Vol 22, No 1 (2022)

Aim – to analyze the severity of burnout syndrome in healthcare workers, to study the correlations between professional risk factors and the emotional burnout in medical staff during the COVID-19 pandemic.

Material and methods. The study groups included healthcare workers of different institutions: workers from COVID hospitals (n=201), outpatient polyclinics (n=186), medical workers of multidisciplinary hospitals (n=195); the control group consisted of 190 healthy persons of other professions. The study participants were interviewed using the questionnaire of V.V. Boyko "Diagnosis of the level of emotional burnout" which consists of 84 questions, in order to identify their attitude to the COVID-19 pandemic situation.

Results. A high level of emotional burnout was revealed in the general sample of medical workers when compared to the control group. The more pronounced signs of emotional distress: tension, resistance, exhaustion were found in medical workers of COVID hospitals in comparison with medical workers of multidisciplinary hospitals and outpatient clinics. The potential professional risk factors for emotional burnout in healthcare personnel during the COVID-19 pandemic were: high workload, introduced restrictive measures, fear of illness, lack and shortage of PPE, the threat and risk of contacting the new coronavirus infection, a long period of isolation, financial instability, insufficient (at the beginning) knowledge about the new little-studied disease, a feeling of discrimination and / or stigmatization.

This article presents a brief analysis of the methodological problems and violations of ethics associated with the COVID-19 era and the transformation of science. The focus is on the transformation of the principle of open science from a local to mass phenomenon. The public exposure of the research has highlighted some methodological problems having unfavorable impact on the healthcare service. The author discusses ethical problems, macro- and microethics, adherence to universal values and personal interests.

For adequate orthopedic dental treatment, not only the volume, but also the quality of the bone tissue in the defect area is important. Therefore, the preservation of the alveolar ridge after tooth extraction is a topical issue in dental surgery. In this regard, a study aimed at prevention of bone atrophy in alveolar process of the upper and lower jaws could be helpful.

The clinical case described in the article shows that the simplest and most logical way to preserve the required volume of bone tissue is to prevent it from the atrophy, in particular by the method of atraumatic removal (partially of the root or tooth).

Aim – to investigate the prevalence and risk factors for signs and symptoms of temporomandibular joint disorders (TMDs) in young people.

Material and methods. A clinical examination and questionnaire were randomly administered to 199 students aged 17 to 28 years using a specially designed questionnaire chart. The respondents with identified laterotrusive or mediatrusive occlusal interferences underwent electromyography (4-channel EMG system "Synapsis", Neurotech) of masticatory muscles before and after elimination of occlusal interferences. Psychoemotional state was assessed using the Spielberger – Hanin situational and personal anxiety test.

Results. The results obtained revealed a high prevalence of signs and symptoms of dysfunctional disorders (87.9%), the leading signs of which were pain or stiffness in the head and neck region (52.7%), sounds (squeaks, clicks, crepitus) in one or both temporomandibular joints when chewing and opening the mouth (39.2%), feeling of pressure, stuffiness or noise in the ears (25.1%), pain when opening the mouth (21.6%). The number of such signs and symptoms was greater in persons with postural disorders and respondents after orthodontic treatment.

Electromyographic study of patients with mediotrusive and laterotrusive contacts showed asynchronous contraction of the masticatory muscles during "protrusion / retrusion" and "opening / closing", increased electrical activity of the temporal muscle on the opposite side in the "right / left mediotrusion" test (111.5 ± 27.1 μV) compared with the indices of the subjects after the elimination of occlusal interferences (75 ± 19.3 μV; p <0.05). Assessment of the psychoemotional state of the examined patients revealed a moderate level of situational (38.9 points) and personal (38.3 points) anxiety.

Conclusion. The signs and symptoms of TMDs are a common finding among young people, such as pain, stiffness in the head and neck, sounds in one or both joints when chewing and opening the mouth, a feeling of pressure, stuffiness or noise in the ears. The most significant risk factors for the development of TMDs in this age group are posture disorders, orthodontic treatment and occlusal obstructions, which affect muscle tone and increase the symptoms of TMDs.

