[Analysis of the dental care for the contagious patients in the in-patient units]. / Analiz sostoyaniya stomatologicheskoi pomoshchi infektsionnym bol'nym v usloviyakh statsionara.

OBJECTIVE: The aim of the study is to assess the status of dental care for contagious patients in hospitals using the example of the Volga Federal District. MATERIALS AND METHODS: The resource allocation of dental care for contagious patients in 313 hospitals of 14 subjects of the Volga Federal District was investigated. RESULTS: It was found that in 86.1% of multidisciplinary hospitals of the Volga Federal District, where infectious beds and dental offices are present, dental care for patients with infectious diseases accompanied by lesions of the oral mucosa is not provided. The bed capacity of 92.9% of infectious hospitals in the Volga Federal District is less than 400 beds, which does not allow to deploy dental offices on their basis. CONCLUSION: An important condition for improving the quality of medical care to patients of infectious hospitals and infectious diseases departments of multidisciplinary hospitals is the availability of dental offices and dental doctors, which will ensure timely diagnosis, treatment and prevention of lesions of the oral mucosa in diseases of infectious genesis.

[On the issue of normative legal regulation of the work of a doctor in a dental office of a multidisciplinary hospital]. / K voprosu normativnogo pravovogo regulirovaniya truda vracha stomatologicheskogo kabineta mnogoprofil'noi bol'nitsy.

OBJECTIVE: The purpose of the study is to investigate the existing normative legal documents governing the activities of doctors specializing in «dentistry¼, providing medical care in a multidisciplinary hospital. MATERIAL AND METHODS: The normative legal coverage of medical workers' activities on delivering dental care for adult population with infectious diseases in stationary conditions for a thirty-year period was analyzed. The research and information method and content analysis were used. RESULTS: The existing regulatory legal framework governing the activities of medical workers does not contain time standards for one patient who is on inpatient treatment to visit doctors specializing in «dentistry¼ in a multidisciplinary hospital, which does not correspond with modern requirements and does not allow determining the workload norms and standard numbers of these specialists. CONCLUSION: Despite the presented modern possibilities of introducing the latest technologies and intensifying the activities of doctors specializing in «dentistry¼ on an outpatient basis, the organization of medical care and the delivering of dental services in a hospital including to infectious patients require further improvement.

[Analysis of dental care provided to the adult population with infectious diseases in in-patient departments]. / Analiz vidov i ob"emov stomatologicheskoi pomoshchi, okazyvaemoi vzroslomu naseleniyu s infektsionnymi boleznyami v usloviyakh statsionara.

The purpose of the study was to analyze the types and volumes of treatment and prophylactic services provided to the adult population with infectious diseases in the dental office of a multidisciplinary hospital. MATERIALS AND METHODS: The types and volumes of dental care provided to the adult population with infectious diseases in a multidisciplinary hospital have been analyzed. RESULTS: The study showed that dentists use 49 types of services when treating adults with infectious diseases, which corresponds to 29.88% of the compulsory medical insurance classifier in Moscow. Provided services can be conditionally divided into 4 groups: consultation, diagnostic, preventive and medicinal manipulations. The share of consulting services corresponds to 18.16±0.41% of the total volume of services provided; on average patients made 320.8 visits to the dentist's doctors per year, which corresponds to 2.38 visits for each patient. The proportion of medicinal manipulations, diagnostic and preventive services corresponds to 68.64±0.49%, 7.02±0.27% and 6.17±0.26%, respectively. Services related to the diagnosis and treatment of diseases of the oral mucosa and salivary glands dominate with 69.3%, on average 5.51 services are provided per visit. CONCLUSION: The compulsory medical insurance program for the city of Moscow should provide services for the diagnosis, treatment and prevention of dental diseases, provided by doctors specializing in «dentistry¼, for patients with infectious diseases who are undergoing treatment in inpatient conditions.

[Operation in DeBakey type I acute aortic dissection according to the Florida Sleeve technique]. / Operatsiia pri ostrom rassloenii aorty I tipa po DeBeiki po metodike Florida Sleeve.

Despite the fact that recent decades have witnessed significant advances in treatment of patients with DeBakey type I acute aortic dissection, it still remains difficult to restore the aortic root when the dissection extends to the Valsalva's sinuses. Thinned aortic walls are vulnerable to traumatization on applying a vascular suture. We used in patients with this pathology the Florida sleeve technique in order to reinforce the weakened aortic root. After mobilization of the aortic root and coronary arteries, the transplant 'wraps' the sinuses from the outside, like the neoadventitia, in order to strengthen the weakened aortic wall. The graft's diameter should be selected with due regard for tight enwrapment of coronary sinuses in their maximal dilatation and, if necessary, preserving the possibility of narrowing the fibrous ring. This technique is simple and effective. First, it allows strengthening the weakened root, secondly helping to prevent haemorrhage. Besides, it may prove alternative, should preservation or correction of the geometry of the aortic root be required.

[Oral health as a factor of primary prevention of postinfectious complications]. / Zdorov'e organov rta kak faktor pervichnoi profilaktiki postinfektsionnykh oslozhnenii.

OBJECTIVE: The purpose of the study is to substantiate the need and importance of early diagnosis and treatment of oral lesions in infectious diseases (ID) by dentists. MATERIAL AND METHODS: A retrospective analysis of the provision of dental care in multi-specialty hospitals to 780 patients with infectious pathology: herpetic infections (HI) - 320 people (41.03%); ARVI - 160 people (20.51%); acute enteric infections (AEI) - 300 people (38.46%). The diagnosis of the disease was established by infectious diseases doctors. The etiology of ID was confirmed using PCR and IFA. RESULTS: The prevalence of caries is 98.5%, the CPEs index is 10.26±0.04. In 84.1% of patient's oral hygiene was unsatisfactory. In the acute period of ID in HI, ARVI and AEI oral mucosa (OM) lesions were detected in 75.89% of cases: stomatitis (81.75%), gingivitis (69.76%), glossitis (35.98%), cheilitis (23.31%). Incidence of OM lesions in ID: catarrhal stomatitis - HI - 52.8%, ARVI - 64.1%, AEI - 67.9%; catarrhal gingivitis: in patients with HI, it is 1.7 times less frequent than in patients with AEI (p<0.001), and in ARVI - 1.6 times more often than in patients with HI (p<0.001). Cheilitis: HI - 25.9%, ARVI - 18.3%, AEI - 23.7%; catarrhal glossitis: AEI - 65.1%, ARVI - 23.2%, HI - 17.0%; candidiasis of the oral mucosal and tongue: HI - 11.1%, ARVI - 27.5%, AEI - 26.9%. A direct relationship between the lesions of OM and the severity of the course of HI, ARVI and AEI was established. CONCLUSION: Thus, dental pathology in infectious patients is pathogenetically determined by combined and interrelated disorders of the functional state of each organ of the oral cavity, the dental system and the body as a whole. Due to the relatively short duration of inpatient treatment for acute ID, priority should be given to the prevention of postinfectious complications of oral mucosal diseases.

[Legislative framework and legal regulation of dental care organization to patients with infectious diseases]. / Zakonodatel'naia osnova i normativnoe pravovoe obespechenie okazaniia stomatologicheskoi pomoshchi infektsionnym bol'nym.

The existing normative legal framework does not fully correspond to modern requirements for the organization and delivering dental care for adult population with various infectious diseases. The authors basing on the analysis of regulatory guidelines consider that in order to provide timely, high-quality and affordable medical care to patients in the infectious diseases departments and clinical hospitals, it is necessary to update the normative legal framework and develop criteria for monitoring the quality of dental care for infectious patients at the stages of its delivering.

[Syphilis in a patient with the primary diagnosis of infectious mononucleosis, cytomegalovirus and herpes infection].

The paper reports a case of fresh secondary syphilis affecting oral cavity and lips in a 25 year old woman. The primary diagnosis of infectious mononucleosis, cytomegalovirus and herpes infection proved erroneous. Retrospective differential diagnostics of infectious mononucleosis, cytomegalovirus and herpes infection from fresh secondary syphilis was performed This case suggests the absence of vigilance with respect to venereal diseases in the medical personnel.

[The state of oral cavity in patients with hepatitis A].

The aim of the study was to estimate oral cavity condition in 42 patients aged 25-58 years with hepatitis A. Forty patients without hepatic pathology served as controls. Hepatitis A is known to be associated with inflammation of oral mucosa with stomatitis occurring in 78.5% of the patients, glossitis in 71.4%, cheilitis in 64.3%, marginal periodontal inflammation in 85.7%. Oral mucosal lesions confound the clinical picture of hepatitis. The prevalence of caries and its complications in patients with hepatitis A amounts to 95.2%. Results of our studies confirm the necessity of early stomatological examination of such patients.

[HIV infection in a patient with a referral diagnosis of sore throat].

HIV infection was documented in a patient with hairy leukoplakia and oral candidiasis who had the wrong referral diagnosis of sore throat in the absence of dental complaints. Dental treatment at an infectious hospital led to regression of oral mucosa lesions, but failed to arrest the progress of severe pneumonia presumably caused by a specific pathogen.

[Concerning changes of oral cavity mucous tunic in acute enteric infection].

The authors represented the results of oral cavity stomatological examination in 171 patients with acute enteric infection (AEI): shigellosis, salmonellosis etc in dynamics of disease. These patients had first diagnosed inflammatory changes of oral cavity mucous tunic: catarrhal gingivitis, catarrhal and benign migratory glossitis, aphthous stomatitis with submandibular lymphadenitis. These changes were accompanied by aggravation of herpetic infection or its debut, candidosis. Lesions of oral cavity mucous tunic in patients with AEI are particular manifestation of infectious process. In acute period patients with AEI have to be examined by stomatologist.

[Health-related assessment of the work training of 5-7th-form pupils]. / Gigienicheskaia otsenka trudovogo obucheniia uchashchikhsia 5-7-kh klassov.

The present investigation is devoted to the study of the influence of labour on the functional state of the organism of medium school-aged pupils. It has been found out that engagement of schoolchildren in the workships and study rooms of service labour are not tiring, which creates reserves for the active development of the motor functions of schoolchildren. At the same time it has been found out that the types of labour which they encounter for the first time (joinery in the 5th form, electrotechnical work) lead to unfavourable changes in the functional state of schoolchildren organisms. The data obtained in the course of investigation on the organization of labour lesson (density of working and lessons structure) have been used in the development of 'Concept of labour preparation of the rising generation and studying young people in the system of continuous education'.