Cytokine profile in multiple sclerosis patients with and without Covid-19.

OBJECTIVE: Aim: To investigate the possible effect of COVID-19 disease on cytokine profile and some circulating growth factors in patients with multiple sclerosis (MS). PATIENTS AND METHODS: Materials and Methods: Serum cytokine levels as well as growth factors content were assessed be means of a solid phase enzyme linked­immunosorbent assay in 97 MS patients of which 41 had and 56 did not have confirmed COVID-19 in the past 4-6-month period, and 30 healthy individuals who were age­, and gender­matched. RESULTS: Results: Some proinflammatory cytokine (such as TNFα, IFNγ) levels were higher while anti-inflammatory cytokine, namely IL­4, was lower in MS patients compared to controls indicating Th1/Th2 imbalance. Our findings revealed that the imbalance of circulating Th1/Th2 cytokines in MS patients after SARS-CoV-2 infection became even more pronounced, thus, might be a reason for the disease deterioration. Furthermore, nuclear factor κB level in MS patients after COVID-19 was found significantly elevated from that with no history of SARS-CoV-2 infection, and could be the cause of proinflammatory cytokines overexpression. CONCLUSION: Conclusions: Our findings revealed that immunopathology of MS is associated with a Th1/Th2 imbalance, furthermore, SARS-CoV-2 infection can lead to the deterioration of this condition in MS patients, causing even more pronounced overexpression of proinflammatory cytokines and decrease in anti-inflammatory cytokines. Our results also indicated that studied growth factors can be involved in MS development but exact mechanism is not clearly understood and requires further research.

SIMULATION TRAINING AND VIRTUAL PATIENTS AS A COMPONENT OF CLASSROOM TRAINING OF FUTURE DOCTORS UNDER COVID-19 CONDITIONS.

OBJECTIVE: The aim: To present and substantiate the theoretical and applied aspects of the organization of simulation training for higher education applicants in the field of health care based on the analysis and generalization of the experience of the Bogomolets National Medical University. PATIENTS AND METHODS: Materials and methods: To perform the set tasks, the following theoretical and empirical methods of scientific research were used: system analysis; comparison and generalization; bibliosemantic method; the analysis and simulation methods. RESULTS: Results: The experience of organizing simulation training for higher education students in the field of health care was analyzed and summarized. There have been investigated the functional capabilities of the most common "virtual patient" modeling systems for the formation of the practical component of the future doctors' professional competence. Finally, the features of the organization of the educational process at a medical university in classroom, mixed (classroom-distance) and synchronous (hybrid) forms of education during the period of quarantine restrictions have been described. CONCLUSION: Conclusions: A technology for conducting an objective structured practical (clinical) exam has been developed. It helps to standardize the procedure for checking the level formation of the clinical professional competence of a future doctor in accordance with the requirements the standard of higher medical education. It is shown that the use of simulation training and modeling systems "virtual patient" in the preparation of future healthcare professionals increases the effectiveness of training, the interest of students and interns, motivating them to develop the necessary components of the future doctor's professional competence.

Analysis of Tongue Color-Associated Features among Patients with PCR-Confirmed COVID-19 Infection in Ukraine

ABSTRACT Objective: To evaluate and systematize tongue color-related manifestations among patients with PCR-confirmed COVID-19 infection. Material and Methods: This retrospective study included analysis of tongue images obtained from patients with PCR-confirmed COVID-19 infection. Evaluation of coronavirus disease severity (mild, moderate, severe, critical) was provided, considering clinical symptomatology and results of laboratorial and instrumental diagnostic methods. Each picture was analyzed considering the parameters of color of the tongue and color of the tongue plaque by two dental specialists. Cochran-Armitage test for trend was used to evaluate associations between the tongue color and tongue plaque color, and coronavirus disease severity. Results: The most prevalent tongue colors were pale pink, red and dark red (burgundy color). A total of 64.29% of patients with mild disease demonstrated pale pink color of the tongue. Patients with moderate coronavirus disease were characterized with the adverse trend: 62.35% of them presented with red-colored tongue, while in 37.64% of cases, the tongue was pale pink. Severe COVID-19 patients, almost in 90% of the cases, had either red or burgundy color of the tongue. Conclusion: SARS-COV-2 infection is not manifested by tongue-targeted or tongue-specific signs and features; however, coronavirus disease itself provokes changes within the tongue color and tongue plaque color similar to those registered during other internal pathologies.

Relationship between idiopathic scoliosis of the spine and dentognathic anomalies in adolescents.