The muscular-articular dysfunction is the most common pathology of the temporomandibular joint, therefore, more and more attention is paid to the diagnosis of this pathology by domestic and foreign researchers. The effectiveness of orthopedic treatment for such patients directly depends on the quality and depth of the examination. In the age of IT technologies, the methods for diagnosing dental patients are constantly improving. At the same time, there is an increasing need to unify the methods of examining patients with difficult-to-diagnose TMJ pathology. This article reviews the studies on the use of modern diagnostic methods in the examination of patients with muscular-articular dysfunction of temporomandibular joint.

Aim – to evaluate the effectiveness of restoring the lateral ankle ligament complex using local tissues according to the Brostrom – Gould technique in patients with different post-traumatic periods.

Material and methods. In 2021, in total 15 patients with lateral ankle instability underwent clinical and instrumental examination and received surgical treatment for this pathology. The patients were divided into three groups depending on the time passed from the primary injury. Group 1 included patients with a post-traumatic period up to 5 years, Group 2 – up to 10 years and Group 3 – more than 10 years. The ankle instability was assessed before and after surgery using the AOFAS and Karlsson – Peterson scales.

Results. In Groups 1 and 2, the patients were satisfied with the results of treatment They could restore the intensity of their physical activity to the level they had before the injury. The patients from Group 3 were not content with the results of treatment and reported the remaining pain, swelling, and joint instability.

Conclusion. With a disease duration of up to 5 years, Brostrom – Gould procedure provides excellent results and remains the preferred treatment for lateral ankle instability. This technique can be successfully used in patients with the post-injury period up to 10 years, if their life-style does not imply the regular intensive load on the ankle. If the history of the disease is more than 10 years, the Brostrom – Gould procedure is ineffective, in such cases other complex treatment methods should be used.

Aim – to establish the morphological, anatomical and microdiagnostic features of the stem, leaf blade, calyx and corolla of Astragalus glycyphyllus in accordance with the regulatory documentation.

Material and methods. The object of the study was the herb Astragalus glycyphyllus harvested in the Kursk region in 2021 during the period of mass flowering of the plant. The State Pharmacopoeia XIV standard was used for macro- and microscopic analysis.

Results. The raw material of the licorice-leaved astragalus consists of non-woody leafy stems 20-25 cm long with flowers, whole and crushed leaves of a grayish-green color, parts of the stem and individual flowers of a greenish-yellow color. The microscopic analysis presented the stem of Astragalus glycyphyllus having a round-ribbed shape, covered on the outside with epidermis with straight-walled cells, with longitudinally wrinkled cuticle. Leaf cells have slightly sinuous walls with anomocytic stomata. The rachis in cross section has a triangular shape with small lateral outgrowths and anomocytic stomata. The epidermis of the rachis is pubescent with simple bicellular hairs with rough surface. Cells of the epidermis of the calyx from the prosenchymal form (in the tube of the calyx) to the parenchyma (in the pharynx, on the teeth of the calyx), anomocytic stomata. At the base of the corolla there are epidermal cells of a prosenchymal form, straight-walled with straight or beveled ends, in the limb of the corolla - epidermal cells of a prosenchymal form, straight-walled with a longitudinal wrinkled cuticle. The epidermis of the stem, leaves, rachis and calyx is pubescent with simple two-celled hairs on a short basal cell with a long terminal cell, with rough surface.

Conclusion. The macro- and microdiagnostic features of the herb Astragalus glycyphyllus were described to distinguish the raw material "Astragalus glycyphyllus herb".

Aim – to improve the dispensary follow-up of patients with type 2 diabetes (DM) by identifying clinical signs, available during examination in the outpatient clinic, that suggest the development of chronic kidney disease (CKD).

Material and methods. A cross-sectional study included a population sample of patients with type 2 diabetes and focused on the clinical indices available during an outpatient consultation. 150 protocols of outpatient consultations were selected using the compliance criteria, including data on 72 clinical indices. The general sample was divided into groups in two ways: by the level of glomerular filtration rate (GFR) and by achieving the goals of glycemic control (calculated parameter delta HbA1c).

Results. The following indices differed most significantly in the groups divided by stages of CKD: gender, age, duration of diabetes and insulin therapy, achievement of target values of glycemic control, blood pressure level, comorbid cardiovascular pathology, pulse on the popliteal artery. In patients with preserved GFR and the early stages of CKD, the fact of unsatisfactory glycemic control was associated with an increase in plasma creatinine and a decrease in GFR, higher blood pressure values. In the advanced stages of CKD, the impact of glycemic control on kidney function was practically absent.