EFFECTS OF BONE AUGMENTATION MATERIALS ON PECULIARITIES OF POSTOPERATIVE PERIOD IN PATIENTS AFTER IMPACTED THIRD MOLAR EXTRACTION AND THEIR CLINICAL EFFICIENCY

The article presents a comparative analysis of the clinical effectiveness of bone augmentation materials, in particular, compositions including multipotent mesenchymal stromal cells of adipose tissue and platelet-enriched plasma, used to fill bone defects during the operation of third molars extraction. The criteria for the effectiveness of treatment at the stage of the early postoperative period in the participants included the assessment of the pain intensity, collateral oedema and hyperaemia of the oral mucosa after the surgery. The aim of the study is to determine the clinical efficiency of osteoplastic materials and to determine the feasibility of using tissue equivalents of bone tissue based on multipotent mesenchymal stromal cells of adipose tissue for healing of bone defects in patients with impacted third molars. Methods and participants. The study was conducted on the basis of the Department of Surgical Dentistry and Maxillofacial Surgery of Bukovynian State Medical University, Chernivtsi, Ukraine. Extraction of impacted third molars surgery was performed on 72 patients. After the tooth extraction, 31.94% of them underwent bone augmentation by osteoplastic material “Colapan–L” (group A); 41.67% of patients had bone augmentation with a combination of multipotent mesenchymal stromal cells of adipose tissue+”Colapan–L”+platelet-rich plasma (group B), and in the rest, 26.39% of patients, wound healing occurred under a blood clot (group C). Postoperative pain syndrome was assessed using the Numerical Rating Scale (NRS) based on patients' subjective feeling of pain. Visual assessment of the severity of collateral oedema and hyperaemia of the oral mucosa after surgery was also performed. A scoring system was used to determine the severity of collateral oedema. To assess the state of the postoperative period in patients of all study groups, a protocol was completed daily during the hospital stay period that reflected the most important data of an objective and subjective nature. During the procedure of morning dressings, we analyzed patients' complaints and evaluated general and local status: presence of appetite, quality of sleep, wound pain, postoperative oedema, hematoma, and hyperaemia of the oral mucosa, presence of secretions from the wound, body temperature, and type of wound healing. The study has demonstrated that at the final stage of postoperative follow-up the 89.31% of patients who received a combination of “Colapan–L” with multipotent mesenchymal stromal cells of adipose tissue and platelet-rich plasma reported no pain that is 1.2 times p1<0.05 and 1.3 times p2<0.05 higher than in the patients of groups A and B. Collateral oedema was absent in 98.47% of the group B patients that exceeded 1.2 times p1<0.05 the number of such individuals in group A, where the bone defect was augmented with the osteoplastic material “Colapan–L”, and in 1.4 times higher, p1<0.01, p1>0.05 that the indicators of group B, where the healing of the bone defect developed without osteoplastic materials. The absence of hyperaemia of the oral mucosa was found in 92.37% of the patients in groups B, which was 1.3 and 1.4 times higher than the values obtained in groups A and B, p1<0.05, p2<0.01.

