Policy and strategy in the field of health protection

EXPERIENCE IN THE ORGANIZATION OF DOCTORS TRAINING IN THE SYSTEM OF CONTINUING MEDICAL EDUCATION UNDER MODERN CONDITIONS OF THE FUNCTIONING OF HEALTHCARE SYSTEM

PUMTS. 2021; 43(3-4): 5-9.
https://doi.org/10.31071/promedosvity2021.03-04.005

The experience of educational work in conditions of quarantine and lockdowns allowed in practice to study the possibilities of distance learning and to form an objective assessment of it in the structure of continuous medical education (CME) for doctors. The survey participants noted the following disadvantages of online distance learning events: the lack of an opportunity to receive information that is of interest to the listener in an in-depth format and in a specific form, because the prevailing volume of videoconferences does not allow for discussions, exchange of experience, review of clinical cases, etc. Distance learning significantly limits the possibilities of practical skills and abilities, the mastering of which is up to 75% of the study time in the format of full-time and part-time education. The positive aspects, from the point of view of distance learning participants, include: the opportunity to get points for registering a teaching staff without interrupting their main work, the ability to choose topics and the modernity of information events. However, the traditional full-time and part-time forms of education also have their drawbacks, namely, for example: to travel and live in the cities where events are held in the absence of state funding for these expenses, that is, at the expense of the doctor himself. The use of innovative educational technologies, such as distance learning and online communication, in the training of doctors cannot fully replace the classical forms of education. The optimal are the combined forms of the educational process organization, which make it possible to rationally use the resource of the participants in the educational process.

REFERENCES
  1. Postanovlenie Kabineta Ministrov Ukrainy ot 28 marta 2018 № 302 «Ob utverzhdenii Polozheniya o sisteme nepreryvnogo professional’nogo razvitiya specialistov v sfere zdravoohraneniya» [The resolution of the Cabinet of Ministers of Ukraine of March 28, 2018, № 302 «On approval of the Regulations on the system of continuous professional development of specialists in the field of health care»].
  2. Prikaz MZ Ukrainy ot 25.04.2013 № 466 «Ob utverzhdenii Polozheniya o distancionnom obuchenii» [The order of the Ministry of Health of Ukraine dated 25.04.2013 № 466 «On approval of the Regulation on distance learning»].
  3. Prikaz MZ Ukrainy ot 22 fevralya 2019 № 446 «Nekotorye voprosy nepreryvnogo professional’nogo razvitiya vrachej» [The order of the Ministry of Health of Ukraine of February 22, 2019 № 446 «Some issues of continuous professional development of doctors»].
  4. Ovcharenko, L. S., Andrienko, T.G, Samohin, I.V., Vertegel, A.A., Zhihareva, N.V., Kryazhev, A.V. (2015). Formirovanie professional’noj kompetentnosti vracha-pediatra pri obuchenii v internature [Formation of professional competence of a pediatrician during internship]. Proceedings from The Implementation of the Law of Ukraine “On Higher Education” in higher medical and pharmaceutical education of Ukraine: Vseukrainskaya uchebno-nauchnaya konferencia s mezhdunarodnym uchastiem (21-22 maya 2015) – All-Ukrainian educational and scientific conference with international participation. (pp. 459-460). Ternopol.
  5. Prikaz MZ Ukrainy ot 19.01.2021 g.. № 74, Kiev «Ob utverzhdenii Izmenenij v nekotorye prikazy Ministerstva zdravoohraneniya Ukrainy» [The order of the Ministry of Health of Ukraine from 19.01.2021 № 74 «About the statement of Changes to some orders of the Ministry of Health of Ukraine»].
  6. Ovcharenko, L.S., Andrienko, T.G, Samohin, I.V., Vertegel, A.A., Zhihareva, N.V., Kryazhev, A.V. Praktika prepodavaniya voprosov okazaniya neotlozhnoj pomoshchi v pediatrii v usloviyah postoyanno dejstvuyushchego seminara [The practice of teaching emergency care in pediatrics in a permanent seminar]. Proceedings from The Implementation of the Law of Ukraine “On Higher Education” in higher medical and pharmaceutical education of Ukraine: Vseukrainskaya uchebno-nauchnaya konferencia s mezhdunarodnym uchastiem (21-22 maya 2015) – All-Ukrainian educational and scientific conference with international participation. (pp. 458-459). Ternopol.
  • Medical education

    THE IMPORTANCE OF THE INTERDISCIPLINARY APPROACH IN THE STUDY OF PEDIATRIC SURGICAL DENTISTRY

    PUMTS. 2021; 43(3-4): 27-32.
    https://doi.org/10.31071/promedosvity2021.03-04.027

