Oral Mucosa in Coronavirus Infection

Inflammatory diseases of the oral mucosa can manifest themselves by various nosological processes of the oral cavity, but sometimes even against the background of pronounced inflammatory processes, stomatitis, gingivitis and many other diseases do not form, often this is due to systemic viral processes, for example, coronavirus infection. At the same time, clinical symptoms can be very diverse, or even absent even against the background of changes in the immune and microbial landscape of the oral cavity. With the progression of the disease, the process may spread to the palate, gums, palatine tonsils, larynx, and digestive tract. It is important to distinguish weakened individuals, individuals with immunodeficiency conditions who were on long-term use of antibacterial agents, corticosteroids and antineoplastic drugs. The persistence and recurrent nature of such inflammatory lesions requires not only the usual hygienic measures for the care of the oral cavity and teeth, but also appropriate justified therapy aimed at stimulating the protective forces of the oral mucosa

Experimental evidence of (M1+E2) mixed character of the 9.2 keV transition in 227^{227}Th and its consequence for spin-interpretation of low-lying levels

The 9.2 keV nuclear transition in $^{227}$Th populated in the $\beta$-decay of $^{227}$Ac was studied by means of the internal conversion electron spectroscopy. Its multipolarity was proved to be of mixed character M1+E2 and the spectroscopic admixture parameter $\delta^2$(E2/M1)=0.695 $\pm$ 0.248 (|$\delta$(E2/M1)|=0.834 $\pm$ 0.210) was determined. Nonzero value of $\delta$(E2/M1) raises a question about the existing theoretical interpretation of low-lying levels of $^{227}$Th.Comment: 14 pages, 3 figures; typo in abstract correcte

The first experimental evidence for the (M1+E2) mixed character of the 9.2 keV transition in Th-227

The 9.2 keV nuclear transition in Th-227 was studied in the beta(-)-decay of Ac-227 by means of the internal conversion electron spectroscopy to clarify the spin-parity assignment of the ground state and the two lowest excited states of Th-227. The transition multipolarity was proved to be of mixed character M1+ E2 and the spectroscopic admixture parameter delta(2)(E2/M1) = 0.695 +/- 0.248(vertical bar delta(E2/M1)vertical bar = 0.834 +/- 0.149) was determined. Nonzero value of delta(E2/M1) questioned the present theoretical interpretation of low-lying levels of Th-227. Calculations performed prefer the 1/2(+), 3/2(+), and 3/2(+) sequence instead of the adopted 1/2(+), 5/2(+) and 3/2(+) one for the 0.0, 9.2, and 24.3keV levels, respectively.Web of Science820art. no. 13659

Transvaginal mesh-reconstruction of anterior apical prolapse: a selective implant choosing approach

Introduction. Transvaginal mesh-reconstruction of urogenital prolapse remains a controversial trend in modern urogynecology. We have seen growth in transvaginal mesh surgery since 2004, followed by a sharp decline after 2011 due to FDA restrictions related to imperfections in previously available prostheses and implantation techniques. Improving the efficacy and minimizing complications of transvaginal mesh-surgery is at the forefront of research in the field of modern urogynecology.Purpose of the study. To optimize the indications for transvaginal mesh-reconstruction of anterior apical prolapse.Materials and methods. The study enrolled 375 patients with anterior apical prolapse. The grade of prolapse was assessed using POP-Q. In patients with endopelvic pelvic fascia insufficiency, severe cystocele (Aa ≥ +1) and hysteroptosis grade II – IV, the correction was carried out using the six-arm OPUR® («ABISS», Saint-Étienne, France). lightweight polypropylene monofilament implant (n = 290). When the cystocele was not prominent (Aa ≤ -1) and grade III – IV hysteroptosis, posterior sacrospinal hysteropexy was preferred with the CYRENE® («ABISS», Saint-Étienne, France) tape (n = 85). In 35 patients, the operation was combined with anterior colporrhaphy. In 5 patients, a simultaneous conization/amputation of the cervix was performed. The examination was performed 1 month after surgery and then annually. Prolapse ≥ grade II was as recurrent. The follow-up period of 67 patients was more than 4 years.Results. After OPUR® prosthesis implantation, recurrent hysteroptosis was detected in 6 women with cervical hypertrophy / elongation within a period of 1 mo to 3.5 yr and cystocele in 4 patients. The efficacy was 96%. In 9 patients, an postoperative ischuria was found associated with extensive dissection and hypotension of the bladder wall due to chronic urinary retention in severe cystocele. Urination improved in 88% of cases. In the remaining cases, long-term mediator and hormone replacement therapy were continued., One recurrent hysteroptosis was observed during the implantation of the CYRENE® prosthesis. No damage to the bladder was observed. Acute urinary retention was detected in 1 case, which resolved after intermittent catheterization. Conclusion. The availability of 2 types of transvaginal prostheses for various degrees and configurations of urogenital prolapses allows a differentiated approach to their choice. Both prostheses suggest reliable «reconstruction-imitation» of the sacroiliac ligament by sacrospinal hysteropexy. If necessary, the operation can be supplemented with anterior colporrhaphy. The prevalence of anterior prolapse with endopelvic fascia insufficiency requires more extensive reconstruction, which can be performed relatively safely and effectively by implantation of a 6-arm OPUR® prosthesis