FILM-FORMING PROPERTIES OF STREPTOCOCCUS SPP. IN THE PRESENCE OF ANTISEPTICS BASED ON CATIONIC SURFACE-ACTIVE COMPOUNDS

According to the American National Institutes of Health, about 80% of bacterial infections are film-associated that impedes their treatment and prevention. Scientists emphasize that the frequent chronicity of diseases associated with film-forming pathogens, and their significant resistance to antimicrobials today poses the major health problem worldwide. The aim of this study is to determine the film-forming properties of clinical isolates of Streptococcus spp. isolated from patients having odontogenic purulent-inflammatory diseases of the soft tissues of the maxillofacial area in the presence of antiseptics decasan and chlorhexidine. Materials and methods. The clinical isolates of S. warneri (n = 3), S. sanguinis (n = 4), S. sobrinus (n = 4), S. mitis (n = 4), S. salivarius (n = 5) were the objects of the study. To identify film-forming properties of the clinical isolates, a spectrophotometric method according to G.D. Christensen was applied. The antiseptics based on cationic surfactants as Decasan 0.2 (LLC "Yuri-Pharm", Kyiv, Ukraine) and chlorhexidine bigluconate 0.05 (Chlorhexidine-KR®, PJSC "Chimpharmzavod" Red Star ", Kharkiv, Ukraine) were used. Results and discussion. The study has shown that S. sorbinus and S. sanguinis have high film-forming properties; S. mitis and S. warneri demonstrate moderate film-forming properties. The antiseptic Decasan helped to reduce the film formation by all investigated isolates of Streptococcus spp. The effect of chlorhexidine on the ability of microbial isolates to produce biofilms was slightly lower compared to Decasan; moreover, in the case of S. mitis species, chlorhexidine even enhances film-forming properties. Conclusion. Streptococci of the viridans group, which are isolated from patients having odontogenic purulent-inflammatory diseases of the soft tissues of the maxillofacial area, have different film-forming properties. Decasan is more effective against the film formation by streptococci compared to Chlorhexidine.

HISTOLOGICAL AND MORPHOMETRIC ASPECTS OF STRUCTURE OF AORTIC WALL AND ITS HEMOMICROCIRCULATORY BED IN LATE STAGES OF EXPERIMENTAL DIABETES MELLITUS

According to the World Health Organization, cardiovascular diseases and diabetes mellitus occupy a significant niche in the structure of diseases with high disability and mortality impact and pose major healthcare and social issues. It should be stressed that 50-80% of fatal cases in patients with diabetes are associated with cardiovascular diseases. The purpose of this study is to determine the histostructural characteristics and to perform morphometric analysis of the components of the aortic wall and its hemomicrocirculatory bed of the aorta in 6 and 8 weeks of streptozotocin-induced diabetes mellitus. The material for the histological study included the sections of the wall of the ascending aorta, the aortic arch, and the descending aorta taken from 26 sexually mature white male rats weighing 100 - 160 g. For morphometric examination, a series of photos of the aortic wall was taken using a Meiji MT4300 LED microscope with an x40 objective, x10 ocular. The measurements were carried out using the Image J software. The development of micro - and macroangiopathies in experimental animals with 8-week streptozotocin-induced diabetes mellitus was histologically confirmed. Statistical analysis revealed a significant difference in all morphometric parameters of the components of the aortic wall and the vessels of its hemomicrocirculatory bed after 8 weeks of experimental diabetes as compared with the normal values, control values, and in values obtained at the 6-week period of the experiment. The study has demonstrated clear dependence between the severity of destructive changes in the aortic wall and sections of its hemomicrocirculatory bed and the duration of the experiment.

EFFECT OF AMMONIUM PYRROLIDINE DITHIOCARBAMBATE ON THE FORMATION OF RACTIVE OXYGEN AND NITROGEN SPECIES IN LIVER OF RATS KEPT ON CARBOHYDRATE-LIPID DIET AND EXPOSED TO ROUND-THE-CLOCK LIGHTING

This aim of the experiment performed on 21 white rats is to clear up the effect of the nuclear factor kappa B (NF-kappa B) inhibitor on the production of reactive oxygen and nitrogen species in the liver of animals kept on carbohydrate-lipid diet and exposed to round-the-clock lighting. The study has demonstrated the administration of ammonium pyrrolidine diothiocarbamate (76 mg/kg three times a week, starting on the 30th day of the experiment) under the conditions of high-calorie carbohydrate-lipid diet (60 days) and exposure of the test animals to round-the-clock light (1500 lux for the last 30 days of the experiment) reduces the production of superoxide anion radical in the liver tissues by NADPH- and NADH-dependent electron transport chains by 45.2% and 43.5%. The production of this radical by leukocytes by NADPH oxidase was 41.6% lower than in the comparison group. The activity of NO-synthase (total and its inducible isoenzyme) decreased by 34.4 and 29.8%, the activity of the constitutive isoform increased threefold. The coupling index of the latter elevated by 5.16 times that indicates the restoration of the coupling state of this isoenzyme. The decrease in the generation of superoxide anion radical and nitric oxide was accompanied by lowering in the peroxynitrites concentration by 36.4%. We can conclude that the administration of ammonium pyrrolidine dithiocarbamate, an NF-kappa B inhibitor, during the metabolic syndrome simulated in rats by round-the-clock lightening exposure and diet rich in carbohydrates and fats is an effective means to restrict the production of reactive oxygen species.

