Вивчення токсичного впливу фулерену С60 на організм щурів

Захворювання слизової оболонки під дією знімних протезів спостерігається у 15 - 70% пацієнтів, хворі скаржаться на неможливість або утруднене користування знімними протезами. Користування пластинковими протезами, виготовленими із акрилатів, призводить часто до досить серйозних ускладнень – протезних стоматитів. Причини виникнення протезного стоматиту обумовлені більшою мірою місцевими факторами, що виходять безпосередньо з основи знімного протеза та матеріалу, з якого він виготовлений. Основною причиною в виникненні протезних стоматитів є хіміко-токсична дія залишкового мономеру базису протеза, який є протоплазматичною отрутою, і поступово, під впливом біологічних середовищ, а також жувальних навантажень, шляхом дифузії, виділяється і потрапляє в порожнину рота. Для профілактики протезних стоматитів нами запропоновано новий спосіб удосконалення знімного пластинкового протезу, виготовленого за традиційною технологією, матеріалом нанорозмірної величини – молекулами фулерену С60. Метою роботи стало вивчення токсичного впливу фулерену С60 на організм щурів для подальшого впровадження матеріалу в клініку ортопедичної стоматології. Отримані дані доводять, що протягом всього періоду спостереження фізіологічний стан дослідних щурів не відрізнявся від контрольних. Всі тварини, яким вводили фулерен, мали додатний приріст щодо до вихідних значень маси тіла і за динамікою приросту не відрізнялися від тварин з групи інтактного контролю, що свідчить про відсутність шкідливого впливу досліджуваного матеріалу на фізіологічні процеси щурів при введенні протягом 21 доби. В аналізі крові спостерігали незначне коливання формених елементів, що можна вважати некритичним, оскільки значення досліджуваних показників залишалися у межах значень інтактних тварин. Введення фулерену протягом 21 доби не впливало на активність печінкових трансаміназ, що свідчить про відсутність токсичного впливу досліджуваних засобів на стан печінки. Тому можна стверджувати, що такий матеріал може бути використаний в стоматології для зменшення кількості ускладнень після протезування - протезних стоматитів. Заболевания слизистой оболочки под действием съемных протезов наблюдается у 15 - 70% пациентов, больные жалуются на невозможность или затрудненное пользование съемными протезами. Пользование пластиночными протезами, изготовленными из акрилатов, приводит часто к весьма серьезным осложнениям - протезным стоматитам. Причины возникновения протезного стоматита обусловлены в большей степени местными факторами, которые исходят непосредственно из основы съемного протеза и материала, из которого он изготовлен. Основной причиной в возникновении протезных стоматитов является химико-токсическое действие остаточного мономера базиса протеза, который является протоплазматическим ядом и постепенно, под влиянием биологических сред, а также жевательных нагрузок, путем диффузии выделяется и попадает в полость рта. Для профилактики протезных стоматитов нами предложен новый способ усовершенствования съемного пластиночного протеза, изготовленного по традиционной технологии, материалом наноразмерной величины - молекулами фуллерена С60. Целью работы стало изучение токсического воздействия фуллерена С60 на организм крыс для дальнейшего применения материала в клинике ортопедической стоматологии. Полученные данные показывают, что в течение всего периода наблюдения физиологическое состояние исследуемых крыс не отличалось от контрольных. Все животные, которым вводили фуллерен, имели положительный прирост по отношению к исходным значениям массы тела и по динамике прироста не отличались от животных из группы интактного контроля, что свидетельствует об отсутствии вредного воздействия исследуемого материала на физиологические процессы крыс при введении в течение 21 суток. В анализе крови наблюдали незначительное колебание форменных элементов, что можно считать не критическим, поскольку значения исследуемых показателей оставались в пределах значений интактных животных. Введение фуллеренов в течение 21 суток не влияло на активность печеночных трансаминаз, что свидетельствует об отсутствии токсического воздействия исследуемых средств на состояние печени. Поэтому можно утверждать, что такой материал может быть использован в стоматологии для уменьшения количества осложнений после протезирования - протезных стоматитов. Diseases of the oral mucous membrane due to wearing removable dentures are observed in 15 - 70% of patients, who report impossibility or difficulties when using removable dentures. Wearing plate dentures made of acrylates often leads to very serious complications known as prosthetic stomatitis. The causes of prosthetic stomatitis to a greater extent are due to local factors directly associated with the base of the removable prosthesis and the material of which it is manufactured. The main cause of the occurrence of prosthetic stomatitis is the chemitoxicity of residual monomer of the prosthesis base that is protoplasmic poison and gradually, under the influence of oral biological media, as well as due to chewing loads, diffuses and enters the oral cavity. In order to prevent prosthetic stomatitis, we proposed a new method to improve the removable plate prosthesis made according to conventional technology, of a material of nanosized value, molecules of fullerene C60. The purpose of this study was to investigate the toxic effects of fullerene C60 on rats for the further introduction of the material into the clinical of prosthetic dentistry. The obtained data have proven that throughout the observation period the physiological state of the experimental rats did not differ from the control ones. All animals administered fullerene had a positive body mass gain compared to baseline body mass values and did not differ from animals in the intact control group, indicating no harmful effect of the test substance on the physiological processes of rats upon administration for 21 days. The blood test showed a slight variation of the formed elements that can not be considered as critical, as the values of the studied parameters remained within the values of intact animals. The introduction of Fullerene during 21 days did not affect the activity of hepatic transaminases that points out the absence of toxic effects of the investigated sunstances on the liver. Therefore, it can be argued that such material can be used in dentistry to reduce the number of complications as prosthetic stomatitis after prosthetic correction

