Izhevsk State Medical Academy

The article presents a literature review of modern Russian and foreign publications devoted to the study of prevalence, pathogenetic mechanisms, diagnostics and treatment of postprandial distress syndrome. It is shown that this variant of functional dyspepsia is the most common. In its pathogenesis, the leading role belongs to disorders of relaxation accommodation of the proximal stomach. Existing diagnostic criteria for functional dyspepsia variants are based on anamnestic data, which does not allow for their clear verification. For the purpose of differential diagnostics of functional dyspepsia, along with endoscopic examination, it is advisable to clarify the disorders of gastroduodenal motility and the profile of intestinal peptides regulating it. Modern approaches to the treatment of patients with postprandial distress syndrome include the use of prokinetics and neuromodulators against the background of diet therapy and non-drug correction.

Tooth ectopia into the nasal cavity is a rare interdisciplinary pathology in the practice of both otorhinolaryngologist and dentist. Ectopia is the process of eruption of one or several teeth that extend beyond the normal line of the dental arch. Only 308 cases have been recorded worldwide for 2023 based on an analysis of the scientific literature on intranasal supernumerary teeth (PubMed database). Intranasal ectopic tooth in combination with a congenital malformation (cleft lip and palate) is even more rare — only 6 published clinical cases have been found. The article presents 2 clinical cases of intranasal ectopic tooth. Literature data are provided. Of interest is the fact that both patients were older than 30 years and had no previous history of ectopia. In addition, intranasal ectopia in both cases was accompanied with concomitant ENT-organs pathology.

Hypogonadism develops in diabetes mellitus (DM) and metabolic syndrome (MS). Testosterone replacement therapy may be applied, but its effect on spermatogenesis is controversial. Hyperglycemia promotes accumulation of glycation products. Cellular receptors for advanced glycation end products (RAGE) trigger inflammatory responses via the proinflammatory transcription factor NF-kB. This signaling pathway may be involved in impairment of spermatogenesis in hyperglycemia and during testosterone therapy. Hence, the aim of our study was to evaluate the effect of testosterone on RAGE and NF-kB levels in rat’s testicles in DM and MS. The experiments were carried out in young rats. The animals were randomly divided into several groups: K (intact animals, n = 6), metabolic syndrome (MS, n = 5), metabolic syndrome + testosterone treatment (MS + Tn, n = 8), testosterone (Tn, n = 4). Experimental data were obtained using Western blotting and immunofluorescence studies. No significant changes were found in RAGE and NF-kB contents in testicular tissue of rats with hyperglycemia, probably, due to insufficient duration of hyperglycemia and mechanisms that inhibit inflammation. The testicular RAGE content was significantly higher in MS + Tn, and Tn groups (Western blotting), as well as in MS + Tn group (immunofluorescence technique). Testosterone, in presence of hyperglycemia is likely to cause an increase of testicular RAGE content. No significant changes were found in testicular NF-kB contents. It seems that the inflammatory cascade mediated by this factor is not activated in the testicles. No significant changes were found in testicle-to-body mass ratio and of lumen area to wall area of seminiferous tubules ratio. These facts suggest the absence of atrophic changes in rat testes. Hence, the 6-week hyperglycemia does not cause an increase in the RAGE and NF-kB levels in rat testes; testosterone increases the RAGE content in rat testicles, both in presence of hyperglycemia and in the intact animals. Despite the increased RAGE, activation of NF-kB-dependent proinflammatory cascade is not revealed, and testicular atrophy does not occur in rats.

Foreskin circumcision is the oldest surgical procedure that has become part of Muslim and Jewish cultures and has been performed on healthy boys and men since ancient times. In addition, circumcision is a surgical method of treating phimosis, balanitis and balanoposthitis, which is used regardless of religion. A review of the literature showed that surgical and medical factors of foreskin circumcision sometimes lead to local complications such as penile ischemia and amputation, wound infection, bleeding, meatal stenosis, cutaneous urethral fistula, urethral erosion, iatrogenic hypospadias, bruising after injection, inflammation, necrosis and abscess. These complications worsen the aesthetic outcome of circumcision, the mood of patients and their relatives, and increase the costs of the healthcare system associated with the treatment of complications. In this regard, the current priority is to improve the safety of surgical procedures and medicinal solutions of the following pharmacological groups: anesthetics (drugs for intravenous anesthesia), local anesthetics, detergents (disinfectants), antiseptic and anti-inflammatory drugs. The fact is that it is these medicinal solutions that are most often used in circumcision. In recent years, targeted changes in local temperature have become very relevant, since hypothermia inhibits the intensity of local complications, increases the viability of damaged, ischemic and excised tissues and hyperthermia potentiates the disinfecting effect of antiseptics and helps stop bleeding. It has been shown that the risk of local complications during circumcision can be reduced by infrared monitoring of the local temperature of the penis and skin at the injection sites, as this ensures early detection of local hyperthermia in inflammation and local hypothermia in ischemia. It has been shown that the risk of ischemic soft tissue injury and amputation can be reduced by therapeutic hypothermia, as cooling increases tissue resistance to ischemia. It has been reported that the risk of wound infection in phimosis, paraphimosis, balanitis and balanoposthitis can be reduced by the use of antiseptic pyolytics, which are warm alkaline hydrogen peroxide solutions, and the risk of post-injection necrosis and abscesses can be reduced by pre-diluting drug solutions with water for injection by 2 or more times.

