Unique molecule filaggrin in epidermal structure and its role in the xerosis development and atopic dermatitis pathogenesis

Atopic dermatitis (AD) is the most common polyetiologic inflammatory skin disease in industrialized countries. Recent non-clinical and clinical studies highlighted the crucial pathogenetic role of a damaged skin barrier in patients with AD. A crucial role in the skin barrier physiology is played by the protein filaggrin, which in addition to humectant function, controls structural protein aggregation, skin pH, antimicrobi-al peptides production by keratinocytes, photoprotection, and epidermal lipid synthesis. Mutations in the human filaggrin gene (FLG), which encodes filaggrin, are the most significant in AD development. The major determinant of filaggrin expression is the FLG genotype, which has three variants: null mutation, heterozygous variant, and absence of mutations in FLG in both alleles. Additional genetic (including intra-genic copy number variation) and environmental modifiers can alter the filaggrin protein expression. Transcutaneous penetration of irritants and allergens leads to chronic inflammation and contributes to the atopic march development. In addition, persistent skin inflammation further weakens the skin barrier function, resulting in a «vicious circle» of pathogenetic interactions between the altered skin barrier and the immune system: Th2 response causes downregulation of filaggrin irrespective of FLG mutation status and significantly aggravates the course of AD. Understanding of skin barrier physiology is important for effective AD therapy and prevention of subsequent atopic manifestations. Currently, the most promising methods of restoring the skin barrier in at-risk individuals are therapies that enhance filaggrin production. © 2021, Media Sphera Publishing Group. All rights reserved

E-LEARNING PROCESS PLANNING IN ORGANIZING OF LINGUISTIC STUDENTS' SELF-STUDY FOR BACHELORS OF PEDAGOGICAL DIRECTION

An intensively developing society requires a systematic update of all kinds of human resources. The gadgets of all kinds are becoming an essential attribute of an individual. The present article is focused on the problem of students' self-study education within E-learning environment. The article aims at justifying and revealing the author's concept of effective self-study organization of educational process in foreign languages. The present article discusses the experience of learningapps.org usage as a means of organizing of linguistic students' self-study in the process of learning the English language. To prove the idea of successful E-learning implementation, the students were divided into 2 groups: a control and an experimental groups. The students of the control group worked traditionally according to their plan of a working program without any changes. The educational process of a second group was planned according to the principals of E-learning. The authors enlighten LearningApps.org background and advantages of web-service implementation into traditional language classroom. The research methods involve analysis of scientific literature on the problem of activity approach to answer questions, solve practical arrangements problems, and derive important information. The presented diagnostic methods, including observation, description, and methods of statistical data processing help describe facts, detect patterns, develop explanations and test hypotheses. The experiment showed that E-learning process planning and its innovative educational model contributed to the formation and development of ability of activity and features of an individual provided their successfulness in future life on a level with Federal State Educational Standard of Higher Education

Predictors of severe course of atopic dermatitis

Atopic dermatitis (AD) is a common inflammatory skin disease that occurs most frequently in children. The disease is characterized as chronic, but only 20% of children suffer from severe AD, while the other 80% reach a long-term remission by the age of 8. The aim of the research was the analysis of modern sources of domestic and foreign literature, highlighting the features of the course of severe forms of AD. Results. The multifactorial nature of AD pathogenesis, based on the complex interaction of genetic factors, the immune system, the skin microbiome and environmental factors, causes certain difficulties for the physician, both in the diagnosis and therapy selection, and in predicting the course of the disease. Each patient has his own individual combination of clinical symptoms, medical history and aggravating factors that should be considered as predictors of the severity of the disease. Conclusion. Particular attention should be paid to patients with an early onset of AD, increased transepidermal water loss, with extensive skin lesions at the onset of the disease and under dynamic observation, with concomitant food allergies and/or bronchial asthma. Copyright© GEOTAR-Media Publishing Group

The experimental study of a Russian orthodontic mini-screw [Eksperimental'noe issledovanie otechestvennogo ortodonticheskogo minivinta]