Features of clinical manifestations, free radical, coagulation and aggregation properties of blood in patients with craniocerebral trauma

In recent years in Ukraine, as in the entire world, there has been an increase in cases of domestic injuries with a raise in the number of patients with craniocerebral trauma and its consequences. The aim of our research was to study clinical symptoms, the state of free radical oxidation, aggregate and hemocoagulative properties of blood in patients with mild craniocerebral trauma. Materials and methods:We conducted comprehensive clinical and laboratory examination of 34 patients with mild craniocerebral trauma and 20 apparently healthy patients (the control group). The diagnosis was made under ICD-10. The verification of the diagnosis was based on data from clinical examination, neurological status of neuroimaging (computer tomography and magnetic resonance imaging). The study group included 24 men and 10 women aged from 19 to 40. In addition, 20 apparently healthy individuals of the same age were examined, who comprised the control group (14 men and 6 women). In the blood parameters of all patients, we examined free radical oxidation, hemostasis and aggregation properties of platelets. Results: The conducted study revealed clinical disturbances, changes in the parameters of free radical lipid oxidation, coagulation and microcirculatory hemostasis. Conclusions: All patients with mild craniocerebral trauma, develop disturbances in the form of symptoms of microorganic lesion of the central nervous system: convergence weakness in 100% of patients, Mann’s symptom (76.4%), disruption of the function of the cranial nerves (58.8%), signs of pyramidal insufficiency (68.4%), vestibular disorders (94.1%), autonomic vascular dysfunction (100%). Mild craniocerebral trauma is accompanied by the activation of free radical lipid oxidation processes, decreased activity of antioxidant enzymes, hypercoagulation, and increased aggregation properties of platelets

Сalix[4]arene chalcone amides effects on myometrium mitochondria

Mitochondria are a key player in a wide range of the most important functions of the cell. Calixarenes are supramolecular compounds that have been widely used in bioorganic chemistry and biochemistry. The aim of this work was to study the effects of calix[4]arenes with two (С-1012, С-1021), three (С-1023, С-1024) and four (С-1011) chalcone amide groups on the myometrial mitochondria membranes polarization, Ca2+ concentration in the matrix of these organelles ([Ca2+]m ) and on the average hydrodynamic diameter of mitochondria. It was shown that permeabilized myometrium cells incubation with calix[4]arenes containing two or more chalcone amide groups, was accompanied by an increased level of myometrial mitochondria membranes polarization. All studied calix[4]arenes increased [Ca2+]m values in the absence and in the presence of exogenous Ca2+. The values of [Ca2+]m in the absence of exogenous Ca2+ were higher at mitochondria incubation in Mg2+-containing, than in Mg2+,ATP-containing medium. Incubation of isolated mitochondria with the studied calix[4]arenes resulted in changes of mitochondria volume: at incubation with С-1012, С-1021, C-1023 the average hydrodynamic diameter was decreased, while with С-1011 it was increased. Thus, we have shown that a short-term (5 min) incubation of mitochondria in the presence of 10 µM calix[4]arenes, which contain from two to four chalcone amide groups, increased the level of mitochondria membranes polarization, ionized Ca concentration in the matrix and had different effects on the mitochondrial volume

Застосування методів симуляційного навчання на кафедрі післядипломної освіти лікарів-стоматологів

