IMMUNITY CHANGES IN PATIENTS WITH ACUTE MAXILLOFACIAL ODONTOGENIC INFECTIONS DURING TREATMENT STAGES: AN ANALYSIS

OBJECTIVE

The aim: Evaluate the expediency of using different methods of treatment for patients with acute purulent-odontogenic inflammatory processes in both the main and control groups. This assessment will be based on various indicators of non-specific immunity.

PATIENTS AND METHODS

Materials and methods: This study involved the evaluation of the humoral component of nonspecific immunity in 114 patients. We assessed changes in total protein and its fractions, C-reactive protein (CRP), lysozyme, and immunoglobulins (A, M, and G) during three distinct time intervals: 1-3 days, 5-7 days, and 8-14 days after treatment initiation. Statistical analysis was conducted using Statistica 10.0 (StatSoft, Inc., USA) and Microsoft Office Excel 2010.

RESULTS

Results: At different postoperative follow-up periods, a significant improvement in humoral nonspecific immunity indicators (p>0.05) was observed when comparing patients treated with and without platelet-rich plasma. This improvement is expected to enhance reparative processes and expedite recovery.

CONCLUSION

Conclusions: The incorporation of platelet-rich plasma, immunocorrective, and adaptogenic therapy into the comprehensive treatment of acute purulent odontogenic inflammatory processes in the maxillofacial region not only leads to pronounced and enduring positive outcomes but also results in substantial improvements, including the potential normalization of key humoral and cellular factors associated with innate immunity.

MANIFASTATIONS OF COMPLICATION IN THE ANEMIC SYNDROME IN NON-HODGKIN LYMPHOMAS OF TRANSCARPATIA

OBJECTIVE

The aim: To investigate the main indicators characterising clinical and haematological manifestations in patients with NHL complicated by anaemia at the stages of the disease development for optimisation of diagnostics and prognosis of the disease.

PATIENTS AND METHODS

Materials and methods: Data from 40 patients were analysed, 40 (100%) of whom were diagnosed with NHL complicated by anaemia. The severity of anaemia was divided into: mild anaemia - haemoglobin 10 - 12 g/dl; moderate anaemia - 8 - 10 g/dl; severe anaemia - 6.5 - 8 g/dl; life-threatening anaemia - below 6.5 g/dl. Patients were divided into 2 groups: the first group included 27 patients with haemoglobin levels of 100-120 g/l; the second group consisted of 13 patients with haemoglobin levels of 80 to 99 g/l. All patients were examined using clinical, laboratory, instrumental and special research methods. Statistical processing of the results was performed using the methods of variation statistics using the Microsoft Excel XP.

RESULTS

Results: The course of lymphoproliferative diseases in which the proliferation of a malignant clone is often complicated by anaemia. The prognostically unfavourable factors were identified. The article discusses possible pathophysiological mechanisms of the identified changes.

CONCLUSION

Conclusions: The results of the study demonstrate that as the disease progresses and the tumour mass increases, NHL patients tend to develop more severe anaemia. The leading cause of anaemia in patients is the infiltration of the bone marrow by tumour cells and their negative impact on erythropoiesis.

EFFECTS OF STRONTIUM RANELATE ON ALVEOLAR BONE IN RATS WITH EXPERIMENTAL DIABETES MELLITUS

OBJECTIVE

The aim: To investigate effects of strontium ranelate on alveolar bone loss in rats with experimental diabetes.

PATIENTS AND METHODS

Materials and methods: Histological examination of bone tissue was carried out for 24 white male rats, divided into three identical groups of 8 animals (the first group included animals with experimental type-2 diabetes, based on the use of Streptozotocin; in the second group, it was additionally reproduced periodontitis by the introduction of Penicillamine; and in the third group, in addition, it was used strontium ranelate) and 6 intact rats.

RESULTS

Results: In the second group, osteoporosis phenomena were most significant, while in the third group the average specific area of the inter-root trabecular bone differed a little from the control. In the control group, the number of osteoclasts was 2.24 ± 1.41 cells per mm2, in the first group - 4.34 ± 1.37 cells per mm2, in the second group - 2.96 ± 1.26 cells per mm2 and in the third group - 2.24 ± 1.41 cells per mm2 (p>0.05). The samples of the third group have the most expressive manifestations of osteogenesis and the most intense expression of osteopontin, both in trabecular and compact bone tissue.

CONCLUSION

Conclusions: The use of strontium drugs reliably slows down the processes of bone resorption due to both inhibition of the function of osteoclasts, and by activating osteoblasts, thus stimulating osteogenesis.

MULTIDISCIPLINARY APPROACH TO MANAGEMENT OF PEDIATRIC PATIENTS WITH SKIN SYMPTOMS OF FOOD ALLERGY

OBJECTIVE

The aim: To determine the significance of multidisciplinary approach to management of pediatric patients with skin symptoms of food allergy.

PATIENTS AND METHODS

Materials and methods: The study included of 36 patients aged 4 to 6 years with skin manifestations of food allergy, of which 18 were randomly included in the study group and had a multidisciplinary approach to treatment and the other 18 patients constituted a comparison group and used a standard therapy regimen. Observation of children was carried out for 3 months.