    The aim of our work was to highlight the importance of an interdisciplinary approach in the study of pediatric surgical dentistry.
    The introduction of the Standard of Higher Education in Specialty 221 “Dentistry” Field of Knowledge 22 “Health Care” for the second (master’s) level of higher education has allowed us to revise and improve a number of provisions regarding the study of pediatric surgical dentistry. First of all, the updated educational-professional program 221- “Dentistry” outlines the list of competencies and learning outcomes in the discipline “Pediatric Surgical Dentistry” and clearly defines the prerequisites on which the study of pediatric surgical dentistry is based. In the study of pediatric surgical dentistry, namely issues related to inflammatory processes of the maxillofacial area, attention should be paid to the etiology and pathogenesis of acute and chronic inflammatory odontogenic processes directly in the age aspect. At the same time, it is important to emphasize the need for preventive dental measures, timely therapeutic intervention, especially during the eruption of permanent teeth and urgent radical treatment to prevent complications. In addition, an important component in the study of this topic are issues related to the age of the formation of organs and systems of the child, the tendency to hyperergic reactions and generalization of the inflammatory process, the factor of minimal anti-inflammatory potential. The presented methodological approach in terms of practical application of interdisciplinary links in the study of pediatric surgical dentistry, according to our observations allowed to increase the level of knowledge within the professional competence of students with a score of “5” from 20% in IV year to 68% V year. Thus, the list of components of the educational process analyzed in this paper creates a promising direction for further improvement of teaching methods at the Department of Pediatric Surgical Dentistry.

    REFERENCES
    1. Tkachenko, P. I., Bilokon, S. O., Lokhmatova, N. M., Dolenko, O. B., Popelo, Yu. V., Korotych, N. M. (2021). Osoblyvosti antenatalʹnoho i postnatalʹnoho periodiv rozvytku ditey z zapalʹnymy protsesamy shchelepno-lytsevoyi lokalizatsiyi [Features of antenatal and postnatal periods of development of children with inflammatory processes of maxillofacial localization]. Svit medytsyny ta biolohiyi – The World of Medicine And Biology, 1(75), 162–167. [in Ukrainian].
    2. Zakon Ukrayiny vid 16.01.2020 r. № 1556-VII. «Pro vyshchu osvitu» [Law of Ukraine of 16.01.2020 № 1556-VII. “About higher education”]. (2014). Vidomosti Verkhovnoyi Rady – Journal of the Verkhovna Rada of Ukraine. 2014, 37‒38. Retrieved from: http://zakon3.rada.gov.ua/laws/show/1556-18. [in Ukrainian].
    3. Zakon Ukrayiny vid 18.12.2019 «Pro vnesennya zmin do deyakykh zakoniv Ukrayiny shchodo vdoskonalennya osvitnʹoyi diyalʹnosti u sferi vyshchoyi osvity» [Law of Ukraine of December 18, 2019 “On Amendments to Certain Laws of Ukraine on Improving Educational Activities in the Sphere of Higher Education”]. (2019). ULR: https://zakon.rada.gov.ua/ laws/show/392-20 [in Ukrainian].
    4. Ilenko N.M., Boychenko O.M. (2018). Mizhdystsyplinarni zvyazky yak faktor vdoskonalennya vyvchennya predmetu terapevtychna stomatolohiya pry pidhotovtsi maybutnʹoho likarya [Interdisciplinary connections as a factor in improving the study of the subject of therapeutic dentistry in the preparation of future doctors]. Visnyk problem biolohiyi i medytsyny – Bulletin of Problems of Biology and Medicine, 2(147), 223-225. [in Ukrainian].
    5. Kasʹkova L. Novikova S. Anopriyeva N. (2018). Navchalna motyvatsiya studentiv v formuvanni profesiynoyi kompetentnosti z dytyachoyi stomatolohiyi Visnyk problem biolohiyi i medytsyny – Bulletin of Problems of Biology and Medicine, 1(1), 231-234. [in Ukrainian].
    6. Tkachenko, P. I., Bilokon, S. O., Lokhmatova, N. M., Dolenko, O. B., Popelo, Yu. V., Korotych, N. M. (2021). Dosvid vykladannya vybirkovoyi dystsypliny «Suchasni pryntsypy diahnostyky ta likuvannya dyzontohenetychnoyi patolohiyi shchelepno-lytsevoyi dilyanky» [Experience of teaching the selective discipline “Modern principles of diagnosis and treatment of dysontogenetic pathology of the maxillofacial area”]. Problemy bezperervnoyi medychnoyi osvity ta nauky – Problems of Uninterrupted Medical Training and Science, 1(41), 17–21. [in Ukrainian].
    7. Tkachenko, P. І., Bilokon, S. О., Popelo, Yu. V., Korotych, N. M., Lokhmatova, N. M., Dolenko, О. B. (2020). Premorbidnyy fon pry hostrykh zapalʹnykh protsesakh shchelepno-lytsevoyi dilyanky v ditey [Premorbid background in acute inflammatory processes of the maxillofacial area in children]. Ukrayinsʹkyy stomatolohichnyy alʹmanakh – Ukrainian Dental Almanac , 3, 15–20
  • Up-to-date problems in medicine

