‘Long Covid’ (post-covid syndrome): Mechanism of occurrence, diagnosis and rehabilitation

The article is devoted to the study of an urgent problem of modern humanity – the fight against a pandemic caused by a new coronavirus infection, namely: the study of the mechanism of development of ‘long Covid’ (post-covid syndrome), a new clinical and laboratory method of its diagnosis, issues of drug and non-drug rehabilitation of patients who have suffered COVID‑19. The paper describes the etiopathogenesis of post-covid syndrome (PS), the distinctive features of which are the defeat of the cardiovascular, respiratory, nervous, digestive, immune systems of the body, ENT organs and musculoskeletal system. For the diagnosis of post-covid syndrome, a monochrome nanoparticle analyzer (MAN) has been tested for the first time in the Russian Federation, which allows determining pathophysiological shifts in the homeostasis system. It was found that the MAN method has a sufficiently high diagnostic sensitivity (78%), and shifts in the homeostasis system in post-covid syndrome are statistically significant (p < 0.001). A fundamentally important point of this study is that an algorithm has been developed for noninvasive diagnosis of PS by saliva (oropharyngeal flushes), based on the detection of a high contribution to the scattering of laser radiation in the mid-frequency range of the spectrum on nanoparticles ranging in size from 119 to 121 nm. The article also pays special attention to medicinal and non-medicinal methods of treatment of patients with ‘long Covid’ experiencing the consequences of a new coronavirus infection. It has been established that the best effect is provided by complex treatment combining methods of the traditional European school (drug therapy with the use of cardiovascular drugs, nootropic agents, chondroprotectors, vitamins and mineral complexes, hormones, hepatoprotectors, biostimulants, sedatives and anti-inflammatory drugs and other drugs) and non-drug methods of restorative treatment practiced by Oriental medicine (acupuncture, hirudotherapy, massage, osteopathy, etc.).

Acetabular Migration of Lag Screw of Intramedullary Nail Used as Treatment for Intertrochanteric Fracture. Case Study

Most trochanteric fractures of the femur are classified as low-energy fractures as they are seen in people with decreased mechanical properties of bone tissue. The treatment is assumed to provide biomechanical fixation with the possibility of dynamization between bony fragments to stimulate the biological processes of bone union. The aim of the study was to analyze a complication presenting as migration of the cervical screw of an intra­medullary nail towards the hip joint acetabulum and present the therapeutic management of this complication. The case report concerned a 74-year-old patient with an AO/OTA type 31 A2.2 fracture of the trochanteric massif of the right femur treated with the Gamma3 intramedullary nail. An assessment of changes over time of the radiological appearances on A-P images after the surgery showed migration of the cervical screw towards the acetabulum and displacement of the major trochanter fracture. Extensive destruction of the acetabular fossa made biologic restorative treatment impossible. A total hip joint prosthesis with a modular stem and MDM articulation was implan­ted and the trochanter was fixed with a "hook" plate with a "cable system". The postoperative course was uneventful. Failure to perform axial radiographs in the preoperative and postoperative period made it impossible to objectively determine the type of fracture and the quality of screw insertion into the femoral neck, and assessment limited to A-P images turned out to be deceptive. The wandering of the screw towards the acetabulum led to extensive destruction of the acetabular fossa. The decision to stop biological treatment, which, if properly performed, stimulates bone union, and perform the mechanical procedure of endoprosthesoplasty was fully prognostically justified. The early and late postoperative course was not complicated.

Detailed three-dimensional orthodontic tooth repositioning to improve restorative outcome:

ABSTRACT The case describes the interdisciplinary treatment of a 23-year-old woman with a Class III malocclusion, missing an upper right lateral incisor, abrasion of the maxillary incisal edges, anterior gingival margin discrepancies, and gingival recession. Initially, the patient was treated with fixed appliances combined with orthognathic surgery. The extraction of the upper left lateral incisor and bilateral canine substitution plan was chosen. At the end of the surgical and orthodontic treatment, the restorative treatment with six veneers was accomplished to improve smile esthetics. Despite the missing lateral incisors, the patient showed a natural, good-looking final result. A symmetric incisal plane was established, a functional occlusion with average vertical and horizontal overlap was set, and the bone scallop and consequently the gingival margins were leveled. The interdisciplinary approach hid all of the initial esthetic defects of the case. The result highlights how to obtain a remarkable improvement of the smile outcome with a well-functioning masticatory system.

Dental Management of Generalised Developmental Defect of Enamel in A Child with Global Developmental Delay

Development Defect of Enamel (DDE) although not common, can bring about serious sequelae and needs immediate action. If we leave the teeth untreated, many complications such as poor dental aesthetics, chipping of teeth and dental pain often set in. These complications are further aggravated if the patient has any coexisting medical issues, such as Global Developmental Delay (GDD). Children with GDD often exhibit poor oral health with an abundance of plaque that leads to caries and periodontal disease progression because of poor motor and cognitive development. Many of them also exhibit negative behaviour toward dental treatment. This case describes the dental care for a Global Developmental Delay (GDD) child with sporadic generalised Development Defect of Enamel (DDE). The case management touches on the appropriate behaviour guidance strategies used to aid the child’s unfavourable behaviour towards treatment and the restorative treatment performed to preserve the structural durability of the affected teeth in a general dental setting.

