Aspirantskiy Vestnik Povolzhiya

Aim – to carry out a statistical analysis of the incidence rate of acute intestinal infections for the period of 2017-2022 and draw a conclusion about the impact of the COVID-19 pandemic on the occurrence of diseases affecting mainly the gastrointestinal tract.

Material and methods. The work used data obtained during Rospotrebnadzor’s monitoring of the epidemiological situation in the Republic of Mordovia in 2017-2022. For statistical analysis, the average values were selected and compared with each other, and confidence intervals were calculated.

Results. The greatest difference in incidence was observed in the year of the outbreak of the pandemic. In 2020, compared with 2017, there was a 3.56-fold decrease in the incidence of acute intestinal infections among patients over the age of 18, including 5.85-fold decrease among children. Compared to 2018, the incidence among adults and children decreased by 3.3 and 1.7 times, respectively. No significant changes were identified in 2019. In 2022, due to the lack of strict anti-epidemic measures, there was a slight increase in the incidence, which increased by 1.64 times.

Conclusions. The study revealed that restrictive measures due to the pandemic and people’s fear of going to medical institutions due to the risk of SARS-CoV-2 infection contributed to a decrease in the frequency of acute intestinal infections.

Aim – to identify the specifics of age-related changes and combinations of metabolic disorders in the risk of developing cardiovascular events among rural residents of the Orenburg region.

Material and methods. 499 people aged 35 to 74 years participated in the study. The follow-up period was 36 months. All patients underwent an analysis of age, anthropometric and metabolic parameters (body mass index, body obesity index, visceral obesity index, atherogenicity index, insulin resistance).

Results. During the analysis of variance, patients of advanced age manifested a statistically significant difference from young and elderly patients in terms of the level of fatal complications (p=0.002). Elderly patients showed a statistically significant difference from young and advanced age patients in terms of the level of nonfatal events.

Conclusion. The role of age-related changes as the only predictor of the development of cardiovascular events remains controversial. The identification of single factors of metabolic imbalance also has a low informational value. An increase in the number of metabolic deviations will determine the course and prognosis of an active person’s life. Patients aged 45 to 59 years are exposed to a more aggressive influence of metabolic predictors of the development of cardiovascular events due to insufficient formation of adaptive mechanisms in the aging process.

Aim – to study the local pharmaceutical market of the Luhansk People’s Republic, compare it with the Russian and international market and determine the characteristic features of the market.

Material and methods. The data of the pharmacy chains of the republic, information and reference materials on oral hypoglycemic drugs registered in the world and in the territory of the Russian Federation were used as research objects. To achieve this goal, graphical, comparative, structural and marketing methods were used.

Results. The global market of oral hypoglycemic drugs is represented by 10 subgroups, 90 international nonproprietary names (INN) and their combinations. There are 35 INNs and 457 trade names (TN) registered on the Russian market. The pharmaceutical market of the republic is represented by 17 INNs and 71 TNs of medicines of the studied group. The share of domestic and foreign drugs on the market is 73.24% and 26.76%, respectively. Among all foreign drugs, 31.58% are produced in Germany, 15.79% each in India, Slovenia and Romania, 10.53% in France, 5.26% each in Greece and the USA. The breadth coefficient is 0.75; the depth coefficient in the republic is 0.55; the range completeness coefficient is 0.15. The average cost of monthly therapy with oral hypoglycemic drugs is calculated in the amount of 679.98 rubles. The capacity of the pharmaceutical market remained stable; the coefficient of variation in the period from 2018 to 2023 was 14.46%.

Conclusion. The comparison of the pharmaceutical market of the republic with the world and Russian is carried out, the coefficients of breadth, depth and completeness of the assortment are calculated. Using the method of established daily doses, the average monthly cost of therapy was calculated and the potential capacity of the oral hypoglycemic drugs market from 2018 to 2023 was calculated and illustrated.