BECOMING OF THE DEPARTMENT OF HUMAN ANATOMY AT POLTAVA STATE MEDICAL UNIVERSITY SINCE ITS FOUNDATION AND ITS MAJOR ACHIEVEMENTS

In its becoming, Poltava State Medical University has passed a thorny path from the odontology faculty, created on the basis of the Kharkov Medical Academy in 1921, to the leading specialized institution for training medical and healthcare professionals. In 2021 the university has celebrated its 100th anniversary. In 1950, the Department of Human Anatomy moved to a new location and dedicated to the training of medical professionals, research activities. The scope of scientific research conducted at the department covered issues on the structure of glands of the mucous membranes, lymphoid tissue of the initial section of the digestive system, structural peculiarities of autonomic nervous system. The department put a lot of effort to equip microscopic, histological, histochemical and photo laboratories, to create the museum of the department. Scientists developed and manufactured various devices and techniques for conducting morphological studies, which made it possible to publish numerous methodological recommendations, textbooks, and to conduct research for the candidate and doctor degrees. The anatomical museum, refurbished and modernized in 2005 and known even abroad is the subject of honour not only for the department, but for the University as well. The museum is also a matter of utmost interest to young visitors during the Open Days, students from other universities. The Department of Human Anatomy seeks to capitalize on a number of pedagogical experiences and research achievements to transfer knowledge and know-how to young generation of students and scientists.

FEATURES OF PREGNANCY AND DELIVERY IN ADOLESCENT WOMEN

Aim: to assess the risk of adverse consequences of adolescent pregnancy for mother and foetus in women from Lviv region. Material and methods. Complications of pregnancy and childbirth in adolescent women were studied retrospectively at the Lviv Regional Clinical Hospital. Results and discussion. 134 cases of adolescent childbirths for 2013 to 2017 were analyzed. The analysis of data on the course of pregnancy in adolescent women showed that the vast majority of them had complicated pregnancy and were at risk of preterm childbirth. A significant proportion of young women, 78 (58.2%), significantly more often required the therapy during pregnancy. Assessment of the health status of newborns showed that ¼ (24.6%) of young women gave birth to premature babies, and almost 1/3 of children, 51 (38.0%), from young mothers had a complicated early neonatal period. Within the spectrum of complications, the commonest diagnosis was "prematurity" in 33 (24.6%) children from young mothers. The pathological course of the early neonatal period in 51 (38.0%) children of the main group required transfer to other departments for further treatment. 82 (61.2%) children from this group were discharged home, while in the control group all 100 (100.0%) children were discharged from maternity home. Conclusions. The study has demonstrated that the risk factors for perinatal pathology in newborns from adolescent women included probably complicated pregnancy, risk of spontaneous abortion (17.9%), preterm birth (24.6%), and the childbirth of premature infants with impaired condition at birth, who needed treatment in other medical institutions (38.0%). Adolescent pregnant women are at risk for obstetric and perinatal complications.