    MORPHOLOGICAL FEATURES AND CRITERIA OF PROGNOSIS FOR STROMAL COMPONENT OF COLORECTAL CANCER IIA-IIIB STAGES

    PUMTS. 2021; 43(3-4): 74-78.
    https://doi.org/10.31071/promedosvity2021.03-04.074

    Colorectal cancer (CRC) is the second leading cause of mortality among cancers after tumors of the respiratory system. One of the most significant prognostic criteria of CRC are the features of stromal component, which are not implemented in clinical practice. The aim was to study the main morphological features of the stroma of CRC T3N0-2M0 and to search for prognostic criteria of their recurrence and death. Group I included primary CRC without recurrences. Group II – primary CRC with recurrences; IIA – with recurrences that did not lead to death; ІІВ – with recurrences and fatal outcome from generalization of tumor process during 5 years from lethal outcome from the moment when the tumor was removed. The microslides of CRC were made by using the standard methods with G + E staining; immunohistochemical (IHC) reaction was performed by using monoclonal antibodies to smooth muscle actin alpha and vimentin. CRC with a stromal-parenchymal ratio (SPR)>50% were in 43.3% (26/60) of cases. SPR>50% is a prognostic criterion for recurrence (p<0.05), shorter disease free survival (p<0.001) and metastasis to regional lymph nodes (p<0.001). Immature stroma type of CRC IIA-IIIB stages is associated with the presence of tumor budding (p<0.001), G3 differentiation (p<0.01), shorter disease-free survival (p<0.001), metastatic activity (p<0.05); among recurrent CRC, the immature type of stroma is associated with the death of patients (p<0.05). A diffuse presence of tumor-activated fibroblasts is one of the criteria for immature CRC stroma (p<0.003), however, as an independent prognostic feature, it has limited prognostic value. SPR>50% and immature type of stroma are prognostic features for recurrence, metastasis and term of recurrence for CRC pT3N0-2M0; the presence of an immature type of stroma was associated with patient death.

    REFERENCES
    1. Fedorenko, Z., Michailovich, Yu., Goulak, L., Gorokh, Ye., Ryzhov, A., Soumkina O., et al. (2020). Rak v Ukraini, 2018-2019. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby [Cancer in Ukraine, 2018-2019. Incidence, mortality, prevalence and other relevant statistics]. Biuleten natsionalnoho kantser-reiestru Ukrainy – Bulletin of the National Cancer Registry of Ukraine, 21, 101 p. Retrieved from http://www.ncru.inf.ua/publications/BULL_21/index.htm [in Urainian]
    2. Ryuk, J. P., Choi, G. S., Park, J. S., Kim, H. J., Park, S. Y., Yoon, G. S., et al. (2014). Predictive factors and the prognosis of recurrence of colorectal cancer within 2 years after curative resection. Annals of surgical treatment and research, 86(3), 143–151. https://doi.org/10.4174/astr.2014.86.3.143
    3. Poornakala, S., Prema, N. S. (2019). A study of morphological prognostic factors in colorectal cancer and survival analysis. Indian journal of pathology & microbiology, 62(1), 36–42. https://doi.org/10.4103/IJPM.IJPM_91_18
    4. Conklin, M. W., Keely, P. J. (2012). Why the stroma matters in breast cancer: insights into breast cancer patient outcomes through the examination of stromal biomarkers. Cell adhesion & migration, 6(3), 249–260. https://doi.org/10.4161/cam.20567
    5. Shimosato, Y., Suzuki, A., Hashimoto, T., Nishiwaki, Y., Kodama, T., Yoneyama, T., et al. (1980). Prognostic implications of fibrotic focus (scar) in small peripheral lung cancers. The American journal of surgical pathology, 4(4), 365–373. https://doi.org/10.1097/00000478-198008000-00005
    6. Martin, M., Pujuguet, P., Martin, F. (1996). Role of stromal myofibroblasts infiltrating colon cancer in tumor invasion. Pathology, research and practice, 192(7), 712–717. https://doi.org/10.1016/S0344-0338(96)80093-8.
    7. Mao, Y., Keller, E. T., Garfield, D. H., Shen, K., Wang, J. (2013). Stromal cells in tumor microenvironment and breast cancer. Cancer metastasis reviews, 32(1-2), 303–315. https://doi.org/10.1007/s10555-012-9415-3
    8. Eriksen, A. C., Sørensen, F. B., Lindebjerg, J., Hager, H., dePont Christensen, R., Kjær-Frifeldt, et al. (2018). The prognostic value of tumour stroma ratio and tumour budding in stage II colon cancer. A nationwide population-based study. International journal of colorectal disease, 33(8), 1115–1124. https://doi.org/10.1007/s00384-018-3076-9
    9. Lugli, A., Kirsch, R., Ajioka, Y., Bosman, F., Cathomas, G., Dawson, H., et al. (2017). Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 30(9), 1299–1311. https://doi.org/10.1038/modpathol.2017.46
  • Dicsussions

