COMPARATIVE EVALUATION OF THE CLINICAL EFFICACY OF MODERN REMINERALIZING DRUGS IN THE TREATMENT OF ENAMEL CARIES (FOCAL DEMINERALIZATION).

The emergence of new concepts and mechanisms for remineralization is of great interest to study. The study objective was to evaluate the clinical efficiency of use of modern remineralizing formulas: "Enamel-sealing liquid" ("Tiefenfluorid", Humanchemie, Germany), "FluoroLux" (TechnoDent, Russia), "InnoDent" (PLC, "InnoDent", Kazakhstan) and ClinproTM XT Varnish (3M ESPE, Germany) in treatment of focal demineralization. According to the number of studied drugs in the framework of a clinical study, four groups of patients with a diagnosis of caries of enamel were formed (n=36): Group 1 (n=9 people, 30 teeth); Group 2 (n=9 people, 29 teeth); Group 3 (n=9 people, 28 teeth); Group 4 (n=9 people, 31 teeth). Evaluation of the clinical efficacy of enamel caries treatment was carried out using 1) vital staining with a 2% aqueous solution of methylene blue followed by evaluation using a control gradation 10-point grayscale; 2) laser-fluorescence method using the apparatus "DiagnoDent Pen" (KaVo). Statistical processing of the obtained results was performed using the Wilcoxon and Money-Whitney test. The confidence level was considered at p≤0.05. According to the data of laser fluorescence of enamel and vital staining, the median index with high statistical significance decreased in all groups after 3 months compared with the data before treatment. Thus, all the studied drugs showed remineralizing activity in the elimination of enamel demineralization foci. This study is the basis for the search and development of new remineralizing compounds for the prevention and treatment of focal enamel demineralization.

[Computer technologies in diagnostics and treatment of worsening post-enucleation socket syndrome]. / Komp'iuternye tekhnologii v diagnostike i lechenii progressiruiushchego anoftal'micheskogo sindroma.

Enucleation with primary orbital implantation and the use of ocular prosthesis does not exclude the risk of post-enucleation socket syndrome (PESS). Correction of such conditions requires modern visualization methods and software for calculation, modelling and control of the surgery. PURPOSE: To demonstrate the capabilities of modern computer technologies in diagnostics and treatment of patients with worsening post-enucleation enophthalmos. MATERIAL AND METHODS: The retrospective study included 6 patients (4 male and 2 female) aged 29-68 years who exhibited signs of PESS in 2017-2018. To define the orbital condition, patients underwent multispiral computed tomography (MSCT) and magnetic resonance imaging (MRI) followed by image analysis with computed exophthalmometry and step-by-step computed exophthalmometry. Results of these examinations helped construct 3D-models of patients' orbits, which were then used to calculate the parameters of the silicone implants. Patient-specific silicone implants were implanted into their orbits during surgery under general anesthesia. RESULTS: Implantation of the patient-specific silicone implant resulted in increase of the volume behind orbital prosthesis and correction of post-enucleation enophthalmos in all patients allowing them to use thinner, more mobile ocular prosthesis, and restore normal eyelid position. The patients also noted better appearance of the eye and personal comfort. CONCLUSION: Modern visualization methods along with computer analysis and modelling, as well as technologies to produce medical products enable creation of the best suitable patient-specific orbital implants. This allows achieving better clinical results and better quality of life for patients with monolateral anophthalmos.

[Non-gonococcal urethritis in men].

This literature review is dedicated to urethritis which is one of the most common disorders of urogenital tract in men. The current views in its etiology as well as problems in diagnosis with the main being the frequent inability to isolate etiological factor of inflammation it the urethra are described. The analysis of literature suggests a possible role of bacteria, which are associated with bacterial vaginosis in women, in the development of the urethritis in men. However, the frequency of such urethritis and causative role of specific pathogens has not been studied yet. Meanwhile, the exact determination of the causes of inflammation has direct influence on the choice of appropriate etiologic treatment and can increase its efficiency.

[Outcomes of intraocular lens implantation in the absence of capsular support: a review of current literature]. / Iskhody implantatsii intraokuliarnoi linzy v sluchae otsutstviia kapsul'noi podderzhki: analiz sovremennykh dannykh literatury.

