Diagnosis and Management of Fractured Teeth; Review Article

Traumatic damage to the teeth and oral tissues are the most common causes of tooth fracture. Because of their location in the oral cavity, front teeth in the upper jaw are the most commonly fractured. Sports, car accidents, and physical violence are the most prevalent causes. Cracked teeth are often diagnosed by visually inspecting the tooth (preferably utilizing microscopes). The size and form of the fracture plane are not always determined by looking at the crack line. One factor that contributes to the difficulty of effectively making an endodontic diagnosis is the inability to visualize the depth of the fracture through a clinical exam alone. Transillumination, microscopes and dyes are a useful tool for finding and diagnosis of the crack, treatment of the crack depends on the type, extend of the crack as well as the condition of the patient. In this review we’ll be looking at the diagnosis, etiology and management of fractured teeth.

EFFICIENCY OF THE PUBLIC URETHROSTOMIA IN CIRCULAR URETHRAL CANAL OBSTRUCTION IN CATS

Absolute indications for performing pubic urethrostomy in cats are recurrent stenosis and overgrowth of the urogenital canal fistula after its formation in the perineal region of the excretory system. Pubic urethrostomy, with the removal of the genitourinary canal outside the pelvic cavity in cats, is the best option for surgical treatment with significant traumatic damage and perforation of the genital part of the urethra and soft tissues in the perineum area.

Results of assessment of oral acid-base balance in patients with mandibular fractures combined with periodontal pathology

Aim. To estimate the condition of acid-main balance of oral cavity in patients with fracture of the mandible in combination with parodontal pathology.Material and methods. 40 patients with fractures of the mandible in combination with parodontal pathology were observed in the study. They were divided into three groups. Patients of the first group had a fracture of the mandible in combination with chronic periodontitis. Patients of the second group had fractures of the mandible and chronic gingivitis. Patients of the third group had no bone-traumatic damages and parodontal pathology.Results and discussion. The activity of the parodontal microflora of the oral cavity in patients with the bone trauma of the mandible in combination with periodontitis is higher and characterizes the quick response component of the acid-main balance regulation in the oral cavity.Conclusion. Lingual raid is the main reservoir of oral microflora and its role under existing bone-traumatic damage on the background of parodontal pathology in maintaining microbiocenosis not only increases but also becomes the factor of destabilization regenerators processes at fracture of the mandible.

THE IMPORTANCE OF EDUCATION TO REDUCE SELF-DESTRUCTIVE NAIL HABITS

Onychophagia and onychotillomania are rarely seen in clinical practice and are considered undervalued. The study aims were to determine the prevalence of onychophagia and onychotillomania habit in the patient group with hand nail damage and control group, to determine which would be the target population to educate. Patients were interviewed about self-destructive habits. Excel and SPSS were used for data analysis. In the nail damage group, 28.6% of the respondents showed self-destructive habits and past habits – 31.4%. In the control group, the result was 22.9% and 31.4%. For 74.3% of patients the cause of nail damage was skin disease (including 61.54% of respondents with nail damage who have psoriasis), for 5.7% it was age-related nail changes, for 20% traumatic damage and for 57.14% of them it was a result of self-destructive habit. In the nail damage group both – present and past self-destructive habits are higher than in the control group, but it has no statistical significance (p=0.785). 1)The prevalence of onychophagia and onychotillomania does not differ between patients and control group. 2)General education of the population is necessary to actualize this problem, which can worsen nail changes.

Hydrogen Sulfide as a Factor of Neuroprotection during the Constitutive and Reparative Neurogenesis in Fish Brain

The H2S-producing systems were studied in trout telencephalon, tectum, and cerebellum at 1 week after eye injury. The results of ELISA analysis have shown a 1.7-fold increase in the CBS expression at 1 week post-injury, as compared to the intact trout. In the ventricular and subventricular regions of trout telencephalon, CBS+ cells, as well as neuroepithelial and glial types, were detected. As a result of injury, the number of CBS+ neuroepithelial cells in the pallial and subpallial periventricular regions of the telencephalon increases. In the tectum, a traumatic damage leads to an increase in the CBS expression in radial glia with a simultaneous decrease in the number of CBS immunopositive neuroepithelial cells detected in intact animals. In the cerebellum, we revealed neuroglial interrelations, in which H2S is probably released from the astrocyte-like cells with subsequent activation of the neuronal NMDA receptors. The organization of the H2S-producing cell complexes suggests that the amount of glutamate produced in the trout cerebellum and its reuptake is controlled with the involvement of astrocyte-like cells, reducing its excitotoxicity. We believe that the increase in the number of H2S-producing cells constitutes a response to oxidative stress, and the overproduction of H2S neutralizes the reactive oxygen species.

Management of tracheo-oesophageal fistula in adults

Tracheo-oesophageal fistula (TOF) is a pathological connection between the trachea and the oesophagus that is associated with various underlying conditions including malignancies, infections, inhalation injuries and traumatic damage. As the condition spans multiple organ systems with varying aetiologies and acuities, TOF poses unique diagnostic and management challenges to pulmonologists, gastroenterologists and thoracic surgeons alike. Although stents have been a cornerstone in the management of TOF, there exists a large gap in our understanding of their efficacy and precise methodology, making stenting procedure both art and science. TOFs relating to underlying oesophageal or tracheal malignancies require advanced understanding of the airway and digestive tract anatomy, dimensions of the fistula, stent characteristics and types, and the interplay between the oesophageal stent and the airway stent if dual stenting procedure is elected. In this review article, we review the most up-to-date data on risk factors, clinical manifestations, diagnostic approaches, management methods and prognosis. Consequently, this article serves to evaluate current therapeutic strategies and the future directions in the areas of 3D-printed stents, over-the-scope clipping systems, tissue matrices and atrial septal closure devices.