EFFECT OF SMOKING ON ORAL HYGIENE PARAMETERS IN ADOLESCENTS AND YOUNG ADULTS

Recent studies have shown that the prevalence of dental diseases is remaining high among the population. It is known that the pathogenesis of dental diseases is strongly associated with smoking. Maintaining proper oral hygiene is an important factor in the prevention of dental diseases. Therefore, the question of studying the impact of smoking on the oral hygiene status in adolescents and young adults is quite relevant as it can promote further development of more effective preventive measures. The aim of the study is to examine the effect of smoking on the oral hygiene parameters in adolescents and young adults. Oral Hygiene Index-Simplified (Green-Vermillion, 1964) was applied to assess the oral hygiene status in 114 adolescents and young adults aged 15 to 24 years, who were divided into groups: group I included 26 people who smoked traditional cigarettes on regular basis; group II included 22 people who smoked electronic cigarettes (Vapes); group III involved 23 people who used to smoke tobacco heating devices (IQOS); group IV included 43 non-smokers. The subjects of group I were found to have an unsatisfactory oral hygiene status, their OHI-S index was equal to 1.77 ± 0.02 scores. The subjects of group II demonstrated 1, 53±0, 01 scores, and the subjects of group III – 1.46±0.02 scores that corresponds to a satisfactory level of hygiene. The subjects of group IV, whose oral hygiene status was also satisfactory, had 0.87±0.03 scores. The study has shown that the state of oral hygiene is affected by smoking of traditional cigarettes or alternative smoking devices and smoking duration. Therefore, much attention should be paid and more efforts should be applied to promote smoking cessation and to elaborate the algorithm of medical and preventive dental care for those who is still smoking.

RESULTS OF ENDOSCOPIC DIAGNOSIS OF BLEEDING AFTER ABDOMINAL SURGICAL OPERATIONS

The aim of the study is to conduct a comparative analysis of the effectiveness of endovidiosurgical diagnosis techniques to detect gastrointestinal and intra-abdominal bleeding, which may occur after abdominal operations. Materials and methods. The main group included patients (n=408), whose condition was controlled by the endovideosurgical techniques. The control group included patients (n=102) who were controlled by using conventional surgical methods to correct bleeding that may occurred after similar surgical interventions. Gastrointestinal bleeding was observed in 323 patients, and intra-abdominal bleeding was observed in 85 patients. In all cases, endoscopic haemostasis was performed by clipping (n=57), submucosal infiltration (n=32), electrocoagulation (n=29), argon-plasma coagulation (n=74), and combined techniques (n=54). Results and discussion. 408 patients with clinical signs of bleeding in the early postoperative period were examined by endoscopic techniques. Patients with alarming clinical and laboratory findings underwent ultrasound examination, which revealed the presence of free fluid in one or more parts of the abdominal cavity. Laparoscopy was performed in the first hours of the postoperative period in 17 cases (n=17); on the first day of the postoperative period (n=36), on the second day (n=19), on the third (n=8), on the fifth (n=3), and on the sixth day (n=2). Complications were excluded in 7 (16.0%) patients, despite a decrease in blood pressure and haemoglobin levels. The volume of blood found in the abdominal cavity, including clots, ranged from 30 ml to 2000 ml. Signs of ongoing bleeding (the predominance of a large amount of liquid blood with a small number of clots) were found in 49 (57.6%) cases, and signs of arrested bleeding (the presence of a large number of clots with a small amount of liquid blood) was detected in 29 (34.1%) cases. Haemostasis was provided by electrocoagulation (n=35), clipping (n=15), suturing (n=12) and tamponade from a mini-laporatomic incision (n=9). Gastrointestinal bleeding was observed in 323 patients, and intra-abdominal bleeding in 85 patients. In 8.4% (n=27) of cases, the suspicious cases of postoperative complication were excluded by endoscopic examinations. In 91.6% (n=296) of clinical cases, early postoperative bleeding or signs of unstable haemostasis with the risk of repeated bleeding were confirmed. In cases of alarming clinical and laboratory findings indicating intra-abdominal bleeding, diagnostic laparoscopy enables to exclude complications in 16.0% of patients, despite a decrease in blood pressure and haemoglobin levels.

ROLE OF STUDENTS’ RESEARCH ACTIITY IN FOSTERING PROFESSIONAL COMPETENCE AT THE DEPARTMENT OF PATHOPHYSIOLOGY OF POLTAVA STATE MEDICAL UNIVERSITY