Тhe prevalence of complications associated with the deficiency or absence of capsular support in cataract patients is 5-15%. Moreover, approximately 20% of patients have an inconspicuous zonular weakness, which is often left undetected preoperatively. AIM: to classify and comparatively analyze the latest published data on the outcomes of various kinds of complicated cataract surgery. MATERIAL AND METHODS: Analysis of available literature on the subject of research published in 2003-2016. RESULTS: The method of sutured scleral fixation of the intraocular lens (IOL) is the most fully covered in the current literature. It has been used long enough and is, therefore, well tested. Its typical complications include sutures degradation, hemorrhage, and inflammation. Sutureless fixation of the IOL, which has become more common in recent years, is free of complications associated with degradation of the sutures. However, studies on the long-term results of this technique are few and most of them were conducted in a small clinical material. CONCLUSION: Basing on the present analysis, one may conclude that at the current level of surgery, sutureless scleral and iridal fixation of the IOL is more preferable in terms of possible postoperative complications.

Platinum polyoxoniobates.

Reaction of [Nb6O19](8-) with [Pt(OH)4(H2O)2] upon heating yielded first characterized platinum polyniobates. A dimeric complex [Nb6O19{Pt(OH)2}]2(12-) (1) is produced in a 1 : 1 molar ratio. Increasing the Pt/Nb6 molar ratio to 1 : 2 yields a mixture of 1 and a sandwich-type complex [Pt(Nb6O19)2](12-) (2).

[Measurement of genital mycoplasma concentration by using a microbiological and molecular-biological methods].

AIM: Establishment of ratios that would allow to execute recalculation of mycoplasma concentration from CFU/ml and/or CCU/ml into units obtained during PCR analysis--geq/ml. MATERIALS AND METHODS: Pure cultures of Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum were studied by cultural and molecular-biological methods with quantitative evaluation. Studies of initial cultures as well as series of 10-fold dilutions were carried out. 32 experiments in total were carried out. RESULTS: Ratio between geq/ml and CFU/ml for M. hominis was 3.5; geq/ ml and CCU/ml ratio--4.4. Ratio between geq/ml and CCU/ml for U. parvum was 7.1; for U. urealyticum--11.2. CONCLUSION: Ratios between indexes obtained during quantitative study of pure genital micoplasma cultures by using 2 methods were established.

[The comparison of tests for qualitative evaluation of Ureaplasma parvum, Mycoplasma hominis: "Mycoplasma duo", "Ureaplasma microtest", "Mycoplasma microtest" and "AmpliSens-Florocenosis-mycoplasma-FL"].

The genital mycoplasma is an opportunistic bacteria and its detection is to be implemented in qualitative format. The study was organized to compare reagents kits "Mycoplasma Duo", "Ureaplasma Microtest", "Mycoplasma microtest" and "AmpliSens-Florocenosis-Mycoplasma-FL". The study resulted in high indicators of diagnostic sensitivity and diagnostic specificity for all kits. At that, the lowest indicators were registered under application of "Mycoplasma Duo" kit. The study reveled correlation of qualitative values detected by using cultural analysis and polymerase chain reaction. The reproducibility of qualitative values of cultural method occurred significantly lower in comparison with "AmpliSens-Florocenosis-Mycoplasma-FL " kit.

[The advantages of the short intensive training course in endoscopic surgery].

The advantages of one-day training courses on the example of the short intensive course "manual suture in endoscopic surgery" are represented. The programme consists of the short 8-hours course, including theoretic lectures, practice seminars, virtual trainings and the trainee's self work under the control of the experienced supervisors. The preliminary assessment of the course, performed with the use of questionnaires and testing in small groups, showed it's unarguable efficacy for surgeons.

[Morpho-functional analysis of blood leukocytes after isoniazid administration].

The functional-metabolic response peculiarities of the rat blood cells to isoniazid (one of the main antituberculosis medications) were studied. Isoniazid or its complex with pyridoxine were administrated orally for 3 months in therapeutic (5 mg/kg) and the toxic (100 mg/kg) doses (based on isoniazid). Isoniazid in toxic dose was found to inhibit the phagocytosis and the myeloperoxidase activity in neutrophils, the hydrolase activity in neutrophils and lymphocytes, but, at the same time, it activated dehydrogenase activity in lymphocytes. Pyridoxine modified the toxic effect of isoniazid on the metabolic processes (prevented the inhibition of phagocytosis and peroxidase activity in neutrophils, stimulated acid phosphatase activity in lymphocytes, decreased in the level of the lysosomal cationic proteins in neutrophils). It is suggested that the response of the blood cells to isoniazid, demonstrated in this work, was caused by the capacity of the medication to functionally activate the adrenal cortex, while the cellular-metabolic effects of pyridoxine could be associated with the modulation of glucocorticosteroid activity.