Проаналізовано методики симуляційного тренінгу для лікарів-інтернів із надання невідкладної допомоги пацієнтам у термінальних станах. Тренінг сприяє підвищенню компетенції лікарів-стоматологів у наданні допомоги в невідкладних станах, упевненому застосуванню знань для підвищення якості медичної допомоги пацієнтам.The aim is to analyze the peculiarities of emergency care to dental practitioners at the department of postgraduate education of dentistry doctors for improving the quality of manual skills of the doctor in an out-patient department. Within the framework of the program, pilot trainings are held in Poltava and Lviv on the following topics: assistance in sudden coronary and sudden cardiac death, assistance with acute cere-brovascular accident, help with hypertensive crises, help with cardiac asthma and pulmonary edema. The training is carried out according to the methodological design and it consists of the theoretical and practical part. The training is provided by a certified teacher at the regional training and training center at M.V. Skli-fosovsky Poltava Regional Clinical Hospital. The optimal number of listeners is 10-12 people. On the theo-retical part the teacher represents the purpose, the plan of the lesson and in the logical sequence the mate-rial is presented. The theoretical part is equipped with a multimedia presentation. In the process, the teacher defines the basic level of knowledge and skills of listeners. In the practical part, the teacher initially deter-mines the level of possession of clinical skills of doctors, teaches work on dummies, models real, simple and accessible to perception simulation scenarios. Doctors have to solve the tasks and practice practical skills from basic resuscitation measures. At the same time, an important place is given to work in the team.On phantoms, elements of the resuscitation brigade are worked out when providing emergency care to a patient with a terminal state (cardiac arrest) using cardiac-pulmonary resuscitation techniques (CPR).At the same time, artificial ventilation of the lungs (ventilation of the lungs) with exhalation in the mouth or the nose (mask) in the area of the head of the phantom is carried out. The modeling of the air duct is then modeled. This verifies the correctness of the laryngoscope in the oropharynx, and the introduction of the laryngeal mask. Doctors will work with Ambu's bag: the first hand fix the mask of the device in the area of the nose, the mouth of the phantom, and the other - by pressing the camera, the air is poured into the roton-nose area of the phantom with a certain frequency of pressure, followed by the use (if necessary) of an oxygen cylinder of type B. This checks the correctness of each reception. Conducting each manual reception and its effective-ness is fixed and processed by a computer program. The result is displayed on the monitor in the form of vi-tal signs of the patient. In the case of effective doctor actions, the vital parameters of the "patient" on the monitor are normalized. The evaluation of the effectiveness of the manipulations is also carried out in balls. In the beginning, the trainer-instructor shows the order and correctness of carrying out emergency assis-tance measures on phantoms. In the future, monitors the implementation of manual techniques and as-sesses the actions of interns at each individual stage, emphasizing the correct implementation of the manual action. The sequence of the manual training on the "phantom-monitor" system gives confidence to doctors in the correctness and efficiency of manual skills. At the end of the practical cycle of training certified teachers of the department summarize the practical training with doctors-dentists.Practical training with the use of modern phantoms with computer processing of results helps to increase the competence of dental practitioners in providing emergency care and to ensure the use of the knowledge to improve the quality of medical care for patients

Electromyography indicators in different periods of using of the removable dentures in patients with acrylate intolerance

