Решение проблемы повышенной чувствительности дентина: механизмы реминерализации при курсовом использовании зубной пасты с фторидом олова

The purpose of the study was clinical and laboratory analysis of the remineralizing properties and clinical efficacy of the course application of the Sensodyne Rapid Relief therapeutic and prophylactic toothpaste for sensitive teeth with tin fluoride. The study involved 50 overwise healthy patients aged from 18 to 25 years diagnosed with a localized form of hyperesthesia of hard dental tissues and no signs of acute inflammation of periodontal tissues. After 7 days of clinical observation and daily use of the toothpaste the hygienic condition of the oral cavity in all patients improved: oral hygiene index was 1.02±0.2 units; gum inflammation index (PMA) - 8.0±1.5%; the absence of hyperesthesia was diagnosed (1 point, p≤0.05). Examination of patients after 14 and 28 days confirmed the absence of pain in 100%, the organoleptic properties of the toothpaste under investigation were also highly appreciated by the participants. A laboratory study showed that patients have an increase in the pH value of mixed saliva and a decrease in its buffer capacity by 13.4±2.25%, which contributes to a more effective remineralizing effect of calcium ions by calcium-binding proteins of mixed saliva. The concentration of fluoride ions in the saliva of patients of both groups increased by average rate of 34±0.5% per week. The combination of tin and fluoride is more effective than fluoride alone. The presence of tin ions causes a higher ability of fluorides to bind with calcium ions on the surface of the dentin and dentinal tubules, inhibits the process of demineralization, enhances the additive interaction of the ions forming the acid-resistant layer on the surface of the dentin and dentinal tubules, leading to a decrease in hyperesthesia of the teeth.Цель исследования - клинико-лабораторный анализ реминерализующих свойств и клинической эффективности курсового применения лечебно-профилактической зубной пасты Sensodyne Мгновенный Эффект для чувствительных зубов с фторидом олова. Обследованы 50 практически здоровых пациентов в возрасте от 18 до 25 лет, у которых диагностированы локализованная форма гиперестезии твердых тканей зубов и отсутствие признаков острого воспаления тканей пародонта. По истечении 7 дней клинического наблюдения и ежедневного использования данной зубной пасты гигиеническое состояние полости рта у всех пациентов улучшилось - индекс гигиены составил 1,02±0,2 единицы; индекс воспаления десны (РМА) - 8,0±1,5%; диагностировано отсутствие гиперестезии (1 балл, р≤0,05). Обследование пациентов через 14 и 28 дней подтвердило отсутствие боли в 100% случаев, органолептические свойства исследуемой зубной пасты также высоко оценены участниками. Проведенное лабораторное исследование показало, что у пациентов наблюдается увеличение значения рН смешанной слюны и происходит снижение ее буферной емкости на 13,4±2,25%, что способствует более эффективной реминерализирующей отдаче ионов кальция кальцийсвязывающими белками смешанной слюны. Концентрация ионов фтора в слюне пациентов обеих групп за 1 нед увеличивается в среднем на 34±0,5%. Сочетание олова и фторида более эффективно, чем применение только фторида. Присутствие ионов олова обусловливает более высокую способность фторидов к связыванию с ионами кальция на поверхности дентина и дентинных канальцев, ингибирует процесс деминерализации, усиливает аддитивное взаимодействие ионов, формирующих кислотоустойчивый слой на поверхности дентина и дентинных канальцев, приводящее к снижению гиперестезии зубов

Hyperexpression of TLR2 and TLR4 in patients with ischemic stroke in acute period of the disease