[Results of assessing the quality of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum DNA by polymerase chain reaction in 2006-2007)].

Analyzing the results of detection of C. trachomatis, M. hominis, and U. urealyticum DNA by the participants of the Federal External Quality Assessment System in 2006-2007 indicated that the share of the fluorescent-probe amplification technique both in the real-time mode and by the end-point tended to increase. The above tendency coincided with the other--the higher proportion of laboratories detecting M. hominis and U. urealyticum at low concentrations (as low as 10(3) copies/ml) although no direct caused-and-effect relation could be established between these two tendencies. In 2006-2007, the section participants demonstrated a sufficiently high specificity (94-98%) in the detection of C. trachomatis, M. hominis, and U. urealyticum DNA while the sensitivity of studies left much to be desired--the proportion of correct results at the concentration of DNA of the above microorganisms of 10(3) copies/ml was as high as 73-82%. The considerable share of laboratories that fail to detect microorganisms at low concentrations suggests that it is necessary to continue work to enhance the sensitivity of this important type of laboratory studies.

[PCR studies in laboratory diagnosis: problems of quality assurance].

The determination of DNA and RNA of causative agents by the nucleic acid amplification techniques (NAT) presented in the Russian laboratory diagnosis of infections solely by polymerase chain reaction (PCR) have currently found the widest application in world practice and, in some cases, is a basic procedure for detecting an infectious agent, particularly in the diagnosis of infections caused by human immunodeficiency virus, hepatitis C virus, hepatitis B virus, cytomegalovirus, Chlamydia trachomatis, Neisseria gonorrhoeae, and others. The paper presents the data available in the literature on the main reasons for false positive and false negative results in PCR studies, international and national programs for the outside quality control (OQC) of detection of causative agents for various diseases, by applying NAT. It is emphasized that the regular participation in OQC programs is likely to be useful in improving the quality of PCR studies.

[Esomeprasol and rabeprasol effects on esophageal acidification in patients with gastroesophageal reflux disease, intensively metabolizing inhibitors of proton pump].

AIM: To compare action of different esomeprasol and rabeprasol doses on esophageal acidification in patients with gastroesophageal reflux disease (GERD). MATERIAL AND METHODS: A cross-over study was made in 27 GERD patients (12 males and 15 females). It included esophagoduodenoscopy with biopsy for detection of H-pylori and 24-h pH-metry of esophageal content. Rabeprasol and esomeprasol efficacy was compared for daily doses 20 mg of each (stage I) and rabeprasol 20 mg and esomeprasol 40 mg (stage II). RESULTS: All the patients proved H-pylori positive. Before the treatment mean daily time of marked esophageal acidification was 29-36%. At stage I significant differences between the drugs were absent. At stage If esomeprasol was more effective from the first day of therapy both in relation to time to effect and its intensity. CONCLUSION: Esomeprasol provided a fast and noticeable correction of esophageal acidification. This relieves symptoms of GERD and accelerates esophageal mucosa epithelization.

[Development of "Amplisens-HCV-genotype" reagent set for identification of hepatitis C virus genotypes 1a, 1b, 2a and 3a]. / Razrabotka nabora reagentov "Amplisens HCV-genotip" dlia opredeleniia subtipov 1a, 1b, 2a, 3a virusa gepatita C.

Multiple alignments of 119 nucleotide sequences of isolates of hepatitis C virus (HCV) were carried out to choose the type-specific primers for the 5'-ultra-core fragment of viral genome for the purpose of detecting the HCV 1a, 1b, 2a, and 3a subtypes. A PCR kit of reagents was designed for the amplification of cDNA HCV with selected type-specific primers and for making the electrophoresis in agarous gel. The kit comprises the positive control samples, i.e. HCV genome fragments, subtypes 1a, 1b, 2a and 3a, cloned in the plasmid vector. 440 cDNAHCV samples were simultaneously tested by using the worked out reagents' set and according to the method of Ohno et al. The results were found to be concordant in 336 cases, and were discordant in 4 samples. A sequencing of the PCR products and phylogenetic analysis showed that 1 sample belonged to subtype 4a, 2 samples belonged to subtypes 2k and 1 sample--to subtype 31.