    PROBLEM ASPECTS OF COMPILING AND OBTAINING INFORMED VOLUNTARY CONSENT FOR ORTHODONTIC TREATMENT

    PUMTS. 2021; 42(2): 55-59.
    https://doi.org/10.31071/promedosvity2021.02.055

    Today, it should be recognized that the legislation of the Ministry of Health of Ukraine on obtaining informed voluntary consent of the patient to medical intervention, in the vast majority relate to general medical and dental practice. The use of orthodontic methods of treatment of dental pathology, especially in combination with modern surgical techniques, requires medical records to reflect specific issues: what information, to what extent it is necessary to inform the patient before orthodontic treatment. Insufficient disclosure leads to problems in the patient’s coordination of the plan, timing of treatment and understanding of possible complications, which can lead to aggravation of the doctor-patient relationship. The article analyzes more than 100 results of the completion of orthodontic interventions for the period of 2018–2020 years of practical activity, which revealed exciting questions from patients and made it possible to compile a generalized list of reasons for the occurrence of possible conflict situations. In the course of treatment, they were successfully eliminated and analyzed, which made it possible to establish the priority components of the practically useful volume of information in the text of the patient’s voluntary consent with the peculiarity of performing orthodontic work. Taking into account these aspects, the doctor gets the opportunity to provide specific argumentation and defense of his actions, prevention of professional misunderstandings and legal issues in dental practice.

    REFERENCES
    1. Babich, O., Krasnik, S., Yudin, O., & Nadutiy, K. et al. (2019). Profesiyni ta pravovi aspekti diyalnosti likarya-stomatologa [Professional and legal aspects of the dentist’s activity]. Stomatologichne zdorovya — integralna skladova zdorovya natsiyi. Zdorovya Ukrayini 21 storichchya — Proceedings of the 5th National Ukrainian Dental
      Congress Dental health — an integral component of the nation’s health. Health of Ukraine of the 21st century. 22(467), 21–22.

    2. Nakaz MOZ Ukrayini “Informovana dobrovilna zgoda patsienta na provedennya diagnostiki, likuvannya ta na provedennya operatsiyi ta znebolennya” № 110 of 14.02.2012 [Decree of the Ministry of Health of Ukraine «Informed voluntary consent of the patient for diagnosis, treatment and surgery and analgesia» № 110 of 14.02.2012]. (2012). Kyiv. URL: https://zakon.rada.gov.ua.
    3. Nakaz MOZ Ukrayini “Pro vnesennya zmin do formi pervinnoyi oblikovoyi dokumentatsiyi № 003-6/o ta instruktsiyi schodo yiyi zapovnennya” № 2837 09.12.2020 [Decree of the Ministry of Health of Ukraine «On amendments to the form of primary accounting documentation № 003-6/о and Instructions for its completion» № 2837 of 09.12.2020]. (2020). Kyiv. URL: https://search.ligazakon.ua.
    4. Protokoli nadannya medichnoyi dopomogi za spetsialnostyami “Ortopedichna stomatologiya”, “Terapevtichna stomatologiya”, “Hirurgichna stomatologiya”, “Ortodontiya”, “Dityacha terapevtichna stomatologiya”, “Dityacha hirurgichna stomatologiya”: normativne virobnicho-praktichne vidannya [Protocols of medical care in the specialties «Orthopedic Dentistry», «Therapeutic Dentistry», «Surgical Dentistry», «Orthodontics», «Pediatric Therapeutic Dentistry», «Pediatric Surgical Dentistry»: normative production-practical edition]. (2014). Kyiv : Medinform.
  • Scientific reviews and clinical lectures