Aim – to evaluate the olfactory function in patients with acute and chronic rhinosinusitis using the data from the hardware and software complex “ReviSmell”, taking into account the perception of simple and binary odors.

Material and methods. At the first stage, the sense of smell was assessed using the “Sniffin Sticks screening test 12” (SST-12) in 69 patients with acute and chronic rhinosinusitis who were treated in the Clinics of the Samara State Medical University. The second stage of the study involved 52 patients with rhinosinusitis who were diagnosed with olfactory impairment. Patients were divided into two groups, with acute rhinosinusitis (n = 18 people, average age 37.7±15.9 years), and with chronic rhinosinusitis (n = 34 people, average age 39.0±0.2 years), to assess the olfactory function using the “ReviSmell” complex.

Results. According to the SST-12 data, the average score in patients with chronic and acute rhinosiniusitis was 7.5±0.2 points and 7.7±1.7 points, respectively. In patients with acute rhinosinusitis, odor perception distortion was observed in 44.4% of patients, no cases of phantosmia were found. Patients with acute rhinosinusitis recognize and identify odors with both olfactory and olfactory-trigeminal action quite well. In patients with chronic rhinosinusitis, parosmia occurs in 23.5% of cases, no patients with phantosmia were found. The worst recognition and identification of binary odorants was revealed, in particular, odorants of eucalyptus, wormwood and mint.

Conclusions. Patients with acute and chronic rhinosinusitis and olfactory impairment perceive odorants that irritate olfactory and olfactory-trigeminal receptors differently. The revealed differences have practical significance for differentiated assessment of individual profile of olfactory dysfunction and prediction of possibility of its correction.

Aim – to conduct a comparative retrospective analysis of the clinical outcomes of implantation of multifocal intraocular lenses (MIOLs) and intraocular lenses with extended depth of focus (EDOF) in patients with a history of refractive surgery. To evaluate the impact of the ocular surface condition on the quality of vision and patient satisfaction in the long term after phacoemulsification (PEC).

Material and methods. In a multicenter retrospective cohort study, data from 72 patients (101 eyes) aged 25 to 76 years were analyzed. After phacoemulsification, various models of intraocular lenses (IOLs) were implanted. The patients were divided into 2 groups: Group 1, patients with implanted full-range of vision IOLs - MIOLs (18 people, 26 eyes); Group 2, patients with implanted extended partial range of vision IOLs - EDOF (54 people, 75 eyes). All patients underwent a standard comprehensive ophthalmological examination. The work included a comparative analysis of uncorrected and corrected distance visual acuity (UCVA and CDVA), refraction data before phacoemulsification and 1 month after cataract surgery. In the late postoperative period, UCVA and CDVA were assessed at near (30 cm) and intermediate (45 cm) distances in both observation groups. The functional consequences of premium IOL implantation and subjective patient satisfaction were assessed using the individual Visual Function-14 (VF-14) quality of life questionnaire. Remote risk factors for the development and progression of dry eye syndrome (DES) were also recorded using the Schirmer 1 Test and the Norn test. Additionally, all subjects completed the Ocular Surface Disease Index (OSDI) questionnaire.

Results. The conducted analysis showed statistically significant change in visual acuity (VA) 1 month after surgery (p <0.001) in both observation groups. In Group 1, UCVA at distance after surgery was 0.70 (0.55–1.00), and CCVA was 0.80 (0.70–1.00). In Group 2, UCVA after surgery increased to 0.60 (0.45–0.85), CCVA 0.80 (0.70–1.00). At near distance (30 cm), UCVA and CCVA in patients with implanted full-range IOLs were 0.73±0.17 and 0.73±0.17, at intermediate distance, 0.40±0.17 and 0.47±0.17, respectively. In the second observation group, with implantation of the extended partial range of vision IOL, the UCVA and UCVA at near distance (30 cm) were 0.54±0.21 and 0.50±0.20, at medium distance (45 cm), 0.42±0.17 and 0.50±0.17, respectively. In both observation groups, a significant decrease in tear production and tear film stability (TS) was noted. The average values of the international OSDI questionnaire in all groups ranged from 21.53 to 22.38 points, which corresponds to normal values. According to the results of the VF-14 questionnaire, high subjective patient satisfaction was revealed, amounting to from 88.50 to 95.50 points.

