasia in all the examinees, as well as heart rhythm and conduction disorders. Echography has shown ventricular and atrial septal defects, mitral valve prolapse, dilatation of the aortic root, tricuspidal valve prolapse, abnormally located chorda. The development of KDC in the presence of external connective tissue stigmata, involvement of the cardiovascular system, changed dermatoglyphic pattern of the palms and fingers (as evidenced by dermatoglyphic analysis), as well as findings of histologic examinations of the cartilage removed in the course of thoracoplasty may indicate a generalized abnormality of the connective tissue in this patient population and KDC may be regarded as one of its manifestations.

[Clinical function of the myocardium and cardio- and hemodynamics in patients with pectus carinatum deformity]. / Kliniko-funktsional'noe sostoianie miokarda, kardio- i gemodinamiki u bol'nykh s kilevidnoi deformatsiei grudnoi kletki.

Seventy patients with pectus carinatum were examined. All the patients demonstrated the minimal signs of connective tissue deficiency. The ECG readings showed incomplete blockade of the bundle of His, ventricular extrasystole, WPW and CLC syndromes, and metabolic alterations in the myocardium. Mitral valve prolapse was discovered in 97% of cases by echocardiography. There was a decrease in myocardial contractility along with changes in cardio- and hemodynamics, which were more marked in patients having the corporocostal type of pectus carinatum. The correlation of these values with chest deformity was revealed.