Nº 1 (2023)

Throughout the history of mankind, technological progress has not stood still, but, unfortunately, the production and discoveries that the age of progress brings to us always go hand in hand with an industrial injury. Despite the fact that over the past decades, the requirements and control of compliance with safety regulations have significantly increased, yet sometimes accidents occur that can take more than one human life. Work involving the risk of inhalation poisoning with particularly dangerous chemical compounds, which can lead to severe systemic and respiratory damage, is particularly dangerous for humans. According to the Federation of Independent Trade Unions of Russia, chemical poisoning accounts for 21.93% of all industrial injuries. Depending on the damaging agent, duration and area of exposure, all victims need a certain amount and specifics of assistance, which often requires prosthetics of several affected body systems, including using extracorporeal technologies. We present a clinical case of the successful application of extracorporeal membrane oxygenation (ECMO) methods in the complex therapy of inhalation poisoning with hydrofluoric acid vapors received by a patient as a result of an industrial accident. Based on the lack of clear clinical recommendations for the treatment of inhalation poisoning of this etiology, the method of extracorporeal membrane oxygenation and respiratory protection for volumetric lung tissue damage in complex therapy has shown its effectiveness and prospects that require further study.

Intravitreal injection is the method of administration of drugs into the eye by injection with a needle; the medication will be directly applied into the vitreous body. Compared to topical administration, this method is allows to deliver medications to the targeted site, as the needle can directly pass through the anatomical eye barrier (e.g. cornea, conjunctiva and lens) and dynamic barrier (e.g. tears and aqueous humor). It could also minimize adverse drug effect to other body tissues via the systemic circulation, which could be a possible risk for intravenous injection of medications. Intravitreal injection was first mentioned in a study in 1911, in which the injection of air was used to repair a detached retina. Intravitreal injection has become more common and a surge in the number of injections performed could be seen. The risk of complications can be minimized if all prescriptions are followed. This article presents in detail the intravitreal injection technique, pre-treatment and post-treatment precautions. Also in this article describes ocular drug delivery systems which provide controlled release for the treatment of chronic diseases, and increase patient’s and doctor’s convenience to reduce the dosing frequency and invasive treatment.

Purpose: analysis of the preventive effectiveness of the agent based on bacteriophages “Phagodent” in persons with dental implants.
Material and methods: two groups were compared: with standard hygienic oral care and with additional applications of Phagodent gel on the gum (main group, 15 people, bridges on 49 implants; comparison group, 10 people, bridges on 42 implants); observation of patients with implants. For comparison, hygienic periodontal indices (oral hygiene index, hygiene index, gingivitis index, Mulleman index) were used.
Results: when using the Phagodent gel at home and with standard oral hygiene, no development of periimplantitis with bone resorption was recorded during the year of observation. At the same time, mucositis was found in one implant in the main group (2.0%) and in two in the comparison group (4.8%). A year later, the index of oral hygiene of IG-U deteriorated in the main group to 1.9±0.1, in the comparison group to 2.1± 0.2; the index of hygiene of IG in the comparison group corresponded to 1.3±0.3, in the main group – 1.0±0.1; the index of gingivitis of IG in the main group was 0.1± 0.1; in the control group 0.2 ±0.1; The Mulleman index in a year it did not exceed 0.1 ±0.1 in both groups. Thus, the use of “Phagodent” gel in the main group of patients prevented the development of mucositis due to the positive effect on oral hygiene, reflected by the hygienic indices of IGM-U and IGIM. Due to the positive effect on oral hygiene in patients with dentures on dental implants, the gel based on bacteriophages “Phagodent” has a preventive effect on inflammatory complications in the state of periimplant tissues and can be used by the patient independently at home.

Analysis of the literature has shown that the progress of early and timely diagnosis of major lung diseases, including tuberculosis, pneumonia and oncology depends on the level of professional knowledge of doctors, the correct use of modern diagnostic technologies. Unfortunately, not all actions of medical workers to provide medical care lead to positive results. The article describes the most common mistakes made by doctors in the diagnosis and treatment of phthisiopulmonology. For each nosological form, there are a number of diagnostic and treatment defects that reduce the clinical effectiveness of care. The vast majority of professional mistakes are made not out of ignorance, but due to inattention or self-confidence of the doctor, lack of legal literacy. Despite the ubiquitous computerization of medical institutions, the availability of state-of-the-art diagnostic equipment, the latest methods of treatment, errors in the activities of doctors of all directions do not disappear without solving the main problems of regulatory regulation. The work is of interest to novice interns, clinical residents of various specialties. Annotation The analysis of scientific publications devoted to the causes of medical errors and ways to overcome them is of increased relevance and practical significance. According to the literature, many authors sought not only to show errors in establishing a clinical and morphological diagnosis, but also to pay special attention to changes in the diagnosis of lung diseases, the impact of new innovative technologies on the effectiveness of therapeutic and surgical treatment, and tried to reflect the deontological side of the error problem. Focusing on errors in the diagnosis of pulmonary tuberculosis, pneumonia, and lung cancer recognition, it is advisable to conduct a comparative study of the diagnostic value of a number of new methods and studies that have been used in clinics for many years, to evaluate the possibilities of using modern technologies.

The purpose of preparing this lecture is due to the prevalence of valvular disease, especially aortic stenosis. The problem is that the course of the disease is usually asymptomatic, but when the stenosis becomes symptomatic, the mortality rate rises sharply. Improving outcomes depends on identifying individuals at risk, accurately assessing severity, and treating comorbidities. Over the past 5–10 years, knowledge about these aspects of the problem has developed significantly. The lecture attempts to reveal the tendencies of this development, which are important for internists.

Angiomyolipoma (AML) is a rare benign tumor originating from mesenchial tissue [1]. Most often, this tumor affects the kidneys and is 0.3–3% [1-3]. Extrarenal AML is observed very rarely (about 40 cases have been described in the literature). After the kidneys, AML is most often found in the liver, then in descending order: in the uterus, brain, vagina, penis, nasal cavity, hard palate, abdominal wall, fallopian tubes, spermatic cord, colon, retroperitoneal space. To date, 6 cases of AML of the nasal cavity have been officially registered [ ]. As a rule, they are hamartomic lesions containing smooth muscles, vascular network and mature adipose tissue. This article presents a clinical observation of a patient with such a rare pathology as AML of the nasal cavity. The use of a complex of histological and immunohistochemical diagnostic methods makes it possible to make the correct diagnosis