Проведене порівняння кількісних показників електроміограм пацієнтів із токсико-алергічним ушкодженням указує на те, що в них змінений динамічний цикл активності й спокою жувальних м’язів у порівнянні з практично здоровими людьми, що підтверджується зростанням коефіцієнта «К»; суттєво знижується середня амплітуда вольового стиснення й довільного жування. Уже через 1 місяць кори стування протезами з профілактичним магнетронним покриттям покращуються показники електроміограм, жування стає досконалішим, що підтверджується біоелектричною активністю власне жувальних м’язів: вона розподілена рівномірніше між робочим і балансуючим боками, динаміка станів спокою й активності жувальних м’язів стає більш збалансованою, ніж у пацієнтів другої групи. Це, своєю чергою, свідчить про краще функціонування протезів із магнетронним покриттям.Despite the achievements in medical rehabilitation of patients with partial and complete absence of teeth, rehabilitation is not a definitely settled issue for orthopedic dentistry. According to the World Health Organiza-tion, about 26% of patients do not use full dentures for various reasons. The most common reasons for non-adaptive removable dentures are poor denture fixation or pain under prosthesis, which may be associated with the development of prosthetic stomatitis. We elaborated a method for the prevention and treatment of prosthetic stomatitis (toxic and allergic), using the magnetron coating with fullerene C60 surface of the pros-thesis base.The aim of the research is the study of bioelectric activity of the masseter muscle in patients with mani-festations of intolerance to acrylic base plastic after covering the prosthesis base with C60 fullerene in the observation period of up to 3 months.Material and methods of the research. We examined 29 subjects who presented to the orthopedic dentistry clinic for restoration of dentitions, using of partial and full laminar removable dentures. Patients were divided into 3 groups. The first group embraced patients with complete dentitions without dentures (9 people). The second group comprised patients who used partial and complete removable dentures with acrylic base for 1-3 months and they were diagnosed with prosthetic stomatitis (10 people). The third group included patients, implanted with partial and complete laminar removable dentures with the phenomena of prosthetic stomatitis, which underwent isolation of the prosthesis base using magnetron nano-coating with C60 fullerene (10 people).The functional state of the masseter muscles was determined by superficial electromyography, taking into account the condition of the prosthetic bed tissues and the period of using the dentures with nano-coating for 1 day, 15 days, 30 days and 2 months after denture placement.Results of the studies and their discussion. As shown by our studies, patients who used partial and complete removable prostheses with symptoms of prosthetic stomatitis (toxic and allergic stomatitis) demon-strated a significant effect on the bioelectric activity of the proper masseter muscles as compared with pa-tients in group 1. The average amplitude of volitional compression was less at 2.8 times and the averageamplitude of arbitrary chewing was less at 2.1 times, the dynamics of the states of rest and activity of chew-ing muscles was impaired. A reduction in the activity time and a slight increase in the resting time both on the working side and on the balancing side, as compared to patients in group 2 were observed in the first day af-ter prosthetics with magnetron C60 fullerene nano-coating. Patients in group 3 demonstrated an increase in bioelectric activity (the amplitude of biopotentials increased), as compared with group 2, both in volitional compression and in arbitrary chewing. On the 15th day of observation, the electromyographic pattern in pa-tients of group 3 changed and was characterized by a pronounced tendency to normalized indicators of the activity and rest time. The electromyogram amplitude of the masseter muscles increased significantly, but at this time the observations did not reach the values of group 1. One month after applying the dentures, elec-tromyograms of patients demonstrated a more pronounced alternation of activity waves with periods of rest, the amplitude of biopotentials oscillation increases. One month after denture placement, the indicators of group 3 approached the data, obtained in patients of group 1. After conducting the electromyographic study within 3 months, we found that in group 3, the values of average amplitude of arbitrary chewing and the am-plitude of volitional compression of the masseter muscles were 2 times higher than those of group 2. The time of activity and rest became more balanced and did not differ significantly from indicators in group 1

Dental status in patients with deficiency of secretory immunoglobulin a in oral fluid

Висвітлено основні показники стоматологічного статусу пацієнтів із дефіцитом секреторного імуноглобуліну А в ротовій рідині. Показано, що дефіцит гуморального фактора імунітету порожнини рота супроводжується збільшенням показника індексу гігієни, індексу КПУ і пародонтальних індексів прямо пропорційно віку хворих у порівнянні з пацієнтами з нормальним умістом sIgA ротової рідини. Проведені авторами дослідження довели, що з віком у пацієнтів із дефіцитом sIgA спостерігається достовірне зниження його рівня, особливо в пацієнтів 3 групи. Аналіз результатів досліджень доводить важливу роль гуморального імунітету порожнини рота, зокрема секреторного імуноглобуліну А у виникненні запального процесу в тканинах пародонта. Отримані факти потребують розробки й удосконалення відомих способів лікування й особливо профілактики генералізованого пародонтиту в осіб із вродженим дефіцитом sIgA. Отражены основные показатели стоматологического статуса у пациентов с дефицитом секреторного иммуноглобулина А в ротовой жидкости. Показано, что дефицит гуморального фактора иммунитета полости рта сопровождается увеличением показателя индекса гигиены, индекса КПУ и пародонтальных индексов прямо пропорционально возрасту больных по сравнению с пациентами с нормальным содержанием sIgA ротовой жидкости. Проведенные нами исследования показали, что с возрастом у пациентов с дефицитом sIgA наблюдается достоверное снижение его уровня, особенно у пациентов 3 группы. Анализ результатов исследований доказывает важную роль гуморального иммунитета полости рта, в частности секреторного иммуноглобулина А в возникновении воспалительного процесса в тканях пародонта. Полученные факты требуют разработки и усовершенствования известных способов лечения и особенно профилактики генерализованного пародонтита у людей с врожденным дефицитом sIgA. Generalized periodontitis is a leader in the structure of dental diseases and dental remains an unresolved problem. According to different authors and WHO GP prevalence among people 45-60 years old is 96-100%. SIgA deficiency occurs in 17% of the population, its lack of saliva can lead to disruption of the relationship between oral microflora, especially its opportunistic forms and microorganism. In the result, it increases the numbers of organisms and their corrosive properties and appearances of forms. This condition occurs rare in healthy people or does not occur at all. The purpose of the article is to assess dental status of patients with deficiency of secretory immunoglobulin A in oral fluid. The study involved 40 patients with generalized periodontitis deficient sIgA, which, depending on the age group, divided into 3 groups. The first group included 12 patients aged 20-35 years, the second - 13, age 36-50, the third - 15 patients, aged 51-65 years. The control group consisted of 10 patients with normal content of sIgA aged 22 to 50 years. The state of immunity oral mucosa was conducted to determine the level sIgA in oral fluid by solid phase ELISA. Oral liquid were collected in the morning on an empty stomach and in the volume of 0.5 ml, and then frozen at a temperature of -8 degrees Celsius. The level of sIgA oral fluid was studied by the using of reagents set of "secretory IgA-ELISA", Russia. All patients was made the standard dental examination that included determining the prevalence and intensity of dental caries index CPV, evaluation of hygienic condition of oral hygiene index using GV (JC Green, JR Vermillion, 1964). Periodontal lesions spent determining periodontal indices - AI (A.Russell, 1956, Leus), the index of bleeding gums (Muhlemann HP, 1971), papillary-marginally-alveolar index (PMA, Parma C., 1960). It was mentioned the structure of lesions of the oral mucosa. All the results recorded in the history of the dental patient (form 043 / y) and specially designed map individual patient. Statistical analysis of the results was performed the using of the method of variation statistics for each row of values to the calculation arithmetic mean value (M), errors arithmetic mean value (m), Student factor (T) and the probability of differences at p <0.05. The article highlights the main indicators of dental status of patients with deficiency of secretory immunoglobulin A in oral fluid. It is shown that deficiency of humoral immunity factors accompanied by increased oral hygiene index indicator, the index CPU and periodontal index is directly proportional to the age of patients compared with patients with normal oral fluid sIgA content. Our studies have shown that in patients with age-deficient sIgA observed a significant decrease in its level especially in patients 3 groups. Analysis of the studies proves the important role of humoral immunity mouth, particularly secretory immunoglobulin A in the causing of inflammation in the periodontal tissues. Obtained facts require the need to develop and improve existing methods of treatment and prevention particularly generalized periodontitis in patients with congenital deficiency of sIgA