[Detection of Treponema pallidum DNA and RNA in clinical material from patients with syphilis at different stages]. / Vyiavlenie DNK i PNK Treponema pallidum v klinicheskom materiale u patsientov s razlichnymi stadiiami sifilisa.

The results of the development and approval of methods for the detection of T. pallidum DNA and 16S rRNA in clinical material (blood plasma, serous exudates) are presented. T. pallidum DNA was detected with the use of primers to the gene coding protein with a moleculat weight of 47 kD and T. pallidum RNA, with the primers to gene 16S rRNA. The isolation, reverse transcription and amplification of DNA and RNA was carried out in the presence of inner DNA and RNA control respectively. The analytical sensitivity of the developed method was 400 DNA copies per ml. The characteristics of analytical and diagnostic specificity were 100%. The specimens of blood plasma, taken from 292 patients with syphilis at different stages before specific antibacterial therapy, were tested by the PCR. The detection rate of T. pallidum DNA and RNA in blood plasma was, respectively, 91% and 100% in primary seropositive syphilis, 68% and 79% in secondary early syphilis, 19% and 26% in latent unverified syphilis. In secondary relapsing syphilis T. pallidum DNA and RNA were detected in 92% and in latent early syphilis, in 14% of patients. T. pallidum nucleic acids were detected in 1 patient at the seronegative period of primary syphilis. No positive result was obtained in the PCR analysis in any of the patients with diagnosed seroresistance, latent late syphilis and tertiary syphilis. In the study of material taken from chancres of 11 syphilis patients the data obtained by dark-field microscopy and the PCR analysis completely coincided.

[Multilocus sequence-typing for characterization of Moscow strains of Haemophilus influenzae type b]. / Kharakteristika moskovskikh shtammov Haemophilus influenzae tipa b metodom mul'tilokusnogo sekvenirovaniia-tipirovaniia.

Haemophilius influenzae, type b (Hib) bacteria, were genotyped by multilocus sequence typing (MLST) using 5 loci (adk, fucK, mdh, pgi, recA). 42 Moscow Hib strains (including 38 isolates form cerebrospinal fluid of children, who had purulent meningitis in 1999-2001, and 4 strains isolated from healthy carriers of Hib), as well as 2 strains from Yekaterinburg were studied. In MLST a strain is characterized, by alleles and their combinations (an allele profile) referred to also as sequence-type (ST). 9 Sts were identified within the Russian Hib bacteria: ST-1 was found in 25 strains (57%), ST-12 was found in 8 strains (18%), ST-11 was found in 4 strains (9%) and ST-15 was found in 2 strains (4.5%); all other STs strains (13, 14, 16, 17, 51) were found in isolated cases (2.3%). A comparison of allelic profiles and of nucleotide sequences showed that 93% of Russian isolates, i.e. strain with ST-1, 11, 12, 13, 15 and 17, belong to one and the same clonal complex. 2 isolates from Norway and Sweden from among 7 foreign Hib strains studied up to now can be described as belonging to the same clonal complex; 5 Hib strains were different from the Russian ones.

[Effectiveness of lamivudine in the treatment of chronic HBeAg-negative viral hepatitis B: results of continuous therapy for 18 months]. / Effektivnost' lamivudina v lechenii HBeAg-negativnogo khronicheskogo virusnogo gepatita B: rezul'taty nepreryvnoi terapii v techenie 18 mes.

The efficacy of monotherapy with one of the analogues of synthetic nucleosides (lamivudine) was studied in 22 patients with chronic viral hepatitis B (CVHB). The specific feature of the selected group was that there was no serum HBeAg, which is usually regarded as a sign of viral mutation. The time course of changes in the activity of blood and hepatic inflammatory processes and viral replication were studied at equal intervals. There was a direct correlation between the suppression of viral replication and the regression of activity indices, such as ALT, serological markers, DNA of viral hepatitis B, and the morphological constituents of the Knodell index) during lamivudine therapy. However, there were no substantial changes in the parameters of fibrosis throughout the treatment. Therapy resistance was revealed in 3 of the 22 patients with CVHV. Its basis was the mutation of hepatitis B virus in the YMDD-motive, which was detected in 2 of the 3 patients.

[Comparative effectiveness of the antisecretory action of rabeprazole and esomeprazole in people with rapid metabolism of proton pump inhibitors]. / Sravnitel'naia éffektivnost' antisekretornogo deistviia rabeprazola i ézomeprazola u lits, bystro metaboliziruiushchikh ingibitory protonnogo nasosa.