    MODERN ASPECTS OF INTERNAL CANAL DISINFECTION IN TREATMENT OF COMPLICATED FORMS OF CARIES

    PUMTS. 2021; 43(3-4): 79-82.
    https://doi.org/10.31071/promedosvity2021.03-04.079

    The widespread prevalence of pulp and periodontal diseases indicates the need for continuous improvement of the method of endodontic treatment and determines the relevance of the development of new methods of complex therapy. The primary etiologic agents of apical periodontitis are microorganisms and their by-products that have invaded the pulpal space and established multispecies biofilm communities in the root canal system. Biofilms are involved in all stages of root canal infection and can be found on root canal walls, in dentinal tubules, and on extraradicular surfaces. The success of endodontic dental treatment is determined by careful mechanical processing using modern instruments, drug treatment and subsequent three-dimensional hermetic obturation of the root canal. Only a high-quality and optimal solution to the three problems allows you to achieve high-quality long-term results of treatment. Instrumentation disrupts biofilms which colonize infected soft and hard tissues and provides access for irrigation and exposure to antimicrobial solutions for disinfection of the root canal system. Disinfection is achieved by the use of both antimicrobial agents and the mechanical flushing action of irrigation, with the goal being the disruption, displacement and removal of pulpal remnants, microorganisms, metabolic byproducts, debris and the smear layer created during instrumentation. The multistage, duration and laboriousness of drug treatment of root canals makes it not always effective, which can subsequently cause unsuccessful endodontic treatment. A practicing dentist should be able to rationally and efficiently utilize standard disinfection protocols in the irrigation and medication of root canal spaces.