Position of the temporomandibular joint dysfunction syndrome among facial pain syndromes

Висвітлюються важливі питання діагностики, диференційованої діагностики пацієнтів із СБД СНЩС із больовими синдромами обличчя та захворюваннями СНЩС. Правильність діагностичного пошуку дає практичному лікарю можливість проведення диференційованої діагностики, мінімізації діагностичних помилок і призначення адекватного лікування з урахуванням комплексного міждисциплінарного підходу; Освещаются важные вопросы диагностики, дифференциальной диагностики пациентов с СБД ВНЧС с болевыми синдромами лица и заболеваниями ВНЧС. Правильность диагностического поиска дает практическому врачу возможность проведения дифференциальной диагностики, минимизации диагностических ошибок и назначения адекватного лечения с учетом комплексного междисциплинарного похода; At the present time, the actual problem of dentistry is the study of the issues of the syndrome of pain dysfunction (SPD) of the temporomandibular joint (TMJ), which is found in 14-20% of teenagers and significantly increases with age (Siemkin V.A, Rabukhina N.A., 2000 ; Khavatova VA, 2005). The pathology of TMJ dysfunction was detected in 80% of the examined patients (Bezrukov V.M, 2002). Separately allocated dysfunction of TMJ in dysplastic-dependent form of joint pathology, thereby emphasizing that dysfunction is a characteristic manifestation of dysplasia of connective tissue in the maxillofacial area (Statovskaia Ye.Ye, 2005; Kozlov D.L., Viazmin A.Y., 2007). According to observations of A.I Mirza, I.V. Mikheieva, V.M. Novikov and according to our data, in more than 90% of people, pathological phenomena in the area of the temporomandibular joint have nothing to do with the inflammatory processes of this combination. At the same time, various dysfunctions and pain spasm of separate areas of chewing muscles occupy the main place. The aim of the work was to analyze the causes and clinical symptoms of patients with SPD. In this regard, as it turned out from the anamnesis, many patients had been undergoing inappropriate treatment for a long time. The cavity of the temporomandibular joint was repeatedly injected emulsion hydrocortisone acetate, antibiotics and other medications, which do not work in case of SPD of the temporomandibular joint. In some cases, after such therapy, dysfunction of the mandible occurred, leading to an even greater disruption of the joint function and increased pain. A number of patients with SPD of the temporomandibular joint due to a false diagnosis for a long time received treatment for neuralgia of the trigeminal nerve by drugs, Novocain blockade or alcoholization of sensitive branches of the trigeminal nerve. These patients often had neuritis, which greatly worsened the patient’s condition and the prognosis of the disease. The clinical picture of the SPD of the temporomandibular joint and a number of such diseases (syndromes of Slider, Sikara, etc.) is often so obscure and confusing that a large clinical experience is needed to evaluate individual symptoms. In addition, it should be noted that dysfunction of the mandible occurs with lesions of any part of the temporomandibular complex. Thus, limitation of the mobility of the mandible usually develops with arthritis of the temporomandibular joint, abscesses and phlegmons of the parotideomasseterica, temporal regions, pterygomandibulare, parapharingenal space, jaw-tongue groove and osteomyelitis of the branches of the mandible. Diagnostic difficulties often increase due to the fact that it is not always possible to find out the atypical etiological origin of the SPD of the temporomandibular joint. Against the background of the listed objective adverse factors, the presence of diagnostic errors largely contributes to insufficient knowledge of dentists who have clinical questions and questions on treatment of the SPD TMJ due to the difficulty in differential diagnosis, which is not fully covered in textbooks on dentistry. Control of correctness of the established diagnosis is the blockade of the motor branches of the trigeminal nerve subcutaneously using the Yehorov's method, which results in the removal of muscle spasm, stops pain and improves the mobility of the mandible. Conducting additional paraclinical examination methods such as dynamic MRT, 3-D MRT, CT and electromyography should be done