Comparative Evaluation of Effectivity of the Intraperitoneal and Intramuscular Administration of Methylethyl Pyridinol Hydrochloride (Emoxypine) in Traumatic Damage of Extremity Muscles

Цель. Оценить эффективность внутрибрюшинного и внутримышечного введения метилэтилпиридинола гидрохлорида (эмоксипина) при травматических повреждениях мышц конечности. Материал и методы. Исследования проводились на 32 белых беспородных крысах. После ввода животных в эфирный наркоз разрушения поперечнополосатой мускулатуры добивались путем сдавления икроножной мышцы в средней ее трети при помощи иглодержателя. Всем животным через 1 час после травмы была выполнена фасциотомия поврежденного сегмента конечности, обезболивание, введение эмоксипина. Животные были разделены на 4 группы по 8 крыс. Первой и третьей группе эмоксипин вводился ежедневно 1 раз в сутки внутрибрюшинно, второй и четвертой группе – внутримышечно (паравульнарно в икроножную мышцу). Первая и вторая группы животных были выведены из эксперимента на 3-и сутки, третья и четвертая – на 7-е сутки. В последующем осуществлялся забор материала для исследования, готовились парафиновые блоки, выполнялись срезы с окраской гематоксилином и эозином. Оценка морфологических изменений производилась при помощи индекса морфологических изменений мышц. Результаты. При оценке выраженности клеточной инфильтрации на третьи сутки определялись статистически значимые различия у животных первой и второй группы по данному показателю (p=0,0357). Индекс морфологических изменений мышц в четвертой группе был равен 3,0 (2,5; 4,0) и значимо отличался от второй – 8,0 (6,0; 9,0) (р=0,0063). На седьмые сутки у животных третьей и четвертой групп также отмечались статистически значимые различия данного индекса (р=0,0046) в пользу внутримышечного введения. Таким образом, при внутримышечном введении эмоксипина отмечается более выраженная клеточная инфильтрация на третьи сутки и менее выраженные некротические изменения в ране на седьмые сутки, что обуславливает более быстрое течение раневого процесса. Заключение. Внутримышечное введение эмоксипина оказывает более выраженный лечебный эффект при травматических поражениях мышц конечности по сравнению с внутрибрюшинным.

Сlinical Case of Successful Lumbar Sympathectomy in the Treatment of Complex Regional Pain Syndrome

ABSTRACT. A 53-year-old male patient had extensive traumatic damage to the right lower limb in a car accident that happened 17 years ago, which subsequently led to a large amputation at the hip level. Later, adduction contracture in the right hip joint with a complex regional pain syndrome developed. Due to the ineffectiveness of various methods of conservative treatment, it was decided to perform right-sided lumbar sympathectomy. Ten days later, the patient was discharged for outpatient treatment. The result of the operation was a complete relief of pain syndrome both in the early postoperative and in the long-term periods of time. Despite the large number of types of conservative therapy in modern clinical practice, none of them is perfect. Doctors decide to operate less often, trying to minimize the intervention. However, therapeutic effects are not always possible as monotherapy, often requiring additional treatments. Due to the wide development and distribution of medical products, doctors often neglect or forget about such a method as lumbar sympathectomy. Therefore, the problem of complex regional pain syndrome remains relevant today.

Complex Restorative Treatment of Patients with Post-Traumatic Tetraparesis

Summary. Despite the rapid development of medical technologies, the problem of restoration the functions of the spinal cord remains unsolved. Objective: to improve the quality of life of patients with the consequences of traumatic damage to the spinal cord. Materials and Methods. The study is based on an analysis of the treatment results of 95 patients with the consequences of traumatic damage to the cervical segments of the spinal cord. Depending on the severity of the spinal cord injury, the patients were distributed as follows: group ASIA A – 43 patients, group B – 37 patients, and group C – 15 patients. Reconstructive surgery was performed on patients from 6 months to 2 years after the injury. Among the methods of rehabilitation treatment, chronic epidural electrical stimulation of the spinal cord (as the first stage of rehabilitation treatment) was used in all patients, neurotization of the anterior interosseous nerve (anterior interosseous nerve AIN) by the branch of the muscular cutaneous nerve – in 38 patients, transposition of the tendon of the deltoid muscle to the tendon of the triceps of the shoulder – in 8 patients. Results. The ASIA impairment scale, SCIM (Spinal cord independence measure scale) and MRC (Medical Research Council scale) were used to evaluate treatment outcomes. The results were evaluated 18 months after reconstructive surgery. In the ASIA A group, the quality of life improved in 74.4% of patients, due to an improvement of the upper extremity function. In the ASIA B group, an improvement in the quality of life was noted in 83.7% of patients, both due to improved self-care and mobility, and due to improved control of the function of the pelvic organs. In the ASIA C group, improved quality of life was mainly due to improved mobility. Conclusions. Complex restorative treatment of patients with incomplete cervical spinal cord injury allowed to improve the quality of life due to correction of segmentary and conductive violations of the spinal cord. In patients with complete spinal cord injury, only segmentary violations are suitable for correction.