    REFERENCES
    1. Chenicheri, S. R. U., Ramachandran, R., Thomas, V., Wood, A. (2017). Insight into Oral Biofilm: Primary, Secondary and Residual Caries and Phyto-Challenged Solutions. The Open Dentistry Journal, 11, 312-333. https://doi.org/10.2174/1874210601711010312
    2. Neelakantan, P., Romero, M., Vera, J., Daood, U., Khan, A. U., Yan, A., et al. (2017). Biofilms in Endodontics-Current Status and Future Directions. International Journal Of Molecular Sciences, 18(8), 1748. https://doi.org/10.3390/ijms18081748
    3. Flemming, H. C., Wingender, J., Szewzyk, U., Steinberg, P., Rice, S. A., Kjelleberg, S. (2016). Biofilms: an emergent form of bacterial life. Nature reviews. Microbiology, 14 (9), 563-575. https://doi.org/10.1038/nrmicro.2016.94
    4. Larinskaya, A., Yurkevich, A., Mikhalchenko, V., Mikhalchenko, A. (2017). Modern aspects of intracanal disinfection in the treatment of complicated forms of caries. Clinical Dentistry, 3, 13-16.
    5. De Gregorio, C., Arias, A., Navarrete, N., Del Rio, V., Oltra, E., Cohenca, N. (2013). Effect of apical size and taper on volume of irrigant delivered at working length with apical negative pressure at different root curvatures. J Endod, 39(1), 119-124. https://doi.org/10.1016/j.joen.2012.10.008
    6. Kazeko, L. A., Fedorova, I. N. (2009). Metody dezinfektsii kornevykh kanalov zubov : ucheb.-metod. posobiye [Methods of disinfection of root canals of teeth: study guide]. Minsk: BGMU. [in Russian].
    7. Fedorowicz, Z., Nasser, M., Sequeira-Byron, P., de Souza, R.F., Carter, B., Heft, M. (2012). Irrigants for non-surgical root canal treatment in mature permanent teeth. Cochrane Database Syst Rev, 9, CD008948. https://doi.org/10.1002/14651858.CD008948.pub2
    8. Boutsioukis, C., Gogos, C., Verhaagen, B., Versluis, M., Kastrinakis, E., Van der Sluis, L.W. (2010). The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady Computational Fluid Dynamics model. Int Endod J., 43(10), 874-881. https://doi.org/10.1111/j.1365-2591.2010.01761.x
    9. Yared, G., Al Asmar Ramli, G. (2020). Antibacterial Ability of Sodium Hypochlorite Heated in the Canals of Infected Teeth: An Ex Vivo Study. Cureus, 12(2), 6975. https://doi.org/10.7759/cureus.6975
    10. Mohammadi, Z., Jafarzadeh, H., Shalavi, S., Palazzi, F. (2017). Recent Advances in Root Canal Disinfection: A Review. Iranian Endodontic Journal, 12 (4), 402-406. https://doi.org/10.22037/iej.v12i4.17935
    11. Mortenson, D., Sadilek, M., Flake, N.M., Paranjpe, A., Heling, I., Johnson, J. D. et al. (2012). The effect of using an alternative irrigant between sodium hypochlorite and chlorhexidine to prevent the formation of para-chloroaniline within the root canal system. International Endodontic Journal, 36, 312-314.
    12. Prada, I., Micó-Muñoz, P., Giner-Lluesma, T., Micó-Martínez, P., Muwaquet-Rodríguez, S., Albero-Monteagudo, A. (2019). Update of the therapeutic planning of irrigation and intracanal medication in root canal treatment. A literature review. Journal Of Clinical And Experimental Dentistry, 11 (2), 185-193. https://doi.org/10.4317/jced.55560
    13. Berber, V. B., Gomes, B. P., Sena, N. T., Vianna, M. E., Ferraz, C. C., Zaia, A. A., et al. (2006). Efficacy of various concentrations of NaOCl and instrumentation techniques in reducing Enterococcus faecalis within root canals and dentinal tubules. International Endodontic Journal, 39 (1), 10–17. https://doi.org/10.1111/j.1365-2591.2005.01038.x
    14. Biryukova, M.M., Sokolova, I.I., Khudyakova, M.B. (2016). Dezinfektsiya korenevykh kanaliv: metody ta zasoby: navch.-metod. Posibnyk [Disinfection of root canals: methods and methods: textbook]. Kharkiv: KHNMU. [in Ukrainian]
    15. Fiorillo, L. (2019). Chlorhexidine Gel Use in the Oral District: A Systematic Review. Gels (Basel, Switzerland), 5(2), 31. https://doi.org/10.3390/gels5020031
    16. Göstemeyer, G., Schulze, F., Paris, S., Schwendicke, F. (2017). Arrest of Root Carious Lesions via Sodium Fluoride, Chlorhexidine and Silver Diamine Fluoride In Vitro. Materials (Basel, Switzerland), 11(1), 9. https://doi.org/10.3390/ma11010009
    17. De Vasconcelos, B. C., Luna-Cruz, S. M., De-Deus, G., de Moraes, I. G., Maniglia-Ferreira, C., Gurgel-Filho, E. D. (2007). Cleaning ability of chlorhexidine gel and sodium hypochlorite associated or not with EDTA as root canal irrigants: a scanning electron microscopy study. Journal of Applied Oral Science: revista FOB, 15(5), 387-391. https://doi.org/10.1590/s1678-77572007000500003
    18. Petrushanko, T.O., Kotelevsʹka, N.V., Lytovchenko, I.Yu., Nikolishyn, A.K., Petrushanko, T.A., Kotelevskaya, N.V. (2014). Zastosuvannya vakuum-terapiyi v kompleksnomu likuvanni periodontytiv ta heneralizovanoho parodontytu [Stagnation of vacuum therapy in complex treatment of periodontitis and generalized periodontitis]. Svit medytsyny ta biolohiyi – Society of Medicine and Biology, 3 (45), 83–87 [in Ukrainian]
    19. Huffaker, S.K., Safavi, K., Spangberg, L.S., Kaufman, B. (2010). Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study. J Endod, 36(8), 1315-1318. https://doi.org/10.1016/j.joen.2010.04.024
    20. Mitchell, R.P., Yang, S.E., Baumgartner, J. C. (2010). Comparison of apical extrusion of NaOCl using the EndoVac or needle irrigation of root canals. J Endod, 36(2), 338-341. https://doi.org/10.1016/j.joen.2009.10.003
    21. Borysenko, A. V., Kodlubovsʹkyy, Yu. Yu. (2010). Metody likuvannya periodontytiv (ohlyad literatury) [Method of treatment of periodontitis (review of literature)]. Sovremennaya stomatolohyya – Modern Dentistry, 1, 15-20. [in Ukrainian]
    22. Skripnikova, T. P., Prosandeyeva, G. F., Skripnikov, P. N. (1999). Klinicheskaya endodontiya. Fizicheskiye faktory, primenyayemyye v endodontii: Posobiye dlya vracheystomatologov [Clinical endodontics. Physical Factors Applied in Endodontics: A Manual for Dentists]. Poltava: Legat. [in Ukrainian]
    23. Batih, V. M., Ivanitsʹka, O. V., Borysenko, A. V., Lynovytsʹka, O. V. (2017). Efektyvnistʹ likuvannya khronichnoho periodontytu z vykorystannyam depoforezu [Efficiency of treatment of chronic periodontitis with viciousness of depophoresis]. Bukovynsʹkyy medychnyy visnyk – Bukovynian Medical Bulletin. Vol. 21, 1, 16-20. [in Ukrainian]
    24. Pourhajibagher, M., Chiniforush, N., Shahabi, S., Palizvani, M., Bahador, A. (2018). Antibacterial and Antibiofilm Efficacy of Antimicrobial Photodynamic Therapy Against Intracanal Enterococcus faecalis: An In Vitro Comparative Study with Traditional Endodontic Irrigation Solutions. Journal of dentistry (Tehran, Iran), 15(4), 197-204.
    25. Tennert, C., Feldmann, K., Haamann, E., Al-Ahmad, A., Follo, M., Wrbas, K. T., Hellwig, E., Altenburger, M. J. (2014). Effect of photodynamic therapy (PDT) on Enterococcus faecalis biofilm in experimental primary and secondary endodontic infections. BMC oral health, 14, 132. https://doi.org/10.1186/1472-6831-14-132
    26. Chiniforush, N., Pourhajibagher, M., Shahabi, S., Kosarieh, E., Bahador, A. (2016). Can Antimicrobial Photodynamic Therapy (aPDT) Enhance the Endodontic Treatment? J Lasers Med Sci, 7(2), 76-85. https://doi.org/10.15171/jlms.2016.
    27. Cohenca, N., Paranjpe, A., Heilborn, C., Johnson, J.D. (2013). Antimicrobial efficacy of two irrigation techniques in tapered and non-tapered canal preparations. A randomized controlled clinical trial. Quintessence Int, 44(3), 217-228. https://doi.org/10.3290/j.qi.a29055
  • To help the practicing physician