RESULTS

Results: Assessment of the severity of the cutaneous form of food allergy by SCORAD score showed the average degree of disease activity in the groups of the study at the beginning of treatment and significantly better dynamics in patients of the study group (p=0.0055). In 88.9% (n=16) of patients in the study group and 61.1% (n=11) of the control group, the process became mild.

CONCLUSION

Conclusions: The application of a multidisciplinary approach allows the integrated implementation of medical, nutritional, and psychological aspects, which significantly increases the effectiveness of treatment and improves the quality of life of patients and their parents.

FUNCTIONAL DISORDERSOF THE SALIVARY GLANDS IN PATIENTS WITH COMPRESSION AND DISLOCATION DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT AND THEIR CORRECTION

OBJECTIVE

The aim: Is to assess the functional state of parotid glands and general secretion in patients with compression, dislocation dysfunction of TMJ, to correct the revealed disorders.

PATIENTS AND METHODS

Materials and methods: We examined 46 patients with dysfunction of TMJ. Examination included TMJ zonography and salivary glands sonography. We studied the general and parotid secretion, transparency, viscosity, pH of the oral fluid and the secretions of the parotid glands before and after treatment. The treatment of dysfunction and hyposialosis included the repositioning of the articular heads of the lower jaw in the correct anatomical position, the use of a repositioning plate on the posterior teeth at the compression side of the articular head, bougienage of the duct of the parotid gland, administration of 10% magnesium-mineral solution of bischofite into the gland.

RESULTS

Results: In patients with TMJ dysfunction, a significant decrease in the oral fluid content was noted before treatment. The saliva transparency was reduced, the viscosity was increased, the pH was slightly acidic. A study, which was carried out a month after completion of the course of treatment showed that all the studied parameters corresponded to those in healthy individuals.

CONCLUSION

Conclusions: The study confirmed that in compression and dislocation dysfunction of TMJ, there are disorders of the functional state of the salivary glands.

OBTURATION INTESTINAL OBSTRUCTION IN THE COURSE OF NECROTIZING ENTEROCOLITIS IN NEWBORN CHILDREN

OBJECTIVE

The aim: To analyze our own results of diagnosis and treatment of newborns with NEC and obturation intestinal obstruction in order to determine theoretically important and practically significant recommendations on this issue, to optimize preventive measures for reducing intestinal obstruction cases in NEC and improving treatment outcome among newborns.

PATIENTS AND METHODS

Materials and methods: Our supervision involved 143 newborns with NEC for the period from 2006 to 2020, including 79 boys (55.24%) and 64 girls (44.76%). Gestational age was 26-42 weeks. The majority of children were premature infants and numbered 121 children (84,62%). The assessment of clinical manifestations, progression of the disease, physical examination of newborns were used to help in diagnosing. All children underwent general clinical tests and instrumental methods of diagnosis including ultrasonography (abdominal organs and retroperitoneum, echocardiography, neurosonography) and X-ray examination (two-dimensional plain abdominal radiography, X-ray contrast study of the gastrointestinal tract). According to the survey, all patients were examined by allied health professionals.

RESULTS

Results: Obturation intestinal obstruction associated with NEC was diagnosed in 26 children (18.18%). 12 children were in serious condition, representing 46.15%. The condition of other 14 children (53.85%) was assessed as critical one. The first signs of intestinal obstruction were observed in children with NEC at the end of the first week or at the beginning of the second week of life. Intestinal obstruction was acute in 21 children (80.77%); 5 children (19.23%) had relapsing course. Blood test results showed the inflammatory process and were not specific. According to the results of our observation, the dynamics of platelets is indicative as there is a correlation between the deterioration in the child's condition and the onset of symptoms of intestinal obstruction and thrombocytopenia. There was an imbalance in protein and electrolyte metabolism - a decrease in the level of albumin, indicators of K, Na, Ca, and an increase of C-reactive protein by several times. Ultrasonography of the abdominal organs showed irregular intestinal pneumatization, dilated intestinal loops with stagnant intestinal contents, pendulum peristalsis, infiltrative bowel wall thickening, free fluid in the abdominal cavity. Plain radiography revealed typical manifestations of small intestinal obstruction with multiple air-fluid levels. In 15 newborns (57.69%), conservative treatment was effective, in particular intestinal obstruction was relieved; 11 newborns (42.31%) underwent surgery. The mortality was 36.36% (4 children died). Postoperative complication in the form of bowel stenosis in the area of the direct anastomosis was observed in 3 patients approximately 2 weeks after the surgery.

CONCLUSION

Conclusions: 1. NEC can lead to the development of obturation intestinal obstruction in newborns. Obturation intestinal obstruction was a form of NEC course in 18.18% of children under our observation. 2. Obturation intestinal obstruction in NEC in newborns is a reversible condition and requires conservative therapy. If symptoms of obstruction persist within 3 days after the start of conservative therapy, surgical treatment is indicated. 3. In case of obturation intestinal obstruction, it is advisable to perform resection of necrotic bowel, formation of a double enterostomy. 4. Enterostomy closure by placing T-shaped intestinal anastomosis should be performed 4 weeks after the primary surgery. 5. The use of modern techniques for early diagnosis and timely treatment of obturation intestinal obstruction in NEC can reduce mortality and the number of postoperative complications. 6. Newborns with NEC should be under the supervision of surgeons, which will help timely determine the indications for surgical intervention.