The cause of biological death in warm-blooded animals and humans is hypoxic brain cell damage. Consequently, oxygen gas is the leading antihypoxant in emergency medical care for all critical conditions. The most common method of oxygen administration is mechanical ventilation. However, in cases of asphyxia caused by airway obstruction with thick sputum, mucus, pus, and/or blood, inhaled oxygen does not reach the alveoli and is not absorbed into the bloodstream. In such situations, traditional mechanical ventilation becomes ineffective and fails to prevent biological death due to hypoxic brain cell damage. At the beginning of the 21st century, as an alternative to gaseous oxygen, mechanical ventilation, and extracorporeal membrane oxygenation, the development of intrapulmonary oxygen-producing antihypoxants through physicochemical repurposing of hydrogen peroxide was initiated in Russia. Professor P.D. Shabanov served as the mind behind and coordinator of the development of new-generation antihypoxants. A new group of antihypoxants — warm alkaline hydrogen peroxide solutions — was discovered. The most effective oxygen-producing antihypoxants, when applied locally via the intrapulmonary route, generate significant volumes of medical oxygen gas through catalase-mediated decomposition of hydrogen peroxide into water and molecular oxygen. The local intrapulmonary, endotracheal, and endobronchial pharmacodynamics and pharmacokinetics of warm alkaline hydrogen peroxide solutions are inseparable from interactions with catalase present in sputum, mucus, serous fluids, purulent masses, and blood that obstruct the airways during asphyxia and/or severe acute respiratory obstruction. The new generation of antihypoxants has demonstrated high therapeutic potential as powerful medical oxygen gas generators when administered intrapulmonarily, endobronchially, or endotracheally during acute severe suffocation caused by airway blockage with colloidal liquids containing catalase. It is hypothesized that intrapulmonary oxygen-producing antihypoxants could be considered therapeutic agents for emergency blood oxygen saturation through the lungs when mechanical ventilation is ineffective and extracorporeal membrane oxygenation is not feasible.

The prevalence of patients with signs and symptoms of temporomandibular disorders (TMD) at dental appointments is quite high. Dentists’ knowledge of the etiology, clinical manifestations, diagnostic and treatment methods of this pathology contribute to early detection and effective treatment of TMD. Aim — to study the awareness of dentists of the Udmurt Republic of the signs and symptoms, diagnosis and management of TMD. Materials and methods. An anonymous survey of 232 dentists of the Udmurt Republic of various specialties was conducted. The questionnaire included 20 questions concerning the prevalence, etiology, clinical signs and symptoms, diagnostic and treatment methods for patients with TMD, and the need of dentists for additional education in TMD. Results. 37.1% of dentists answered that the frequency of patients with signs of TMD at their reception is from 10 to 20%. At the same time, questions to identify TMD are asked by 56.5% of dentists. Only 10.3% of dentists identified all the clinical symptoms characterizing this pathology. 32.3% of dentists noted all possible etiological factors of TMD. Palpation of the maxillofacial region and determination of the degree of mouth opening are performed by 44.0% and 46.6% of dentists, respectively. Treatment of this category of patients is carried out by 12.5% of doctors, mainly dental surgeons. The most frequently prescribed are pharmacotherapy (75.9%), physiotherapy methods (69.0%) and selective grinding (58.6%). The average score of knowledge of anatomy and biomechanics of the dental system of all participants according to the results of self-assessment was 2.78±0.19 on a five-point scale. 81% of dentists would like to improve their knowledge in TMD. Conclusion. The survey revealed an insufficient level of knowledge among dentists of all specialties about the signs and symptoms, methods of diagnosis and treatment of TMD. There is a high need to continuing education in the diagnosis and management of TMD among dentists.

The transformation of capitalism into a new socio-economic state formation modern discussion about the forms of alienation acquires a special character. The new social reality shows emergence of new forms of alienation not only in the economic sphere of society, but also forms of alienation that have arisen in other spheres of public life. The materials of modern scientific publications draw attention to the need for a careful study of human existence in the context of new forms of relationship between the individual and society.

To study the interaction of hormonal factors and indicators of vegetative homeostasis in violation of the motor evacuation function of the duodenum in chronic duodenal insufficiency (CDI). 70 patients with CDI were under observation. The average age of patients was 35.7±11.4 years, women were 32 (45.7%), men - 38 (54.3%). The control group included 31 healthy individuals [average age 39.1±12.3 years; there were 15 women (48.3%), 16 men (51.7%)]. Cardiorhythmographic examination and analysis of heart rate variability with the "Varicard 2.51" complex were used to study the ANS. To study the intramural nervous apparatus of the duodenum, a biopsy piece of its wall from the lower horizontal section was examined. Electrochemiluminescence analysis made it possible to determine the content of gastrin, insulin, cortisol, and somatostatin in the blood. To diagnose motor disorders of the gastroduodenal zone, peripheral electrogastroenterography was performed using the gastroenteromonitor GEM-01 "Gastroscan-GEM". In patients with CDI, in addition to changes in the clinical and electrophysiological picture, changes in the vegetative status were revealed. This condition correlates with the following electrophysiological signs in CDI - hypomotor duodenum leads to a greater increase in the ratio Pi/Pi + 1 stomach / duodenum after food stimulation (17.43±2.46) in this group of patients (p=0.000). The study of the basal hormone content in CDI showed a significant increase in gastrin, cortisol and a decrease in insulin and somatostatin in comparison with the control group. The relationship between them and vegetative-electrophysiological indicators is revealed. Comprehensive studies of myoelectric activity, the functional state of the autonomic nervous system and hormonal regulatory factors, followed by the analysis of multidimensional statistics data, revealed new pathophysiological patterns in duodenal motility disorders in CDI.

The article is dedicated to the 85th anniversary of Lyudmila Fedorovna Molchanova. Her life and scientific work at ISMA are described in the article.