Возможность использования местной анестезии при чрескожной криоаблации почечно - клеточного рака под ультразвуковым контролем

Background. There is a category of patients with renal masses, due to severe concomitant diseases, can not perform the operation or may be associated with a threat to life. In addition, many patients with small tumor sites are extremely concerned about their disease and are negative about the tactics of active observation and insist on treatment. These patients can be offered alternative methods of treatment of renal cell carcinoma (RCC), the leading of which is cryoablation.Objective: to evaluate the effectiveness and safety of percutaneous cryoablation of the kidney tumor under ultrasound control.Materials and methods. In the Urology Clinic of the I.M. Sechenov First Moscow State Medical University during the period from 2015 to 2017 performed 23 percutaneous cryoablation of RCC, 7 (men – 4, women – 3) of which were performed under local anesthesia. In 4 patients due to severe concomitant diseases, general anesthesia was associated with an extremely high risk. Three patients refused from dynamic observation and from traditional surgical treatment; preferred an alternative treatment in the form of a percutaneous cryoablation under local anesthesia. In 4 cases, the formations were located in the lower segment along the posterior surface of the kidney, in 3 – along the lateral surface in the middle segment. The size of the formations was not used 4 cm (T1a). The age of the patients was 62.3 years (51 to 83 years). Right-sided localization of the tumor was noted in 3 patients, left-sided – in 4. One patient had a single kidney.At the preoperative stage and 6 months after the operation, all patients underwent ultrasound with dopplerography, multislice computerized tomography with contrast, and computer 3D modeling, which helped to clearly assess the size of the tumor, clarify the prevalence of the tumor process and the spatial ratio of the internal surface of the tumor node to the elements of the bowl-and-pelvis system. In all the observations, the formations were located along the posterior or lateral surface of the kidney; in the lower or middle segment; without invasion of the sine. We used a 3rd generation cryomash machine SeedNet gold (Galil Medical), cryoprobes IceSeed and IceRod. Intraoperative, immediately before cryoablation, a tumor biopsy was performed, the presence of RCC in all patients was confirmed morphologically.Results. According to the ultrasound examination with echodopplerography at 6 months after the operation, the size of the tumor node’s formations decreased on average by 6–8 mm, while there was no blood flow in them. When multislice computerized tomography with 3D modeling was performed, the formation was reduced and the accumulation of the contrast preparation was completely absent or their accumulation gradient did not exceed 10 HU (initially it was about 200 HU). There were no intraoperative complications. In 1 observation, a postoperative hematoma measuring 7 × 3 cm was resolved conservatively and did not require surgical treatment.Conclusions. Percutaneous cryodestruction under local anesthesia using ultrasound guidance seems to be an effective and safe technique for treating patients with stage T1a RCC with localization in the posterior or lateral surface in the lower or middle segments without invasion of the renal sinus and surrounding tissues. It is planned to continue monitoring patients to assess the long-term effectiveness of cryoablation.Введение. Существует категория пациентов c почечно-клеточным раком (ПКР), у которых в связи с тяжелыми сопутствующими заболеваниями операция не может быть выполнена или сопряжена с угрозой для жизни. Кроме того, многие пациенты с небольшим размером опухолевого узла крайне обеспокоены своим заболеванием и отрицательно относятся к тактике активного наблюдения, настаивая на лечении. Таким пациентам могут быть предложены альтернативные методы терапии ПКР, ведущим из которых является криоаблация.