OBJECTIVE: Introduction: According to the data of the national statistics, the disease of the musculoskeletal system among the teenagers takes the third place among the main types of diseases. So, we decided to analyze and study the connection between the idiopathic scoliosis of the spine and dentognathic anomalies in children aged 12-15 years old in Uzhhorod (Ukraine). The aim: To determine the characteristic violations of the dentognathic system in adolescents with idiopathic scoliosis of the spine, taking into account the anatomical type of lesion. PATIENTS AND METHODS: Materials and methods: 225 people were examined, including 190 girls and 35 boys. All patients were under the control of an orthopedic physician. RESULTS: Results: The most common type of scoliosis is found to be thoracolumbar, which is noted in 114 patients. As a result of analysis it was found that the most characteristic disorders of the dentognathic system in patients with thoracolumbar scoliosis were distal bite (80 ± 2.0%), sagittal gap (37.5 ± 2.1%), deep bite (22.5 ± 2.3%). In the group of healthy children, without scoliosis, the prevalence of dentognathic anomalies is 2.6 times lower than in patients with idiopathic adolescent scoliosis. CONCLUSION: Conclusions: Regardless of the localization of deformation in the spine under scoliosis, all the groups of patients are characterized by the following signs: sagittal gap, shortening of the upper dentition, distal bite, crowding of the teeth on the lower jaw.

Prevalence of main dental diseases in children who live in conditions of biogeochemical fluorine and iodine deficiency.

BACKGROUND: Dental status is one of the main indicators of overall health. We examined it in children aged 6-15 years who live in conditions of biogeochemical fluorine and iodine deficiency (Transcarpathian region, Ukraine), to improve the quality of dental care. MATERIALS AND METHODS: In this cross sectional study To assess the state of teeth, we used indicators recommended by the WHO Expert Committee. The prevalence and intensity of dental caries, periodontal status, oral hygiene status and dentoalveolar anomalies were determined using a questionnaire and descriptive analyses was done (P < 0.05). RESULTS: The total prevalence of caries in deciduous teeth in children was 57.86% ± 1.56%, with intensity of 2.61 ± 0.6. The total prevalence of caries in permanent teeth was 71.45% ± 1.31%, with intensity of 2.36 ± 0.52. Analysis of the results showed a high prevalence of periodontal disease, which increases with age. The level of oral hygiene was evaluated as unsatisfactory. Studying the prevalence of dentoalveolar anomalies showed the lowest prevalence (40.05% ± 2.56%) at the age of 6 years and the maximum value at 12 years (77.20% ± 2.75%). In addition, we found poor hygienic knowledge of the parents, lack of medical activity of parents to preserve dental health of the child, lack of dentists' work on hygiene education, and public health education for prevention of dental diseases. On the other hand, a high level of confidence was revealed in the information received from dentists. CONCLUSION: The high prevalence of leading dental diseases requires modernization of the existing prevention programs for children.

Socio-psychological aspects in the prevention of dental diseases.

OBJECTIVE: Introduction: Measures to prevent dental diseases are included in the list of medical care provided by dentists. Modern socio-economic transformations, including in health care, have contributed to the gradual evolution of the patient from the recipient of medical care to the consumer of services. The aim: To study the position of patients regarding the need and effectiveness of preventive dental care. PATIENTS AND METHODS: Materials and methods: Study was conducted among 310 patients who were admitted in various municipal and state medical institutions, dental clinics and private dental offices in Uzhhorod. The average age of respondents is 26 years. The survey was conducted using questionnaires. RESULTS: Results: 90% of respondents are willing to pay for dental treatment based on the use of innovative technologies; 64% of people refer to paid services aesthetic therapeutic treatment; 87% of patients agree to pay for orthopedic treatment and 48% - for surgical intervention. Only 16% of respondents consider additional professional hygiene services and ready to pay for it themselves. Survey data show that 43.2% of patients give a doctor the main role in the treatment process. 42.8% of respondents need medical help in the form of advice or counseling for a decision on treatment. 14% of patients prefer to choose their own medical care and control the treatment. CONCLUSION: Conclusions: Dental prophylactic measures that are implemented in the practice of regulating social and labor relations, the presence of relationships between the physician and the patient develop by socio-psychological laws.

Prevention of main dental diseases in children using herbal tea «dentesvita¼

Introduction: Transcarpathian region refers to the climate-geographic zone with a low level of fluoride and iodine in the environment and as shown by the epidemiological survey «very high¼ according to WHO criteria for the level of intensity of main dental diseases. With the purpose of directing the implementation of the state policy in the field of health care and for the prevention of dental diseases, the industrial release of a functional food product - «DentesVita¼ enriched with iodine and fluorine - has been adjusted. The aim: Was to study the effectiveness of the use of functional food product - DentesVita for the prevention of dental caries in children. Material and methods: A comprehensive dental examination of 180 children of 12 years of age has been carried out: 60 of them in each of the climatic and geographical zones of Transcarpathia: plain, foothills and mountains. The intensity of caries according to the DMF index, increase of intensity was determined. A simplified hygiene index (OHI-S) was used to assess the hygienic state of the oral cavity. Carried out research on the mineralization potential of saliva. Results: The growth of caries in children of the main group of the plain zone was 1.8 times smaller, and in the foothills and mountains 1.6 times smaller than the similar rates of control group children (p <0.05). The caries prophylactic effect at that was among schoolchildren in the plain zone: 43.48%, foothill - 38.66%, and mountainous - 23.53%. Conclusions: These studies confirm the effectiveness of using «DentesVita¼ for the prevention of dental caries in children living in conditions of biogeochemical deficiency of fluorine and iodine on the basis of caries intensity growth indexes, hygienic indexes of the oral cavity and mineralizing ability of oral liquid.