Aid Methods of Treatment in the Recovery Period of Patients Underwent Surgical Treatment of Cervical Hip Fractures (Literature Review)

The literature review summarizes the scientific information devoted to the study of auxiliary methods used in restorative treatment after surgery for fractures of the femoral neck. The restoration of motor functions in patients with cervical hip fractures is a priority task of the comprehensive restorative treatment program. Despite the achievements in the field of osteosynthesis and endoprosthetics, many patients receive an unfavorable outcome of surgery and a group of disabilities. As a result of an improperly selected program of complex rehabilitation treatment or neglect of auxiliary methods, in most cases, patients gradually develop secondary complications from the damaged segment: the formation of articular contractures, muscle hypo- and atrophy, violation of the walking stereotype, ineffective consolidation, fracture and migration of metal structures with excessive load on the limb, etc., as well as the general somatic condition of the patient worsens: secondary hypostatic complications join and chronic diseases a exacerbated. The purpose of the literature review is to systematize data on the use of auxiliary treatment methods in the recovery period of patients who have undergone surgical treatment of hip fractures and their effectiveness. The article discusses the general characteristics of the applied auxiliary methods of restorative treatment, the timing and scope of their implementation, and also presents the results of individual randomized controlled trials on their effectiveness.

Analog and digital modeling of sound and impaired periodontal supporting tissues during mechanical testing

Periodontitis is one of the most common conditions affecting oral health among adults, posing a great challenge for both patients and also for dentists aiming to treat this disease. In severe stages such deterioration of the supporting tissues, namely the periodontal ligaments and the bone, can occur, which will affect the biomechanical behavior and therefore the longevity and survival of the affected teeth. In order to be able to plan both periodontal and subsequent restorative treatment properly, valid modelling of the current clinical situation is advised. The aim of the present article is to comprehensively discuss possible analog and digital modeling methods of periodontally affected teeth and the periodontal structures surrounding them. Modelling possibilities can serve later as the basis of mechanical load, digital finite element studies, and also aid clinical treatment planning.

Selective Outcome Reporting (SOR) in Pediatric Dentistry restorative treatment randomized clinical trials - A meta-research.

BackgroundSelective outcome reporting (SOR) is a type of bias that occurs when the primary outcome of a randomized clinical trial (RCT) is omitted or changed prospectively. We evaluated the prevalence of SOR in RCTs on restorative caries treatment in primary teeth.MethodsWe conducted an electronic search on ClinicalTrials.gov and the World Health Organization (WHO) platform up to April/2021. We included RCT protocols that tested restorative treatments in primary teeth and excluded any protocol that has not resulted in at least one publication in a peer-reviewed scientific journal. The Chi-square test was used to detect the association between SOR and other variables (α = 5%).ResultsOut of 294 potential protocols, thirty were included. We found 34 corresponding publications and had the one that seemed to report the primary outcome and longest follow-up, resulting in 30 publications. SOR was observed in 53.3% (n=16) of the published trials and was significantly associated with the discrepancy in the follow-up period (p=0.017).ConclusionThere is a considerable prevalence of selective outcome reporting (SOR) on restorative trials in primary teeth. Properly pre-registered protocols and assessing them for the peer review processes will help decrease SOR.Practical implicationsRestorative treatment trials in primary teeth that selectively modify outcomes of interest have been shown to distort the treatment effect. Practitioners should avoid using restorative treatments based on misleading results in clinical practice.

Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review

In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.

Therapeutic physical factors in restorative treatment of patients with nonalcoholic steatohepatitis combined with biliary sludge

Purpose of the study. To study the effectiveness of restorative treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge at the inpatient stage when low-mineralized mineral water and preformed peloid therapy are included in the basic scheme. Material and methods. A total of 119 patients with nonalcoholic steatohepatitis in combination with biliary sludge were observed and distributed into 3 randomized groups: in the main group, 39 patients received basic drug therapy in accordance with the Federal Clinical Recommendations, «Sernovodskaya» mineral water for ingestion and in the form of gallbladder cleanse, and preformed application peloid therapy; in the comparison group, 40people received only pharmacotherapy and balneotherapy, in the control group — pharmacotherapy. The control of the effectiveness of the treatment was carried out according to the dynamics of clinical, biochemical and functional studies. Results. The inclusion of medium-mineralized mineral water «Sernovodskaya» in the form of drinking treatment and cleanse and preformed peloid therapy in the complex of therapeutic measures for patients provides a significant decrease in the intensity of clinical manifestations by 54.4% versus 40% with the use of pharmaco- and balneotherapy and 28,8% — with only drug therapy; cytolysis and cholestasis syndromes — by 46,2; 39,8 and 28.9%, respectively. Restoration of the contractile function of the gallbladder is observed in 78,8% of cases versus 65.6% when using only pharmacotherapy. The duration of hospitalization in the main group was reduced by 3 days, and in the comparison group — by 1,5 days, compared with the indicators in the control group. Conclusion. The developed new medical technology for the treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge with the combined use of mineral waters and preformed peloid preparations against the background of basic pharmacotherapy at the inpatient stage provides a significant increase in the efficiency of therapeutic measures.