BACKGROUND: The aim of this research is the experimental study measuring stability of the orthodontic miniscrews «Turbo» designed in Russia in comparison with its foreign analogues, namely, «Vector Tas» (USA) and «BioRay» (Taiwan). MATERIAL AND METHODS: Four self-drilling orthodontic miniscrews of each manufacturer, i.e. «Vector Tas», USA, (10-mm length, 2-mm diameter), «BioRay», Taiwan, (10-mm length, 2-mm diameter), «Turbo», Russia, (9-mm length, 2-mm diameter), a total of 12 items, were inserted into native pig mandible sample. Their stability was estimated by torques using a dynamometer (Zahoransky AG, Germany) and «Periotest» device («Periotest M», Germany). This experiment was conducted in native pig mandible sample immediately after the screws' placement and in 7 days after loading at an angle 70°. RESULTS: After application of a load, the decreased torque values and increased Periotest values were registered in all orthodontic miniscrews. CONCLUSION: Orthodontic miniscrews «Turbo» designed in Russia are slightly inferior to «VectorTas» miniscrews and superior to «BioRay» miniscrews in primary stability and stability after 7 days under loading.ЦЕЛЬ ИССЛЕДОВАНИЯ: Сравнительное изучение стабильности разработанного отечественного ортодонтического минивинта (МВ) «Турбо» с зарубежными аналогами VectorTas (США) и BioRay (Тайвань) в эксперименте. МАТЕРИАЛ И МЕТОДЫ: Всего в исследовании использовано 12 саморежущих винтов по 4 от каждого производителя: Vector Tas, США, (длина 10 мм, диаметр 2 мм), BioRay, Тайвань, (длина 10 мм, диаметр 2 мм), «Турбо», Россия, (длина 9 мм, диаметр 2 мм). Все МВ были вкручены в нативный препарат нижней челюсти свиньи. Стабильность количественно оценивали по крутящим моментам (КМ) динамометрической машиной (Zahoransky AG, Германия) и прибором «Периотест» (Periotest M, Германия) в нативном препарате нижней челюсти свиньи сразу после вкручивания и через 7 дней после нагружения под углом 70°. РЕЗУЛЬТАТЫ: У всех ортодонтических МВ после нагрузки наблюдалось снижение КМ и увеличение показателей периотестометрии. ЗАКЛЮЧЕНИЕ: Отечественные ортодонтические МВ «Турбо» по первичной стабильности и устойчивости после 7 сут нагрузки незначительно уступают МВ VectorTas и превосходят МВ BioRay

SPITZ nevus (juvenile melanoma) in the pediatricians practice: Clinical picture, diagnosis, prognosis and treatment

Spitz nevi (epithelioid and spindle-cell nevi) are a special group of melanocytic neoplasms with a specific clinical, dermatoscopic and histological picture. There are typical and atypical Spitz nevus. The typical Spitz nevus is more common in pediatric practice and has a benign course. Of particular interest are atypical forms that combine the characteristics of a typical Spitz nevus and melanoma. The article presents an analysis of the clinical picture, dermatoscopic, immunohistochemical, histological and genetic characteristics in various forms of Spitz nevus. The existing classification according to the metastasis risk degree is presented. The last recommendations on the tactics of managing patients with this nosology are discussed with examples of original observations. © 2021, Pediatria Ltd.. All rights reserved

Peutz-Jeghers' syndrome in pediatric dermatological practice [Синдром Пейтца-Егерса в детской дерматологической практике]

Peutz-Jeghers' syndrome is a rare hereditary disease inherited by an autosomal dominant type, manifested by a characteristic clinical picture of skin lesions and hamartomas of the gastrointestinal tract. Complications of the disease include bleeding from polyps, anemia, intussusception and intestinal necrosis, as well as a high likelihood of developing malignant tumors. For the first time the syndrome was described at the beginning of the last century, and it is of interest to dermatologists, gastroenterologists, oncologists and surgeons due to the clinical heterogeneity of intestinal and skin manifestations. The article describes a clinical case of a 5-year-old girl with the Peutz-Jaegers syndrome. The patient complained of periodic dull abdominal pain that worsened after eating solid food. During the examination of the skin and mucous membranes the doctors discovered rashes on the face: perioral area, on the red border of the lips and on the mucous membrane of the lips, inside the cheeks, hard palate. Esophagogastroduodenoscopy (EGDS) revealed a polyp on a pedicle in the prepyloric part - it was removed during repeated EGDS under endotracheal anesthesia. Fibrocolonoscopy revealed hyperpigmentation of the dome of the cecum. To confirm the diagnosis, the doctors carried out DNA testing which found a mutation of the STK11 gene. Pigmentation of the perioral area is an early symptom of Peutz-Jeghers' syndrome suggesting optimal examination. Early recognition of the syndrome in children is important in the context of reducing the risk of developing intestinal obstruction, bleeding, and cancer complications in the future. © 2021 National Academy of Pediatric Science and Innovation. All rights reserved

Algorithm for treatment of patients with class II malocclusion rejecting orthognathic surgery [Algoritm lecheniya patsientov s nizhnei retrognatiei, otkazavshikhsya ot kostno-rekonstruktivnoi operatsii]