Conclusions. The results of implantation of full-range IOLs and extended partial range IOLs showed comparable high clinical results of distance VA one month after FEC. However, at near distance, multifocal IOLs provided higher visual acuity, and at intermediate distance, on the contrary, extended partial range of vision. These types of premium high-tech pseudo-accommodating IOLs can provide high subjective satisfaction of patients with a history of keratorefractive surgeries, taking into account their individual needs in everyday life. This work confirms the need for an individual approach to each patient after previous keratorefractive surgery.

Aim – to conduct a comparative characterization of the properties of polymer materials (water absorption and solubility) used for the manufacture of removable denture bases using traditional and digital methods.

Material and methods. To conduct the study, experimental samples were made from cold polymerized base resin based on polymethylmethacrylate Vertex Castapress (Vertex Dental, the Netherlands) and photopolymer material for 3D printing Next Dent Base (Next Dent, the Netherlands) in the amount of 5 pieces for each material. The study was conducted in accordance with GOST 31572-2012 “Polymer materials for denture bases”. Statistical analysis was performed using the Mann – Whitney test.

Results. For the photopolymer base material for 3D printing, Next Dent Base, the average value of water absorption is 9.857 ± 0.2165 micrograms/mm³, and solubility is 0.22 ± 0.1483 micrograms/mm³. For the basic cold-polymerized resin based on polymethylmethacrylate Vertex Castapress, the average value of water absorption is 13.46 ± 0.1826 micrograms/mm³, solubility is 0.74 ± 0.1342 micrograms/mm³.

Conclusions. Criteria of water absorption and solubility are used to assess the ability of basic plastics to withstand the effects of saliva and are indicators of durability and bioinertness of dentures. Next Dent Base, a photopolymer base material for 3D printing, has better water absorption and solubility in comparison with Vertex Castapress cold polymerization resin, which indicates that this material has greater strength and wear resistance (the medians of the samples differ by 32.4% according to the criterion of water absorption, and by 75.0% according to the criterion of solubility).

Aim – to evaluate markers of the inflammatory process in the oral fluid of patients in need of orthopedic dental care.

Material and methods. A study of dental status was conducted, determining the DMFT (Decayed, Missing, Filled Teeth) index and the Green – Vermillion index in 40 individuals, 20 of whom were in the control group and 20 were patients requiring dental orthopedic care. Assessments were made during the initial consultation and after hygiene measures. Cytokine response indicators, viz. IL-1, IL-6, and immunoglobulin A, were determined using ELISA. CRP (C-reactive protein) levels were assessed using the Cobas Integra+ automatic biochemical analyzer (Roche). Statistical analysis included both parametric and non-parametric methods.

Results. When comparing the data from the control group and patients requiring dental prosthetics before sanitation, deviations were detected in CRP levels, more than 4 times higher, and IL-1, 158% higher. After sanitation and hygiene measures, the most pronounced changes were observed in CRP levels, with a 70.5% reduction.

Conclusions. Deviations in the levels of pro-inflammatory cytokines in oral fluid can serve as indicators of the risk of developing inflammatory processes in the body. The level of CRP in oral fluid is a reliable and rapidly responsive indicator of adequate anti-inflammatory therapy.

The work dwells on a rare case of a late complication of a gynecological operation: internal urethral fistula with a giant retroperitoneal extravasation of urine up to 2 liters. The diagnostic was complicated by the size of the fistula and its localization in the lower third of the right ureter. The diagnosis was made on the basis of ultrasonic examination, CT and urethroscopy. The treatment also had its own characteristics and consisted of two stages: opening and drainage of the extravasation of urine and ureterocystoneoanastomosis. Long-term results were satisfactorily and were observed for up to 5 years.