    FEATURES OF DIAGNOSIS AND TREATMENT OF A PATIENT WITH FUNCTIONAL DYSPEPSIA ON THE EXAMPLE OF CLINICAL CASE

    PUMTS. 2021; 42(2): 60-63.
    https://doi.org/10.31071/promedosvity2021.02.060

    Today, the diagnosis of functional dyspepsia is quite common and is very common in the practice of a physician, family doctor and gastroenterologist. Functional dyspepsia is the presence of symptoms in the gastroduodenal area without the presence of organic, systemic or metabolic disorders. This condition is defined as a feeling of discomfort and pain in the epigastric region in the absence of symptoms of reflux. Symptoms of dyspepsia are found in many patients, but not all of them seek medical attention. To date, the issues of etiology and pathogenesis remain unexplored. But much of the role is given to genetic factors, the polymorphism of some genes. Lifestyle, eating fatty, fried, spicy foods, smoking, drinking alcohol, infections, and psychogenic factors are also likely to be important. These factors include the characteristics of the patient’s character, the presence of chronic stress, psychological states accompanied by depression, anxi-ety and others. Patients with functional dyspepsia have the following complaints: epigastric pain, early satiety, burning in the epigastrium, postprandial overflow. But keep in mind that this diagnosis is an exclusion diagnosis. That is, it is necessary to make sure that the patient has no symptoms of anxiety (progressive dysphagia, unmotivated weight loss, anemia, fever, etc.), that the patient does not take nonsteroidal anti-inflammatory drugs, no Helicobacter pylori infection, endoscopy, which revealed no abnormalities. Patients with prolonged symptoms should be excluded from the psychological connection with the disease or the possible presence of food intolerance.

    REFERENCES
    1. Ralston, S. H., Penman, I. D., Strachan, M. W., & Hobson, R. (Eds.). (2018). Davidson’s Principles and Practice of Medicine E-Book. Elsevier Health Sciences.
    2. Sharma, A., Schauer, D. P., Kelleher, M., Kinnear, B., Sall, D., & Warm, E. (2019). USMLE Step 2 CK: best predictor of multimodal performance in an internal medicine residency. Journal of graduate medical education, 11(4), 412.
    3. Beeckmans, D., Farré, R., Riethorst, D., Keita, A. V., Augustijns, P., & Söderholm, J. D., et al. (2020). Relationship between bile salts, bacterial translocation, and duodenal mucosal integrity in functional dyspepsia. Neurogastroenterology & Motility, 32(5), e13788.
    4. Vanheel, H., Carbone, F., Valvekens, L., Simren, M., Tornblom, H., & Vanuytsel, T., et al. (2017). Pathophysiological abnormalities in functional dyspepsia subgroups
      according to the Rome III criteria. American Journal of Gastroenterology, 112(1), 132–140.