Student research activity is one of the most important forms of the education and the driving force of quality assurance activities. Ukraine has developed a regulatory and legal framework that ensures high-quality research work, which should meet the needs of future specialists in intellectual and professional development and increase their professional competence. The involvement in research work requires, first of all, gaining deep theoretical and practical knowledge in medicine, well-designed extra-curricular activities to guide students in their mastering methodology of scientific research and developing research skills, and university promotion. The experience of Poltava State Medical University convincingly proves that the most effective means of improving the quality of training is the regular active involvement of students in research activity. The role of scientific knowledge in higher education is decisive, since the active participation of the teaching staff in fostering research skills makes it possible to demonstrate the latest scientific achievements and their practical application. Structured research activities, woven into the medical school curriculum provide an opportunity to evince the intellectual potential of both students and educators, to contribute to deeper investigation of medical problems, to master the methods of scientific investigation, and to realize the importance of such activity in increasing one's competitiveness in the labour market. This approach also contributes to better comprehension of professional information, to develop mindset associated with high professionalism. Pathophysiology as a discipline is at the junction of theoretical and clinical disciplines that serves as a wide background to meet the diversity of students’ scientific demands and interests. Involving students into structured research activities not only promotes gaining special knowledge, but also builds up ethical and deontological foundations of future successful medical research career; enhances team spirit and cooperation between students and educators. This interaction enables in clearly stating their focus and research question, engaging in an adequate critical discussion of the strengths and weaknesses of the study methods, and offering conclusions that are properly qualified in the scope given the evidence gathered and analyzed. This department is proud to maintain a high university rank on student research results performance among the non-clinical departments. The culmination of knowledge in this developmental trajectory can reinforced and extend other aspects of high quality training.

INVESTIGATION OF ANTIMICROBIAL EFFECT OF DECASAN CHLORHEXIDINE AND IODOPHORAM ON STANDARD MICROBIAL STRAINS

The problem of treatment and prevention of infectious-inflammatory post extraction complications in modern surgical dentistry are still challenging, despite the great advances in this field. Many etiological factors are identified as contributing to the development of such complications, but at present scientists are paying much attention to the infectious factor, which is associated with the microflora of the tooth socket after tooth removal. According to the literature, the most common post-extraction complication during an outpatient surgical appointment is alveolitis, which accounts for 1-35% of all cases of tooth extraction. To combat an infectious etiological factor of alveolitis, dental surgeons apply topical antiseptics with a broad spectrum of action such as iodoform and chlorhexidine. As a topical antiseptic drug in the treatment and prevention of oral infectious and inflammatory complications, a domestic antiseptic, Decasan, based on decamethoxine, is becoming more widely applied. Previous studies have shown that this antiseptic has antimicrobial effect against gram-positive and gram-negative, aerobic and anaerobic bacteria; this requires further in-depth studies of its properties, which could be applied in the dental surgical practice to treat and prevent infectious-inflammatory post extraction complications. Chlorhexidine bigluconate is a cationic biguanide. Penetrating into the intracellular membranes of bacteria, it impedes the oxygen consumption and leads to the death of bacterial cells. This antiseptic is widely used in dental practice. Treatment of alveolitis is carried out by using the standard method, namely by using iodoform tamponade of the tooth socket in combination with other medicines. Iodoform (triiodomethane) is a yellow crystalline substance with a strong characteristic odor, practically insoluble in water. In dentistry, this drug is used as an antiseptic in powder form, or combined pastes. The purpose of this in vitro study is to investigate the antimicrobial properties of Decasan, chlorhexidine and iodoform against museum microbial strains. Materials and methods. Museum strains of Staphylococcus aureus ATCC 25923, Staphylococcus epidermidis ATCC 14990, Enterococcus faecalis ATCC 29212, Esherichia coli ATCC 25922, Candida albicans ATCC 10231, obtained from L.V. Gromashevsky Institute of Epidemiology and Infectious Diseases, National Academy of Medical Sciences of Ukraine, were used as studied cultures of microorganisms. The antimicrobial effect of decasan, chlorhexidine and iodoform was assessed by quantitative method of serial dilutions in broth and agar according to the order №167, dated 5.04.2007 On approval of guidelines “Determination of sensitivity of microorganisms to antibacterial drugs". Conclusion. According to the data obtained, decasan and chlorhexidine demonstrate higher bacteriostatic and bactericidal effect on the studied museum microbial strains at a concentration thousands of times lower than the concentration of iodoform.