APPLICATION OF METHODS OF SIMULATION TRAINING AT THE DEPARTMENT OF POSTGRADUATE EDUCATION OF DENTISTS

The aim is to analyze the peculiarities of emergency care to dental practitioners at the department of postgraduate education of dentistry doctors for improving the quality of manual skills of the doctor in an outpatient department. Within the framework of the program, pilot trainings are held in Poltava and Lviv on the following topics: assistance in sudden coronary and sudden cardiac death, assistance with acute cerebrovascular accident, help with hypertensive crises, help with cardiac asthma and pulmonary edema. The training is carried out according to the methodological design and it consists of the theoretical and practical part. The training is provided by a certified teacher at the regional training and training center at M.V. Sklifosovsky Poltava Regional Clinical Hospital. The optimal number of listeners is 10-12 people. On the theoretical part the teacher represents the purpose, the plan of the lesson and in the logical sequence the material is presented. The theoretical part is equipped with a multimedia presentation. In the process, the teacher defines the basic level of knowledge and skills of listeners. In the practical part, the teacher initially determines the level of possession of clinical skills of doctors, teaches work on dummies, models real, simple and accessible to perception simulation scenarios. Doctors have to solve the tasks and practice practical skills from basic resuscitation measures. At the same time, an important place is given to work in the team. On phantoms, elements of the resuscitation brigade are worked out when providing emergency care to a patient with a terminal state (cardiac arrest) using cardiac-pulmonary resuscitation techniques (CPR). At the same time, artificial ventilation of the lungs (ventilation of the lungs) with exhalation in the mouth or the nose (mask) in the area of the head of the phantom is carried out. The modeling of the air duct is then modeled. This verifies the correctness of the laryngoscope in the oropharynx, and the introduction of the laryngeal mask. Doctors will work with Ambu's bag: the first hand fix the mask of the device in the area of the nose, the mouth of the phantom, and the other - by pressing the camera, the air is poured into the roton-nose area of the phantom with a certain frequency of pressure, followed by the use (if necessary) of an oxygen cylinder of type B. This checks the correctness of each reception. Conducting each manual reception and its effectiveness is fixed and processed by a computer program. The result is displayed on the monitor in the form of vital signs of the patient. In the case of effective doctor actions, the vital parameters of the "patient" on the monitor are normalized. The evaluation of the effectiveness of the manipulations is also carried out in balls. In the beginning, the trainer-instructor shows the order and correctness of carrying out emergency assistance measures on phantoms. In the future, monitors the implementation of manual techniques and assesses the actions of interns at each individual stage, emphasizing the correct implementation of the manual action. The sequence of the manual training on the "phantom-monitor" system gives confidence to doctors in the correctness and efficiency of manual skills. At the end of the practical cycle of training certified teachers of the department summarize the practical training with doctors-dentists. Practical training with the use of modern phantoms with computer processing of results helps to increase the competence of dental practitioners in providing emergency care and to ensure the use of the knowledge to improve the quality of medical care for patients

Comparative characteristics of the effectiveness of direct and indirect restorations on teeth with discoloration