    5. Masuy, I., Van Oudenhove, L., & Tack, J. (2019). treatment options for functional dyspepsia. Alimentary pharmacology & therapeutics, 49(9), 1134–1172.
    6. Wauters, L., Talley, N. J., Walker, M. M., Tack, J., & Vanuytsel, T. (2020). Novel concepts in the pathophysiology and treatment of functional dyspepsia. Gut, 69(3), 591–600.
    7. Fallone, C. A., Chiba, N., van Zanten, S. V., Fischbach, L., Gisbert, J. P., & Hunt, R. H., et al. (2016). The Toronto consensus for the treatment of Helicobacter pylori infection in adults. Gastroenterology, 151(1), 51–69.
    8. Vanheel, H., Carbone, F., Valvekens, L., Simren, M., Tornblom, H., & Vanuytsel, T., et al. (2017). Pathophysiological abnormalities in functional dyspepsia subgroups according to the Rome III criteria. American Journal of Gastroenterology, 112(1), 132–140.
    9. Nakagawa, K., Hara, K., Fikree, A., Siddiqi, S., Woodland, P., & Masamune, A., et al. (2020). Patients with dyspepsia have impaired mucosal integrity both in the duodenum and jejunum: in vivo assessment of small bowel mucosal integrity using baseline impedance. Journal of gastroenterology, 55(3), 273–280.
    10. Stanghellini, V., Chan, F. K., Hasler, W. L., Malagelada, J. R., Suzuki, H., Tack, J., & Talley, N. J. (2016). Gastroduodenal disorders. Gastroenterology, 150(6), 1380–1392.
  • Tribune of young scientist

    PREDICTIVE VALUE OF ATRIAL FIBRILLATION CATHETER ABLATION ON COGNITIVE FUNCTIONS IN PATIENTS WITH CHRONIC HEART FAILURE

    PUMTS. 2021; 42(2): 75-81.
    https://doi.org/10.31071/promedosvity2021.02.075

    Atrial fibrillation (AF) directly leads to a cognitive function decline regardless of the cerebrovascular fatal events, but it is unclear whether the sinus rhythm restoration and reducing the AF burden can reduce the rate of this decreasement. Data on the effect of radiofrequency ablation on patients’ cognitive functions are conflicting and need to be studied. The aim of the study was to evaluate the prognostic value of atrial fibrillation radiofrequency catheter ablation on cognitive functions in patients with chronic heart failure with preserved left ventricular ejection fraction. The impact of AF radiofrequency catheter ablation on cognitive function in 136 patients (mean age 59.7 ± 8.6 years) with chronic heart failure with preserved left ventricular ejection fraction and compared with 58 patients in the control group (58.2 ± 8.1 years), which did not perform ablation and continued the tactics of drug antiarrhythmic therapy was investigated. Cognitive function was assessed using the Montreal Cognitive Test (MoCA) at the enrollment stage and 2 years follow-up. Decreased cognitive function was defined as a MoCA test score < 26 points, cognitive impairment < 23 points. Two years after the intervention, there was a positive dynamics (baseline MoCA test — 25,1 ± 2,48, 2-year follow-up — 26,51 ± 2,33, p < 0,001) in the ablation group and negative in the control group (25,47 ± 2,85 and 24,57 ± 3,61, respectively, p < 0,001). Pre-ablation cognitive impairment was significantly associated with improved cognitive function 2 years after AF ablation according to polynomial regression analysis. The obtained data suggest a probable positive effect of AF radiofrequency ablation on cognitive functions in patients with preserved left ventricular ejection fraction.

    REFERENCES
    1. Jin, M., Kim, T., Kang, K., Yu, H., Uhm, J., Joung, B., et al. (2019). Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function. Circulation: Arrhythmia And Electrophysiology, 12(7). https://doi.org/10.1161/circep.119.007197.
    2. Medi, C., Evered, L., Silbert, B., Teh, A., Halloran, K., & Morton, J., et al. (2013). Subtle Post-Procedural Cognitive Dysfunction After Atrial Fibrillation Ablation. Journal Of The American College Of Cardiology, 62(6), 531–539. https://doi.org/10.1016/j.jacc.2013.03.073.
    3. Graves, K. G., May, H. T., Jacobs, V., Bair, T. L., Stevens, S. M., Woller, S. C., Crandall, B. G., Cutler, M. J., Day, J. D., Mallender, C., Osborn, J. S., Peter Weiss, J., & Jared Bunch, T. (2017). Atrial fibrillation incrementally increases dementia risk across all CHADS2 and CHA2DS2VASc strata in patients receiving long-term warfarin. American heart journal, 188, 93–98. https://doi.org/10.1016/j.ahj.2017.02.026.
    4. