[Use of miramistin for the treatment of patients with odontogenic phlegmons in the maxillofacial area].

In experimental and clinical conditions the use of miramystin (0.1% solution and liniment) was validated for complex treatment of patients with odontogenic maxillofacial phlegmons (110 patients with mild, moderate and severe inflammation). Significant efficacy of a wide spectrum antiseptic (miramystin) and laser fluorescent diagnostic method for achievement of objective assessment of the treatment of patients with phlegmons in maxillofacial area is shown. The disease duration (time from its onset till discharge from the hospital) varied from 8.2 to 24.1 days depending upon the degree of severity of the inflammatory process versus 13.7 to 30.4 days in controls, respectively. The developed treatment-and-diagnostic methodology is recommended for wide clinical practice.

[Laser fluorescence in assessing the hygienic status of oral cavity]. / Primenenie lazernoi fliuorestsentsii dlia otsenki gigienicheskogo sostoianiia polost rta.

The issue related with an objective evaluation of a hygienic status of the oral cavity and a method to solve it by modern laser technologies are addressed in the paper. The efficiency of bacteriological and of laser-fluorescence express-diagnostics is comparatively analyzed. A hygienic index and its clinical value are substantiated.

[Microecology of non spore-forming anaerobes in health and in disease]. / Mikroékologiia nesporoobrazuiushchikh anaérobov v norme i pri patologii.

The authors studied the species-specific and quantitative composition of the large intestinal microbiocenosis on exposures to various factors of endo- and exogenous etiologies: the presence of a pathological process and its specific features, dietary trace element composition, unfavorable environmental (chemical) factors, as well as the impact of coexistence in the same family and the factors of family variability (the individual genotype of the macro-organism). The microenvironment of non spore-forming anaerobes that colonize the large bowel was found to be influenced by a number of various factors, both exo- and endogenous. The magnitude of these changes is associated with the intensity and specificity of an influencing factor.

[Problem in the diagnosis of anaerobic infections and dysbacteriosis in clinical dentistry]. / Problema diagnostiki anaérobnoi infektsii i disbakterioza v klinicheskoi stomatologii.

The fluorescence technique was proposed for rapid diagnosis of anaerobic infection. It determines the microbiocenosis of a wound, the gastrointestinal tract, maxillofacial region, and other pathologically changed organs and tissues. The technique allows one to follow the time course of changes in the microflora and in the pathological process during the treatment and follow-up of a patient. An attempt was made to establish a rapid diagnosis of intestinal dysbacteriosis and to evaluate its severity. A real-time feed-back unit was developed for the diagnosis of anaerobic infection. An anaerobic microflora model in dental caries was used to work out criteria for the informative value of the proposed technique and it was clinically tested.

[Myocardial functional state in neurocirculatory dystonia]. / Issledovanie funktsional'nogo sostoianiia miokarda u bol'nykh neirotsirkuliatornoi distoniei.

The function of the myocardium during bicycle ergometry (submaximum exertion) was studied in 97 patients with neurocirculatory dystonia (NCD) bymeans of polycardiography. Three types of reaction of cardiodynamics to the exertion were revealed: a favourable reaction, similar on the whole to the normal reaction; hyperdynamic reaction which was evidence of hyperkinetic cardiac activity; unfavourable reaction associated with impaired myocardial contractility. Clinical and instrumental comparison enabled the author to detect some regular features as the result of which the severity of NCD could he objectified, the decrease in physical exertion tolerance to be assessed differentially, and the working capacity in persons with the pathological condition to be assessed.

[Characteristics of the sound symptomatology of the heart in functional cardiopathy]. / Osobennosti zvukovoi simptomatiki serdtsa pri funktsional'noi kardiopatii.

Sixty persons with functional cardiopathy who had a systolic murmur were examined. The purpose of the study was the demonstration of the criteria for the positive diagnosis of a functional systolic murmur in this pathologic condition since hyperdiagnosis of valvular heart disease among these patients is a frequent occurrence. The auscultatory and phonocardiographic characteristics of the functional systolic murmur are described, a conclusion on the absence of any connection between this murmur and the valvular apparatus of the heart is drawn, an opinion on the mechanism of its formation is presented, and the data on the effect of beta-blocking agents on the systolic murmur (single dose and a course of treatment) are discussed.

[Clinical symptoms and the diagnosis of the hyperkinetic cardiac syndrome]. / Klinicheskaia simptomatika i diagnostika giperkineticheskogo kardial'nogo sindroma.

The authors examined 40 patients with the hyperkinetic syndrome (HS) who underwent thorough clinical and instrumental examination including ECG, PCG, bicycle ergometry, hyperventilation and orthostatic tests, and determination of the central hemodynamic indices by echocardiography and the rate heart indices in dopplercardiography. The great diagnostic possibilities of doppler-cardiography are demonstrated. The diagnostic criteria of HS are suggested and general recommendations for treatment are given.

[Central hemodynamic function of neurocirculatory dystonia patients at rest and during the performance of load tests]. / Sostoianie tsentral'noi gemodinamiki u bol'nykh neirotsirkuliatornoi distoniei v pokoe i pri provedenii testov s nagruzkoi.

Central hemodynamic (CH) parameters were examined in 288 patients with neurocirculatory dystonia (NCD) and 50 normal subjects, using radiocardiography (RCG), echocardiography (EchoCG) and heart catheterization thermodilution (TD). All the tests were carried out at rest and during bicycle ergometry (BEM), the atrial stimulation test (AST) and the intravenous isadrin test (IT). Patients with severe NCD and basically hyperkinetic hemodynamic type responded to stress with an inadequate rise in the minute volume (MV) and a decline of the stroke index (SI). Thermodilution during the AST demonstrated increased MV, lowered end diastolic left-ventricular pressure and insignificantly reduced SI. TD and EchoCG during stress exposure produced similar results.

[The use of radiothermometry in patients with rheumatoid arthritis]. / O primenenii radiotermometrii u bol'nykh revmatoidnym artritom.

As a result of the work carried out, one could decide some problems: to develop standardized points of measuring temperatures of the deep structures of the joints using radiothermography, to establish for the first time the normal radiothermographic values of the temperatures for different joint groups, to recommend radiothermography as an adjuvant method for revealing early signs of the activity of rheumatoid arthritis (RA) associated with OA. Radiothermography is a convenient, cheap, available and an informative enough method, fit for the use in clinical practice to improve the diagnosis and treatment of RA.

[The preliminary results of using tramal in rheumatoid arthritis patients]. / Predvaritel'nye rezul'taty ispol'zovaniia tramala u bol'nykh revmatoidnym artritom.

Patients suffering from active rheumatoid arthritis (RA) were examined for the analgesic effect of tramal. All the patients were administered basic therapy and nonsteroidal anti-inflammatory drugs. Tramal produced a beneficial effect in 79% of the patients. The stable analgesic effect ensued on days 3-5 since the onset of continuous treatment. Provided the drug was administered for a short period of time (not more than 14 days), addiction to tramal was not recorded. Only 11% of the patients demonstrated tramal-induced side effects (drowsiness, dizziness, skin itch), seen in cases where the daily dose exceeded 300 mg.

[Various problems of the diagnosis and therapeutic tactics in systemic lupus erythematosus]. / Nekotorye voprosy diagnostiki i taktiki vedeniia bol'nykh sistemnoi krasnoi volchankoi.

The authors discuss diagnostic aspects of systemic lupus erythematosus (SLE) with emphasis on its early stages and outpatient policy. Formalized diagnostic criteria of the disease are recommended. Clinical features of the variants of SLE onset are briefly reported. Various aspects of the patients' management and regime, limiting measures are considered for a confirmed and tentetive SLE diagnosis.

[Cardiac rhythm and conduction disorders in polymyositis and dermatomyositis]. / Narusheniia serdechnogo ritma i provodimosti pri polimiozite i dermatomiozite.

To assess condition of the heart in polymyositis (PM) and dermatomyositis (DM) in terms of defects in the rhythm and conductivity, we carried out ECG, 24-hour ECG monitoring, EIA measurements of KPK MB-fraction and myoglobin, echocardiography and Doppler echocardiography. Maximal frequency of arrhythmia presenting as supraventricular and ventricular extrasystole occurred in patients with acute PM/DM. Blockade of the bundle of His left anterior branch was detected most frequently in patients with acute and subacute PM-DM and in those with high serum levels of KPK MB-faction and myoglobin. Frequency of rhythmic and conductivity disorders seems unrelated to the disease duration. We registered no alterations at rest either in intracardiac hemodynamics or myocardial contractility. The study of these parameters under exercise test may provide objective information on early defects in myocardial contractility.

[Pathogenesis of anemia in systemic scleroderma]. / K patogenezy anemii pri sistemnoi sklerodermii.

The paper reports a case of anemia with complicated genesis in a male patient with systemic scleroderma (SS). Antianemia therapy was not easy, as after rapid disappearance of iron deficiency vitamin B12 deficiency remained, hemolytic component of the disease persisted. The case demonstrates that multicomponent pathogenesis of anemic conditions is possible. This must be taken into consideration when planning therapeutic policy in SS.

[Ways to improve the treatment of patients with phlegmons of the maxillofacial area]. / Nekotorye puti sovershenstvovaniia lecheniia bol'nykh s flegmonami cheliustno-litsevoi oblasti.

The examination has involved a total of 216 patients (111 in the study group and 105 in the reference one) with maxillofacial phlegmons. Patients of the main group were administered multiple-modality treatment with surgical treatment of the purulent focus, involving a primary suture on the wound and intraarterial local drug therapy. Partial necrectomy was found possible in the majority of cases with the surgical treatment of the purulent focus; therefore to prevent dissemination of the inflammatory process and liquidate it as soon as possible surgery had to be performed against the background of the maximal permissible antibiotic concentration in the adjacent tissues. Primary suturing of the purulent wound had to be combined with draining and continuous dialysis of the postoperative wound. The postoperative wound healed by primary tension in 91.89% of patients in the main group; the incidence of complications was lower in them than in the reference group; the length of hospital stay and invalidity periods were reduced almost twofold.

[The interrelation of indices of the functional activity of phagocytosing cells with the status of their receptor apparatus in patients with acute inflammatory diseases of the maxillofacial area]. / Vzaimosviaz' pokazatelei funktsional'noi aktivnosti fagotsitiruiushchikh kletok s sostoianiem ikh retseptornogo apparata u bol'nykh s ostrymi vospalitel'nymi zabolevaniiami cheliustno-litsevoi oblasti.

Rapid techniques were applied to study functional activity of peripheral blood phagocytes in acute sick patients and upon discharge. E-rosette formation is recommended as such rapid technique, for it revealed the cells' superficial E-receptors. The nitro blue tetrazolium reduction test proved useful to probe the oxygen related bactericide mechanisms.

[An analysis of the psychoemotional tension in patients before oral surgery in relation to their psychological personality traits]. / Analiz psikhoémotsional'nogo napriazheniia bol'nykh pered stomatologicheskoi operatsiei v zavisimosti ot psikhologicheskikh osobennostei lichnosti.

Psychoemotional strain caused by the anticipation of surgical intervention with premedication exhibited greater anxiety levels (detected by means of Spielberger test) in extraverts as compared to introverts. This coincided with an elevated RR interval variability and, in extraverts, more pronounced alterations in ECG T-wave amplitude.

[The physiological adaptation functions of cellular and humoral immunity in patients with phlegmons of the maxillofacial area]. / Adaptatsionno-fiziologicheskie funktsii kletochnogo i gumoral'nogo immuniteta u bol'nykh s flegmonami cheliustno-litsevoi oblasti.

In order to evaluate the necessity in immunocorrective therapy the patients with maxillofacial phlegmons were tested for their cellular and humoral immunity. A slight increase or decrease in immunity indices before surgery in several patients were not beyond the physiological norm. Postoperative repetitive investigations the immune parameters attained the mean levels or even went higher without immune-correcting therapy. The above changes are characteristic of the peculiarities of cellular and humoral immunity in individual patients and do not require any interference into the immune system.

[The dynamic biochemical indices of the blood in patients with suppurative-inflammatory processes of the soft tissues of the face and neck]. / Dinamika biokhimicheskikh pokazatelei krovi u bol'nykh s gnoino-vospalitel'nymi protsessami miagkikh tkanei litsa i shei.

Changes in the blood serum protein and mineral composition, trypsin inhibitor content, alanine amino-transferase, aspartate aminotransferase, alpha-glutamyl transpeptidase, creatine kinase, choline esterase activities, blood plasma trace element levels were examined in 112 patients with pyoinflammatory involvement of the soft tissues of the face and neck. The study was revealed reduced blood serum albumin concentration, elevated trypsin inhibitor levels and alpha-glutamyl transpeptidase and creatine kinase activities, decreased content of Mg and Zn and, in some patients, of choline esterase activity. Biochemical parameters gradually normalize, as the patients recover, their normalization depending on the therapeutic methods and detoxication treatment.

[The efficacy of using a helium-neon laser, ascorbic acid and methylene blue in the combined treatment of patients with maxillofacial phlegmons]. / Effektivnost' ispol'zovaniia gelii-neonovogo lazera, askorbinovoi kisloty i metilenovogo sinego v kompleksnom lechenii bol'nykh s flegmonami cheliustno-litsevoi oblasti.

The efficacy of multiple-modality treatment including interstitial He-Ne laser exposure and agents normalizing redox processes due to their antioxidant effect, 5 percent ascorbic acid and 1 percent methylene blue aqueous solution, was assessed in the treatment of 188 patients with maxillofacial phlegmons. The treatment accelerated injured tissue regeneration, this permitting early secondary suturing and shortening the invalidity periods.

[Neutrophil-macrophage correlations during the healing of suppurative wounds in patients with phlegmons of the maxillofacial area undergoing combined treatment with the use of low-frequency ultrasound]. / Neitrofil'no-makrofagal'nye vzaimootnosheniia v protsesse zazhivleniia gnoinykh ran u bol'nykh s flegmonami cheliustno-litsevoi oblasti pri kompleksnom lechenii s ispol'zovaniem nizkochastotnogo ul'trazvukom.

The results of investigation into neutrophilic-macrophagal relationship in purulent wound cicatrization in patients with maxillofacial phlegmons are presented. The one-factor analysis of variance was used to calculate the determination coefficient which proved that the neutrophils exert a strong influence on the mononuclear phagocytes.