Проведено оцінку і порівняння якості прямих і непрямих реставрацій зубів фронтальної групи з дисколоритами. Перша група – хворі, яким проведено лікування прямими реставраціями, виконаними світлополімерним реставраційним матеріалом «Estet X HD» («Dentsply») (50 хворих, 125 реставрацій); друга група – хворі, яким проведено лікування з використанням непрямих керамічних реставрацій, виготовлених методом пресування кераміки за високої температури («IPS Emax»). Останню групу було розділено на дві підгрупи залежно від методу лікування: 2А – пацієнти, яким непрямі реставрації фіксували за загальноприйнятими методиками на композит подвійного твердіння «Calibra» виробництва «Dentsply» (20 хворих, 70 вінірів), і 2В – пацієнти, яким вініри було зафіксовано на розігрітий композит «Gradia Direct» виробництва «GC» (20 пацієнтів, 55 вінірів).Порівняльну оцінку проводили через рік після закінчення реставрації. Визначали показники стану цих реставрацій за допомогою модифікованих критеріїв USPHS (United States Public Health Service; Ryge, G., 1980, 1981) для фронтальної групи зубів. Дослідження показали, що найвищий рівень якості спостерігається в групі, де були виготовлені непрямі реставрації (вініри), зафіксовані на розігрітий композит «Gradia Direct» виробництва «GC». Отримані результати підтверджені статистичним аналізом.The rapid development of dental industry and constant improvement of technologies in production of ba-sic dental materials contribute to the increase of the quality of rendering dental care with the obligatory con-sideration not only of functional but also aesthetic parameters during a patient's rehabilitation. However, there is still no precise indication for the use of metal-free structures for the qualitative and durable aesthetic restoration of the frontal group of teeth, white-pink aesthetics and prosthetic rehabilitation, taking into ac-count changes in the parameter of biological width of the tooth and aesthetic criteria.The aim of the research is to improve the effectiveness of treatment of frontal group teeth with discolora-tion using direct and indirect restorations by evaluating and comparing the quality of restorations.Research materials and methods.For clinical substantiation and comparison of direct and indirect ce-ramic restorations with classical fixation and the proposed method of fixation on the heated composite, 90 patients with discoloration and defects of the crown of the front teeth, aged 18 to 65 years, were examined and treated. A comparative evaluation was carried out one year after the restoration was completed.The distribution of patients into clinical groups was as follows: the first group – patients who were treated by direct restorations, performed with light- polymer restorative material Estet X HD (Dentsply) (50 patients, 125 restorations); the second group embraced patients, treated with indirect ceramic restorations manufac-tured by the method of pressing high temperature ceramics (IPS Emax). The latter group was in turn divided into two subgroups, depending on the treatment method: 2A – patients with indirect fixation by conventional methods on the Dentsply dual-cure composite of Calibra production (20 patients, 70 veneers) and 2B - pa-tients with fixation treated on the heated composite Gradia Direct by GC production (20 patients, 55 ve-neers).In order to evaluate the quality of prosthetics in patients with direct and indirect ceramic restorations (ve-neers) it has been determined the status of these restorations using the modified USPHS (United States Public Health Service; Ryge, G., 1980, 1981) criteria for the frontal teeth group. The obtained results were processed by the method of variational statistics using Student's test.Research results. During the clinical evaluation of direct restorations using the modified USPHS criteria for the frontal teeth group, the following complications were identified: tooth sensitivity was present in 5.6% of teeth, fractures, cracks, chips – in 20 restorations (16%); discrepancy between the color of restoration and the color of natural teeth – in 30 restorations (24%); the presence of defects in the texture of the surface – 30 teeth (24%). Impaired marginal adaptation was in 32 restorations, which amounted to 25.6%; loss of restora-tion gloss – in 66,4%, the presence of secondary caries – in 17 teeth (13,6%); deficiency of occlusal contact –in 13 restorations (10.4%), of approximate contact – in 17 restorations (3.6%). A detailed analysis of the condition of indirect restorations and clinical complications in the second group showed that the most com-mon defects are impairment of marginal adaptation – 16 veneers (12.8%), impairment of the integrity of ve-neers due to fractures, cracks, chips – 6 (4.8%), inconsistency of color – 13 veneers (10.4%), the presence of surface texture defects – 0, secondary caries – 3 teeth (2.4%), the position of fixing cement – 4 veneers (3.2%). Impaired occlusal contact was observed in 1 tooth (8.8%). No changes in approximate contacts were detected. The total number of complications was 17%, which indicates the need to find the optimization ap-proaches to treatment with these structures. Comparison of the status of indirect restorations, depending on the method of fixation by subgroups showed that the impaired integrity of veneers due to fractures, cracks, chips in subgroup 2A was detected in 4 teeth (5.7%), and in the subgroup 2B – in 2 teeth (3.6%). Color change in group 2A was observed in 12 teeth (17.1%), in group 2B – in 3 teeth (5.5%). Disorders of marginal adaptation in group 2A were observed in 12 teeth (17.1%), in group 2B – in 4 teeth (6.6%). Secondary caries was observed on 2 teeth (2.9%) in group 2A and in one patient in group 2B (1.8%). According to the criteria for evaluating the state of indirect ceramic restorations and recommended follow-up professional actions, the following estimates were estab-lished: 28% of restorations in the first group, 55.7% of restorations in group 2A, 85.5% of restorations in group 2B received an “excellent” rating; 33.6% of restorations in the first group, 25.7% in group 2A, 5.5% ingroup 2B received a “good” rating; a “satisfactory” rating was obtained by 11.2% of restorations in the first group, 11.7% in group 2A, 5.4% in group 2B. In the first group, 27.2% of restorations needed immediate re-placement, 11.4% – in the second and 3.6% – in the third group.The total score for the first group was 3.87±0.07, for 2A – 4.26±0.12, p.05, for group 2B – 4.73±0,1,p1˂p,05, p2˂0,05.Conclusion.Thus, our studies of direct and indirect restorations after one year of use showed that the highest level of quality was observed in the group where indirect restorations (veneers) were manufactured, which were fixed on the heated Gradia Direct composite by GC production. The obtained results are con-firmed by the statistical analysis.To evaluate the quality and duration of using direct and indirect structures with different types of fixation, it is advisable to carry out a long-term monitoring for up to 10 years