Цель исследования – оценить эффективность и безопасность чрескожной криоаблации опухоли почки под ультразвуковым контролем. Материалы и методы. В клинике урологии Первого Московского государственного медицинского университета им. И.М. Сеченова в период с 2015 по 2017 г. выполнены 23 чрескожные криоаблации ПКР, из них 7 (4 мужчин, 3 женщин) проводили под местной анестезией. У 4 пациентов ввиду тяжелых сопутствующих заболеваний общее обезболивание было сопряжено с крайне высоким риском. От динамического наблюдения и традиционного хирургического лечения отказались 3 пациента. Они предпочли альтернативное лечение в виде чрескожной криоаблации под местной анестезией. В 4 наблюдениях образования располагались в нижнем сегменте по задней поверхности почки, в 3 – в среднем сегменте по латеральной поверхности. Размер образований не превышал 4 см (стадия Т1a). Средний возраст пациентов составил 62,3 года (51–83 года). Правосторонняя локализация опухоли отмечена у 3 пациентов, левосторонняя – у 4. У 1 больного почка была единственной.На дооперационном этапе и через 6 мес после вмешательства всем пациентам проведены ультразвуковое исследование с допплерографией, мультиспиральная компьютерная томография с контрастированием и компьютерное трехмерное моделирование, что помогало четко оценить размер опухоли, уточнить распространенность опухолевого процесса и пространственное отношение внутренней поверхности опухолевого узла к элементам чашечно-лоханочной системы. Во всех наблюдениях образования располагались по задней или латеральной поверхности почки в нижнем или среднем сегменте без инвазии в синус.Мы использовали криомашину 3-го поколения SeedNet gold (Galil Medical), криозонды IceSeed и IceRod. За 3 нед до проведения операции выполняли биопсию опухоли. Наличие ПКР у всех больных было подтверждено морфологически.Результаты. По данным ультразвукового обследования с эходопплерографией через 6 мес после операции размер образований опухолевого узла уменьшился в среднем на 6–8 мм, при этом в них отсутствовал кровоток. При проведении мультиспиральной компьютерной томографии с трехмерным моделированием также отмечались уменьшение образований и полное отсутствие накопления контрастного препарата либо его градиент накопления не превышал 10 ед. HU (первоначально он составлял около 200 ед. HU). Интраоперационных осложнений не зарегистрировано. В 1 наблюдении выявлена послеоперационная гематома размером 7 × 3 см, разрешившаяся консервативно и не потребовавшая оперативного лечения.Заключение. Чрескожная криодеструкция под местной анестезией с использованием ультразвуковой навигации представляется эффективной и безопасной методикой лечения больных ПКР стадии Т1а с локализацией образования по задней или латеральной поверхности в нижнем или среднем сегменте без инвазии в почечный синус и окружающие ткани. Планируется продолжить наблюдение за пациентами для оценки долгосрочной эффективности криоаблации

MICROBIOLOGICAL ASPECTS IN CONSERVATIVE TREATMENT OF GENERALIZED PERIODONTITIS USING AUTOTROMBOCYTIC MASS

The primary factor causing periodontal damage is plaque bacteria. The etiological structure of infectious processes in the last decade has changed significantly, due to the constant evolution of microbes and the involvement of opportunistic microbes in the pathological process, which can act as commensals in the normal microflora and manifest their pathogenicity with a decrease in the body's immune status. Inflammatory processes in the oral cavity are sometimes an endogenous infection caused by the resident flora of not only the oral cavity, but also other ecosystems of the body

SPECIFIC FEATURES OF DENTAL PATHOLOGIES IN PREGNANT WOMEN

Pregnancy should be considered as a risk factor for the main dental pathology - caries and periodontal disease. The most common dental disease that develops during pregnancy is gingivitis. Estrogens, progesterone and prostaglandin, the production of which increases during pregnancy, disrupt the blood supply to the gums, affect the cellular link of immunity, interfere with the synthesis of collagen and contribute to a change in the properties of the subgingivalmicroflora