Organization of Intern-Doctors’ Training in the Therapeutic Dentistry Department

У статті наведено досвід роботи по організації теоретичної та практичної підготовки лікарівінтернів на кафедрі терапевтичної стоматології. Ефективність підготовки інтернів стоматологів визначається якістю навчання на кафедрі вузу з використанням нових технологій і роботою на лікувальній базі інтернатури. Придбання навичок самостійної роботи з літературою, індивідуалізація навчання, рішення діагностичних і лікувальних завдань, участь в навчальних іграх, виступ на клінічних конференціях забезпечує високу професійну підготовку лікарів-інтернів стоматологів і готовність їх до самостійної лікарської діяльності. В статье приведен опыт работы по организации теоретической и практической подготовки врачей-интернов на кафедре терапевтической стоматологии. Эффективность подготовки интернов стоматологов определяется качеством обучения на кафедре вуза с использованием новых технологий и работой на лечебной базе интернатуры. Приобретение навыков самостоятельной работы с литературой, индивидуализация обучения, решение диагностических и лечебных задач, участие в учебных играх, выступление\ud на клинических конференциях обеспечивает высокую профессиональную подготовку врачейинтернов стоматологов и готовность их к самостоятельной врачебной деятельности. The article deals with the experience of organizing theoretical and practical training for intern-doctors, which were studied in the therapeutic dentistry department. Effectiveness of the intern-doctors training is determined by a quality of education at the university, innovative technologies usage and working on the therapeutic basis. Acquisition of skills should be achieved through the independent work with literature sources, self- education, diagnostic and therapeutic tasks solution, participation in educational games, and presentation of reports at the clinical conferences. Such activities provide a high level of professional training for the intern-doctors and determine their readiness to independent professional activity

Severe rhinovirus bronchiolitis in premature infant with bronchopulmonary dysplasia

Acute bronchiolitis is an inflammatory disease of the lower respiratory tract with a predominant lesion of small bronchi and bronchioles developing in children under 2 years of age. The main etiological factor of bronchiolitis is the respiratory syncytial virus (RSV), the second place in the etiologic structure belongs to rhinovirus, which causes bronchiolitis usually at 6 months age. Severe bronchiolitis is characterized by the need for auxiliary or artificial lung ventilation (ALV). The main risk groups for severe bronchiolitis include premature infants with or without bronchopulmonary dysplasia (BPD), children with hemodynamically significant congenital heart defects. The article presents a clinical observation of rhinovirus bronchiolitis severe course in a preterm infant aged 4,5 months (post-conceptual age-42 weeks) with severe BPD manifesting with an apnea episode followed by the development of severe respiratory failure requiring mechanical ventilation accompanied by sinus tachycardia. The study demonstrates the possibility of acute bronchiolitis severe course in a premature infant with BPD, not only because of RSV infection, but with rhinovirus infection in the first half of life, which should be considered during virus examination. © 2017, Pediatria Ltd. All rights reserved

Severe rhinovirus bronchiolitis in premature infant with bronchopulmonary dysplasia

Acute bronchiolitis is an inflammatory disease of the lower respiratory tract with a predominant lesion of small bronchi and bronchioles developing in children under 2 years of age. The main etiological factor of bronchiolitis is the respiratory syncytial virus (RSV), the second place in the etiologic structure belongs to rhinovirus, which causes bronchiolitis usually at 6 months age. Severe bronchiolitis is characterized by the need for auxiliary or artificial lung ventilation (ALV). The main risk groups for severe bronchiolitis include premature infants with or without bronchopulmonary dysplasia (BPD), children with hemodynamically significant congenital heart defects. The article presents a clinical observation of rhinovirus bronchiolitis severe course in a preterm infant aged 4,5 months (post-conceptual age-42 weeks) with severe BPD manifesting with an apnea episode followed by the development of severe respiratory failure requiring mechanical ventilation accompanied by sinus tachycardia. The study demonstrates the possibility of acute bronchiolitis severe course in a premature infant with BPD, not only because of RSV infection, but with rhinovirus infection in the first half of life, which should be considered during virus examination. © 2017, Pediatria Ltd. All rights reserved

Deep margin elevation: a systematic review

Deep margin elevation (DME) is a nonsurgical, alternative technique of dental crown lengthening. Portion of direct restoration placed only at the deep apical part of the cavity to elevate the margin to a more coronal and more adequate position for final cementation of indirect restoration. Materials and methods. In this systematic review, we were looking for in vitro studies in which deep margin elevation (DME) technique were used. The electronic databases PubMed and EMBASE were used for the search. The search began on July 29, 2021 and ended on August 10, 2021. We have analyzed the materials and methods of each research and entered them in the appropriate tables to give a clearer assessment of the obtained results. Results. Analysis of marginal quality showed the best results when indirect restorations luted to dentin directly and with DME technique with three consecutive layers of resin composite. In groups without DME there were fewer microleakage. DME did not statistically significantly influence the fracture strength. Conclusions. We conducted a systematic review that included 12 in vitro studies. Even though samples without DME showed better results in in vitro studies, the difference between samples with and without DME was not statistically significant. However, in clinical practice, DME facilitates the insertion of indirect restorations. Therefore, further studies and clinical observations are necessary

Практикум по педиатрии: учебное пособие для студентов 5-го курса

Practicum in Pediatrics includes 132 clinical cases of diseases of newborns, infants and older children. In the cases, there are discharge reports from the medical records of real patients with common diseases in pediatric practice (perinatal and neonatal diseases, deficiency conditions, anemia, as well as diseases of lungs, heart, joints, gastrointestinal tract, kidney and allergy). After discharge reports, there are questions and at the end of each section – diagnostic keys. The method of case studies refers to a non-gaming simulation methods of interactive learning and allows to apply theoretical knowledge to solve practical problems, trains making the right decisions in particular situations. Cases are designed to discuss them at classroom practice sessions, for self-study and for control of knowledge at the exam. The manual is aimed at students, residents, graduate students, pediatricians. Prepared by the Department of Pediatrics, Medical Faculty of Peoples' Friendship University of Russia

Частота, факторы риска, особенности бронхиальной астмы у детей с бронхолегочной дисплазией и ведение коморбидных пациентов

Bronchopulmonary dysplasia (BPD) and bronchial asthma (BA) are the most common chronic lung diseases in children, but the relationship between these diseases has not been fully defined. The incidence of atopic diseases (atopic dermatitis, allergic rhinitis, and BA) in children with BPD are significantly different according to national and international studies. There is not enough data on risk factors for the development, clinical and laboratory features of the course and treatment of BA in children with BPD. Material and methods. The case histories of 1104 patients (2004-2017) with BPD criteria were analyzed at the Department of Pediatrics at the RUDN University. On the basis of clinical and anamnestic data, allergological examination, and study of respiratory function, the frequency of asthma was determined. The comparative study was conducted in patients with isolated diseases - BPD (without BA) and BA (without BPD) - to determine the risk factors and characteristics of BA in children with BPD. Results and discussion. The frequency of BA was 7%, atopic dermatitis - 3.8% and allergic rhinitis - 3.6%. The risk factors for the development of BA in children with BPD were determined for low birth weight (LBW) (p=0.0037), late prematurity (p=0.0007), family history of allergy through asthma (p=0.0334), concomitant atopic dermatitis (p=0.0018) and allergic rhinitis (p=0.0022). Severe BPD (p=0.0002), episodes of bronchial obstruction in the first 3 years of life (p=0.0272). It was found that BA in children with BPD, compared with children without BPD is statistically significant. It characterized by an earlier onset (p=0.0168), a mild intermittent course (p=0.0003), a rarer need for inhaled bronchodilators (p=0.0034) and more frequent administration of inhaled corticosteroids as basic therapy (p=0.0399). Conclusion. We suggested that BA in children could be a respiratory consequence of BPD and a comorbid disease with a separate phenotype. The management of children suffering from BA and BPD should include the registration and evaluation of epidemiology, risk factors, clinical and laboratory features. It would be necessary to implement the clinical and allergological examination and the development of an individualized management program for patients.Бронхолегочная дисплазия (БЛД) и бронхиальная астма (БА) являются самыми частыми хроническими заболеваниями легких у детей, однако связь между данными заболеваниями до конца не определена. Частота развития атопических заболеваний (атопического дерматита, аллергического ринита и БА) у детей с БЛД существенно отличается; по данным отечественных и зарубежных исследований, немногочислены данные о факторах риска развития, клинико-лабораторных особенностях течения и терапии БА у детей с БЛД. Материал и методы. Были изучены истории болезней пациентов с БЛД и БЛД в анамнезе, наблюдавшихся на кафедре педиатрии ФГАОУ ВО «Российский университет дружбы народов» (Москва) на базе консультативно-диагностического отделения с дневным стационаром ГБУЗ «Детская инфекционная клиническая больница № 6» Департамента здравоохранения г. Москвы с 2004 по 2017 г. Среди этих больных на основании клинико-анамнестических данных, аллергологического обследования и исследования функции внешнего дыхания определена частота БА, проведено сравнительное исследование с пациентами с изолированными заболеваниями: БЛД (без БА) и БА (без БЛД) для определения факторов риска и особенностей БА у детей с БЛД. Результаты и обсуждение. Проанализировано 1104 медицинских карт пациентов, удовлетворяющих критериям диагноза БЛД, определена частота развития у них атопических заболеваний. Частота БА составила 7%, атопического дерматита - 3,8%, аллергического ринита - 3,6%. Определены факторы риска развития БА у детей с БЛД: низкая масса тела при рождении (р=0,0037), поздняя недоношенность (р=0,0007), отягощенный семейный аллергоанамнез по БА (р=0,0334), сопутствующие атопический дерматит (р=0,0018) и аллергический ринит (р=0,0022), тяжелая БЛД (р=0,0002), эпизоды бронхиальной обструкции в первые 3 года жизни (р=0,0272). Установлено, что БА у детей с БЛД по сравнению с детьми без данного хронического заболевания легких новорожденных статистически значимо чаще характеризуется более ранним началом (р=0,0168), легким интермиттирующим течением (р=0,0003), более редкой потребностью в ингаляционных бронхолитиках (р=0,0034) и более частым назначением ингаляционных глюкокортикоидов в качестве базисной терапии (р=0,0399). Заключение. БА у детей является респираторным последствием БЛД, коморбидным заболеванием с отдельным фенотипом. Оказание медицинской помощи детям, страдающим БА и БЛД, должно предусматривать учет и оценку эпидемиологии, факторов риска развития, клинико-лабораторных особенностей с реализацией этапного клинического и аллергологического обследования и выработкой программы индивидуализированного ведения пациентов

In children with bronchial asthma: Causal, complicated, unspecified, reverse

The review, based on modern literature data and the results of many years of research conducted by the authors, highlights the problem of comorbidity (multimorbidity) in children with bronchial asthma (BA). There is a grouping of concomitant diseases in children with asthma depending on the type of comorbidity (causal, complicated, unspecified, reverse). Based on epidemiological data, observational and cohort studies, systematic reviews and meta-analyses, information on the frequency of BA in children with various comorbid diseases and comorbid diseases in children with BA was summarized. Scientific, theoretical and practical significance of comorbidity in BA, diagnostic and treatment programs in pediatric patients suffering from BA and comorbid diseases are substantiated. © 2021, Pediatria Ltd.. All rights reserved