Effiectiveness of Etiotropic Therapy in Patients with Chronic Recurrent Oral Candidiasis: a Randomized Controlled Clinical Trial

Background. Effective treatment of oral candidiasis is especially relevant due to the increase in patients with recurrent fungal lesions of the oral cavity caused by the growing number of Candidaspp. strains refractory to antimycotic drugs. The paper presents the results of the study on the clinical efficacy of etiotropic therapy in patients with chronic recurrent course of oral candidiasis.Objective. To assess the effectiveness of etiotropic therapy in patients with chronic recurrent oral candidiasis.Methods. A randomized controlled clinical trial was conducted in 56 patients with chronic recurrent oral candidiasis aged 45 to 74 years. Examination and treatment of patients was performed at the Department of Dentistry of Volgograd State Medical University and at Volgograd Regional Clinical Dental Polyclinic (Volgograd, Russia). Study timeline: September 2020 — November 2022. Patients were divided into 2 groups depending on the antimycotic drug used: in the main group, patients took voriconazole, in the control group — fluconazole. In addition to etiotropic therapy, patients of both groups were prescribed complex treatment aimed at stimulating the immune protection of the body, restoring vitamin and mineral deficiency, and correcting the imbalance of the oral ecosystem. The patients underwent local symptomatic therapy: antiseptic treatment with 0.06% chlorhexidine bigluconate solution, anesthesia with 15% lidocaine gel, and 3.44% retinol oil solution to stimulate epithelization. Oral sanitation and professional hygiene were recommended for patients to prevent oral candidiasis. In order to restore chewing function, patients were referred to prosthodontic treatment. The main reference point of the study was to assess the effectiveness of the therapy, both by clinical criteria and by evaluating the results of bacterial culture test in order to record the quantitative, species and susceptibility profile of Candidaspp. strains in 3 weeks, 6 and 12 months after the end of treatment. Analysis and statistical processing of the obtained data were performed using Excel program to MS Windows 10 (Microsoft Corp., USA).Results. The most common pathogenic agent of chronic recurrent forms of oral candidiasis is C. albicans (69.6%), followed by C. non-albicans species — C. krusei (10.7%), C. tropicalis (10.7%) and C. glabrata (8.9%). Analysis of the quantitative characteristics of Candidaspp. using bacterial culture test revealed a high and moderate number of Candidaspp. CFU in most clinical isolates before treatment, and no such cases in patients of the main group after treatment. The susceptibility test of yeast fungi to fluconazole and itraconazole showed the presence of isolates with dose-dependent susceptibility, and the resistance of individual samples C. krusei to fluconazole and C. glabrata (16.7% and 60%, respectively) and to itraconazole (33.3% and 100%, respectively). All Candidaspp. isolates were found to be highly susceptible to voriconazole. The efficacy of the combined treatment of an episode with voriconazole is 95.4%. Continued suppressive therapy with voriconazole resulted in relapse prevention in 98.3% of patients. Etiotropic therapy with voriconazole provided a stable clinical effect (92.7%) after a year of follow-up.Conclusion. The results of the study confirm the effectiveness of etiotropic therapy with voriconazole for chronic oral candidiasis complicated by a recurrent course, especially in case of detected C. non-albicans or fluconazole- and itraconazole-resistant C. albicans, or if it is impossible to identify the pathogenic agent

Doppler assessment of throphoblastic blood flow to predict adverse pregnancy outcome

Objective. To evaluate the diagnostic utility of trophoblastic blood flow Doppler parameters in predicting an adverse pregnancy outcome.Material and Methods. This was a retrospective study of 218 pregnancies of women between 8 and 11 weeks’ gestation. Depending on the pregnancy outcome, patients were divided into 4 clinical groups. All women underwent an ultrasound examination using Voluson S8, Voluson E8 with high-quality grey scale, color flow mapping and pulsed-wave Doppler modes. We used a program for obstetric research with the following instrument settings: 100 MHz Doppler frequency, thermal index (TI) was <1, mechanical index (MI) was 1. The examination time did not exceed 20 minutes. There was no radiation exposure. Transvaginal and transabdominal sonographies were performed.Results. To form a risk group for an adverse fetal outcome due to fetoplacental insufficiency, it is necessary to identify ultrasound markers of inadequate placental perfusion by means of a Doppler study of fetoplacental blood flow. For this purpose, we examined 218 pregnancies of women between 8 and 11 weeks’ gestation to determine the diagnostic utility of various parameters: resistivity index, pulsatility index, systolic/diastolic ratio and chorionic vascularization index (k, %). We received results proving high sensitivity (76.9%) and specificity (89.7%) of the chorionic vascularization index (k, %), as well as low specificity (54.7%) and high sensitivity (81.5%) of trophoblastic blood flow resistivity index.Conclusion. Thus, the chorionic vascularization index (k, %) is of high diagnostic utility for predicting an adverse fetal outcome