AIM: To compare antisecretory effects of Rabeprazole and Esomeprazole in proton pump inhibitors extensive metabolizers in an open, randomized, two-way crossover study. METHODS: Sixteen GERD H. pylori-positive patients (8 men, mean age 49.6 and 8 women, mean age 49.3) with the homozygous extensive metabolizer genotype of CYP2C19 determined by polymerase chain reaction-restriction fragment length polymorphism analysis received Rabeprazole 20 mg or Esomeprazole 20 mg daily on days 1-6, with a 14-day wash-out period. Intragastric pH was recorded continuously on days 0, 1, 5 and 7. RESULTS: On days 1 and 5 no differences were found between Rabeprazole 20 mg and Esomeprazole 20 mg in 24-hours median pH (day 1: 5.9 versus 5.0; day 5: 6.45 versus 6.3) or in percent of time with pH 4 (day 1: 57.8% versus 50.5%; day 5: 81.4% versus 81.2%). On day 1, mean percent of time pH 4 were significantly greater after Esomeprazole 20 mg 52.6% (95% CI: 23.6-68.2) than Rabeprazole 20 mg 33.0% (95% CI: 15.3-48.2) during 0-6 h (p = 0.02). On day 7 (24 later the last dose), 24-hours median pH was higher after Esomeprazole 20 mg than Rabeprazole 20 mg (2.7 versus 5.05; p = 0.02). CONCLUSIONS: Rabeprazole 20 mg and Esomeprazole 20 mg are equally effective in increasing gastric pH in H. pylori-positive PPI extensive metabolizers on days 1 and 5. Esomeprazole 20 mg is more effective than Rabeprazole 20 mg in maintaining pH 4 during the first 6 hours on the first day and increasing of intragastric pH on the day 24 hours later the last dose.

[Stability of hepatitis C virus RNA in human blood plasma in a panel of control samples]. / Stabil'nost' RNK virusa gepatita C v plazme krovi cheloveka v paneli kontrol'nykh obraztsov.

The stability of hepatitis C virus (HPC) RNA concentration in 5 human plasma samples after storage at +22 degrees C for two months, at -20 degrees C, and +4 degrees C for six months after 10 freezing-unfreezing cycles was evaluated. In this study, the concentration of HCV RNA in the samples was stable after six months of storage at -20 degrees C. The concentration of HCV RNA decreased on the average of 92% after 2-month storage at +22 degrees C. After six months of storage at +4 degrees C and after 10 freezing-unfreezing cycles, that decreased by 28 and 42%, respectively. Based on their own findings, the authors developed a HCV-RNA panel containing 5 positive human plasma samples with RNA levels of 103-105 IU/ml. The panel may be recommended both for the standardization of PCR kits and for the intra- and interlaboratory quality control of PCR laboratories.

Atypical presentation of Acanthamoeba keratitis.

PURPOSE: To present two cases of minimal pain Acanthamoeba keratitis to alert clinicians to remember Acanthamoeba when evaluating atypical cases of keratitis. METHODS: The histories of two cases were reviewed with attention to clinical presentation subjective complaints, treatment, and long-term outcome. RESULTS: In case 1, a 24-year-old man presented with decreased vision and an irritated feeling in his eye. He did not wear contact lenses. His initial diagnosis was adenoviral conjunctivitis. One month later, he was diagnosed with atypical herpes simplex keratitis and started on acyclovir. Two weeks later, he was referred to the Cornea Service. Further history revealed the patient to be a professional triathlete who trained by swimming in a fresh water pond. He was found to have an unusually high pain tolerance. Biopsy revealed Acanthamoeba. He was admitted for intensive therapy with neomycin, propamidine isethionate, and polyhexamethylene biguanide. Two years after diagnosis, he has best-corrected visual acuity of 20/100. In case 2, a 28-year-old man with known herpes simplex keratitis presented with decreased vision. He was started on topical trifluridine. After 6 weeks without improvement, he was referred for corneal evaluation. His eye always remained comfortable. Corneal sensation was markedly decreased. Further history revealed that he swam in fresh water. Biopsy was positive for Acanthamoeba. After 1 year of therapy with polyhexamethylene biguanide and neomycin, visual acuity was 20/200, and the patient underwent a corneal transplant. CONCLUSION: Acanthamoeba keratitis must be considered in the differential diagnosis of keratitis, even without the classic presentation of severe pain and predisposing corneal trauma, including contact lens wear.