Improving students’ autonomous work at the department of nervous diseases with neurosurgery and medical genetics by usage of innovative technologies

Пріоритетною метою медичної освіти і критерієм її ефективності стають розвиток особистісного потен- ціалу та реалізація професійної складової майбутнього лікаря. Актуальність проблеми оволодіння студентами методами самостійної пізнавальної діяльності зумовлена тим, що в період навчання у виші закла- даються основи майбутньої самостійної професійної діяльності. Кафедра нервових хвороб з нейрохірургією та медичною генетикою ВДНЗУ «Українська медична стоматологічна академія» створює адекватні умови для самостійної роботи студентів, щоб у майбутньому молоді фахівці-неврологи могли впевнено працювати завдяки тим умінням і навичкам, які вони сформували за час навчання; Приоритетной целью медицинского образования и критерием его эффективности становятся развитие личностного потенциала и реализация профессиональной составляющей будущего врача. Актуальность проблемы овладения студентами методами самостоятельной познавательной деятельности обусловлена тем, что в период обучения в вузе закладываются основы будущей самостоятельной профессиональной деятельности. Кафедра нервных болезней с нейрохирургией и медицинской генетикой ВДНЗУ «Украинская медицинская стоматологическая академия» создает адекватные условия для самостоятельной работы студентов, чтобы в будущем молодые специалисты-неврологи могли уверенно работать благодаря тем умениям и навыкам, которые они сформировали за время обучения; The foreground aim of medical education and the criterion of its effectiveness become the development of personal potential and implementation of professional component of the doctor to-be. The relevance of the issue is to acquire the methods of autonomous cognitive activity determined by the fact that during the period of study at the university, the foundation for future independent professional activity is created. The aim of the study is to implement the innovative technologies for students’ autonomous work at the Department of Nervous Diseases with Neurosurgery and Medical Genetics in order to improve the development of theoretical material and practical skills. Students’ autonomous work during classes includes activities at lectures and practical exercises that vary for instance: “brainstorm”, debate, discussions of specific situations etc. Students’ autonomous work after classes includes the study of literature occupational edition, referencing literature, annotated books, articles, review the developed theoretical material, exercises, problem solving, preparing the reports, and autonomous work on the Internet (search for information on-line, organization of the dialogues online, creating thematic web-pages and web-quests). Another option in the process of students’ autonomous work at the Department of Nervous Diseases with Neurosurgery and Medical Genetics, is the educational module aimed on independent supervision of patients followed by the writing of academic case histories. The distance education technologies are of great interest over the world nowadays, which is particularly important in higher and post-graduate education. Such learning method is provided by the development of telecommunication systems and the Internet. With the aim of selfstudy of the discipline at the Department, the video films and video clips about nosology, electronic stands of topical diagnosis were developed. Students are provided with the opportunity to work at the electronic library of the Academy, which stores a large number of textbooks, monographs, manuals, educational videos, and research papers on the most difficult topics of neuroscience. A large amount of educational material is presented on the website of the Academy. The students who are the most interested in learning are able to attend students’ scientific group, meetings are held twice a month on different subjects aimed at in-depth study of neurology and acquiring and development of practical skills. At the end of academic year, some of them demonstrate research reports at students’ conference according to the topics which they have chosen and have been working on with their scientific supervisors, while the rest of students publish the theses only. The Department of Nervous Diseases with Neurosurgery and Medical Genetics of Higher State Educational Establishment of Ukraine “Ukrainian Medical Stomatological Academy” creates adequate conditions for students’ autonomous work so that young neurologists to-be could confidently pursue their profession thanks to the skills and abilities which they have obtained during the educational process