Electronic structure and magnetic state of transuranium metals under pressure

Electronic structure of bcc Np, fcc Pu, Am, and Cm pure metals under pressure has been investigated employing the LDA+U method with spin-orbit coupling (LDA+U+SO). Magnetic state of the actinide ions was analyzed in both LS and jj coupling schemes to reveal the applicability of corresponding coupling bases. It was demonstrated that whereas Pu and Am are well described within the jj coupling scheme, Np and Cm can be described appropriately neither in {m-sigma}, nor in {jmj} basis, due to intermediate coupling scheme realizing in these metals that requires some finer treatment. The LDA+U+SO results for the considered transuranium metals reveal bands broadening and gradual 5f electron delocalization under pressure.Comment: 5 pages, 5 figure

Metodologia para melhorar a qualidade na organização do processo educacional através da implementação de software

The article deals with the issues of information exchange between teachers, pupils and educational organization departments. They analyzed the advantages and the disadvantages of traditional approaches: e-mail, communication via phones, social networks. They considered the issues of information placement intended for a large number of users. They revealed the need to address the problems associated with the publication of events - major administrative announcements of educational organizations, which are visible to all users and set to a certain date. The approach to publication of events is proposed within the framework of a system separate module. They considered the mechanism of mass mailings which allows users to transmit information to two or more recipients and ensures the exchange of information available only to recipients, unlike the "wall". An approach is proposed to increase the quality of the educational process organization, which allows a rapid exchange. The issues of information placement are considered on the website of the educational organization using the example of the training schedule. The advantages and the disadvantages of the traditional approach are analyzed. The issues of schedule planning among part-timer teachers are considered. They propose the approach to increase the quality the educational process quality organization, which allows you to place and make changes to the curriculum quickly using the example of the "Electronic Schedule" system.El artículo trata sobre los temas de intercambio de información entre profesores, alumnos y departamentos de organizaciones educativas. Analizaron las ventajas y desventajas de los enfoques tradicionales: correo electrónico, comunicación a través de teléfonos, redes sociales. Consideraron los problemas de la colocación de información destinados a un gran número de usuarios. Revelaron la necesidad de abordar los problemas asociados con la publicación de eventos: los principales anuncios administrativos de las organizaciones educativas, que son visibles para todos los usuarios y se establecen en una fecha determinada. El enfoque para la publicación de eventos se propone en el marco de un módulo separado del sistema. Consideraron el mecanismo de correo masivo que permite a los usuarios transmitir información a dos o más destinatarios y garantiza el intercambio de información disponible solo para los destinatarios, a diferencia del "muro". Se propone un enfoque para aumentar la calidad de la organización del proceso educativo, lo que permite un intercambio rápido. Los problemas de colocación de información se consideran en el sitio web de la organización educativa utilizando el ejemplo del programa de capacitación. Se analizan las ventajas y desventajas del enfoque tradicional. Se consideran los problemas de planificación de horarios entre los maestros a tiempo parcial. Proponen el enfoque para aumentar la calidad de la organización de la calidad del proceso educativo, lo que le permite ubicar y realizar cambios en el plan de estudios rápidamente utilizando el ejemplo del sistema "Programación electrónica".O artigo trata das questões de troca de informações entre professores, alunos e departamentos de organização educacional. Eles analisaram as vantagens e desvantagens das abordagens tradicionais: e-mail, comunicação via telefones, redes sociais. Eles consideraram os problemas de colocação de informações destinados a um grande número de usuários. Eles revelaram a necessidade de abordar os problemas associados à publicação de eventos - grandes anúncios administrativos de organizações educacionais, que são visíveis para todos os usuários e definidos para uma determinada data. A abordagem para publicação de eventos é proposta no âmbito de um módulo separado do sistema. Eles consideraram o mecanismo de envios em massa que permite aos usuários transmitir informações a dois ou mais destinatários e garante a troca de informações disponíveis apenas para os destinatários, ao contrário do "muro". Uma abordagem é proposta para aumentar a qualidade da organização do processo educacional, o que permite uma troca rápida. As questões de colocação de informações são consideradas no site da organização educacional usando o exemplo do cronograma de treinamento. As vantagens e desvantagens da abordagem tradicional são analisadas. As questões do planejamento do cronograma entre os professores temporários são consideradas. Eles propõem a abordagem para aumentar a qualidade da organização da qualidade do processo educacional, que permite colocar e fazer mudanças no currículo rapidamente usando o exemplo do sistema "Programação Eletrônica"