Pathogenesis of ischemic stroke  is actively  involved  in the  system  of innate immunity. Under conditions of cerebral  ischemia, a number of biologically  active  substances are  released  that  interact with innate immunity receptors, in particular TLR2  and  TLR4, which  exacerbate inflammation in brain  tissue. Identification of predictor markers  at the level of the innate immunity system may foresee the clinical course of ischemic stroke and ensure timely treatment. Our objective was to study expression of TLR2 and TLR4 receptors in peripheral blood leukocytes  in patients with ischemic stroke in the dynamics of the disease. 27 people  were included in the study. The main  group consisted of patients with ischemic stroke of varying severity (n = 19). Patients of the main  group were divided into two subgroups:  with an NIHSS index value of < 10 (n = 10) and > 10 (n = 9). The control group included healthy  donors  with no history  of acute  and chronic inflammatory diseases (n = 8). Peripheral blood  leukocytes  were used as the  test material. To determine expression  of the TLR2  and TLR4  genes, RT-PCR in real time was used. Surface  expression  of TLRs was determined by flow cytometry. A study of the TLR2 and TLR4 gene expression showed that on the 1st, 3rd  and 7th  day post-stroke, the TLR4 gene expression  in patients was significantly  increased, when compared to the control group (p < 0.01), whereas TLR2 gene expression on the 3rd  day of the disease was not statistically different from the control group. A study of surface expression  of receptors showed that the average TLR2 fluorescence intensity on the patients’ peripheral blood monocytes was significantly  increased on the 1st  and 3rd  day of disease when compared to the control group.  The  surface  expression  of TLR4  on monocytes has a statistically significant  increase  only on day 7. Assessment  of surface expression  of TLRs in subgroups  with different  severity values by NIHSS showed that  patients with a NIHSS index > 10 had a significantly  higher  level of surface of TLR2  expression  over the observation period, while the largest difference in TLR4  expression  in the subgroups  was observed  on the 1st day of the disease (p < 0.05). Patients with ischemic stroke showed an increase  in TLR2 and TLR4 expression at the gene and protein level, compared to healthy  donors. These indices can be considered possible predictors for clinical  prognosis  of ischemic stroke

ВЕДЕНИЕ БЕРЕМЕННОСТИ, РОДОВ И ПОСЛЕРОДОВОГО ПЕРИОДА У ПАЦИЕНТКИ С ЛЕКАРСТВЕННО-УСТОЙЧИВЫМ, ДЕСТРУКТИВНЫМ ТУБЕРКУЛЕЗОМ ЛЕГКИХ ПОСЛЕ ЭТАПНОГО ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ

The article describes a clinical case of the successful management of pregnancy, delivery and post-natal period in the female patient with fibrous cavernous tuberculosis with extensive drug resistance and multiple thoracic surgeries in the past. This clinical case demonstrates that it is possible for a mother with the advanced form of tuberculosis to give birth to a healthy mature newborn.Представлено клиническое наблюдение успешного ведения беременности, родов и послеродового периода у пациентки с фиброзно-кавернозным туберкулезом с широкой лекарственной устойчивостью возбудителя и многократными торакальными операциями в анамнезе. Показана возможность рождения здорового доношенного ребенка у матери с тяжелой формой туберкулеза

Russian clinical practice guidelines «congenital adrenal hyperplasia»

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases characterized by a defect in one of the enzymes or transport proteins involved in the cortisol synthesis in the adrenal cortex. The most common form of CAH, which occurs in more than 90% of cases, is a 21-hydroxylase enzyme deficiency. The latter is subdivided into nonclassical and classic (salt-losing and virilizing) forms. The prevalence of classic forms of 21-hydroxylase deficiency ranges from 1: 14,000 to 1:18,000 live births worldwide. According to the data of neonatal screening in the Russian Federation, the prevalence of the disease in some regions ranges from 1: 5000 to 1: 12000, in the country as a whole - 1: 9638 live newborns. The non-classical form of CAH occurs more often - from 1: 500 to 1: 1000 among the general population. In second place is the hypertensive form of CAH - a deficiency of 11β-hydroxylase, which, according to the literature, occurs in about 1 per 100,000 newborns. These clinical guidelines were compiled by a professional community of narrow specialists, approved by the expert council of the Ministry of Health of the Russian Federation, and updated the previous version published in 2016. The clinical guidelines are based on systematic reviews, meta-analyses and original articles, and scientific work on this issue in the Russian Federation and other countries. The purpose of this document is to provide clinicians with the most up-to-date, evidence-based guidelines for the CAH diagnosis and treatmen

Our experience of radio-waved surgery in oral and maxillo-facial region

Surgical treatment of 53 patients with various pathologies of the soft tissues of the maxillofacial region using the radio wave surgery was performed. Clinical data indicate a high efficiency of radio wave surgery in the treatment of patients with soft tissue tumors of the face and oral cavity