The aim of this study is to develop algorithms for the treatment of patients with class II malocclusion and incisor protrusion using the combination of bracket system, functional fixed telescopic appliance (FFTA) and skeletal anchorage, which allows to achieve effective dentoalveolar compensation of skeletal forms of class II malocclusion. MATERIALS AND METHODS: Orthodontic treatment of 60 patients with class II malocclusion at the age of 18 to 44 years, using the bracket system, FFTA and orthodontic miniscrews was performed. In order to assess the results of treatment, cone-beam computed tomography were obtained at the beginning and at the end of treatment. RESULTS: As a result of the treatment normalization of lower jaw position, dental position and occlusion were achieved, the lower incisors protrusion was eliminated and the facial profile was improved, reliably confirmed by lateral cephalograms. CONCLUSION: The proposed treatment algorithm proved to be effective for stable correction of skeletal class II malocclusion in patients rejecting orthognathic surgery.ЦЕЛЬ ИССЛЕДОВАНИЯ: Разработка алгоритмов лечения пациентов с нижней ретрогнатией, дистальной окклюзией зубных рядов (ДОЗР) и протрузией резцов с помощью комбинированного применения несъемной ортодонтической техники и скелетной опоры, позволяющих эффективно проводить зубоальвеолярную компенсанцию скелетных форм дистальной окклюзии. МАТЕРИАЛ И МЕТОДЫ: Проведено ортодонтическое лечение 60 пациентов с нижней ретрогнатией и ДОЗР в возрасте от 18 до 44 лет при помощи брекет-системы, функционального несъемного телескопического аппарата (ФНТА) и ортодонтических минивинтов. С целью оценки результатов лечения каждому пациенту проводилось рентгенологическое исследование до и после лечения. РЕЗУЛЬТАТЫ: Было достигнуто улучшение соотношения челюстей по сагиттали, нормализовано положение нижней челюсти, нормализовано положение зубов и смыкание зубных рядов, устранена протрузия резцов и улучшен профиль лица, что достоверно подтверждено данными телерентгенографии черепа в боковой проекции. ЗАКЛЮЧЕНИЕ: Таким образом, разработанные нами алгоритмы лечения позволяют достичь стабильных результатов ортодонтической коррекции скелетных форм ДОЗР у пациентов, отказавшихся от ортогнатической хирургии

Comparative Assessment of The Expansion of The Dentition Using Ligature and Passive Self-Ligating Braces in Combination with Pitts Broad and Early Elastics

Background: The study aimed to analyze the effectiveness of the use of the Pitts Broad and early elastics in the treatment of patients with narrowing and deformation of the dentition. Materials and methods: A comprehensive examination of 46 patients, aged 18 to 30 years, with narrowing and deformation of the dentition was performed. Patients were separated into two groups, depending on the algorithm of treatment: group 1 - using the brackets of passive self-ligation, the Pitts Broad and early short elastics; group 2 - using ligature brackets and archwires Orthos. Results: Biometric analysis of the diagnostic models of the 1st group after treatment showed a significant expansion of maxillary arch between the premolars and molars (a distance between premolars: 39,8 +/- 0,4mm, between molars: 48,3 +/- 0,5mm) and mandibular arch (a distance between premolars: 37,1 +/- 0,5mm, between molars: 46,3 +/- 0,6mm) compared to the data before treatment. Biometric analysis of the diagnostic models of the 2nd group showed that expansion between the molars was achieved on a much smaller extent on both jaws, compared with the 1st group (maxilla: a distance between premolars - 35,7 +/- 0,4mm, between molars 43,5 +/- 0,5mm; mandible: a distance between premolars - 33,2 +/- 0,3mm, between molars - 42,3 +/- 0,5mm). Conclusions: As a result of the study, it was found that the passive self-ligation system in combination with a protocol of the Pitts Broad contributes to the expansion of dentition in aesthetically significant areas (distal regions) at the early stages of treatment. The use of early light elastics provides an early control of the premolars torque, and it allows us to achieve a balanced and wide smile at the end of treatment

Adalimumab discontinuation in patients with rheumatoid arthritis after achieving sustained remission

Objective: to assess whether adalimumab (AD) can be gradually discontinued during continuous methotrexate (MTX) use in patients with early rheumatoid arthritis (ERA). Subjects and methods. Within the REMARCA (the Russian study of methotrexate and biological agents in early active arthritis) study, the investigators examined 20 patients (17 women and 3 men; median age, 51 [41.5; 56] years) with ERA (disease duration, 10 [5.5; 20] months; DAS28, 5.17 [4.37; 6.51]; 85% of the patients were seropositive for rheumatoid factor and 85% for anti-cyclic citrullinated peptide antibodies. Results and discussion. All the patients received subcutaneous MTX 25 mg/week. Twelve weeks after beginning therapy with MTX, due to its inefficiency, ADA was added according to the standard scheme. At week 24, the median DAS28 was 3.0 [1.65; 3.73]; 85% of the patients achieved remission or low disease activity. After 3 months of ADA therapy, high or moderate disease activity remained in 3 (15%) patients; median DAS28 was 4.4 [4.3; 6.1]; the drug was discontinued in them due to ineffective therapy. After 12-month follow-up, low DAS28 scores were observed in 5 (29.4%), DAS28 remission was in 12 (70.6%) of the 17 patients who continued ADA treatment; after 24 months, all the 17 patients were noted to have remission. After achieving sustained remission (≥ 6-month duration during ADA therapy), there was a carefully controlled reduction (titration) in the dose of ADA with its complete discontinuation, by maintaining remission at 36-month follow-up; the median DAS28 was 1.6 [1.4; 2.2]. During ADA treatment, one female patient developed pustular psoriasis and therefore the drug was discontinued at 24-month follow-up during the period of sustained remission. Other serious adverse events and tuberculosis cases were not recorded. Conclusion. Thus, the results of the study are indicative of the high clinical efficiency of the therapy. After ADA discontinuation, sustained remission can be maintained in patients with ERA and if they took biological agents early. © 2018 Ima-Press Publishing House. All rights reserved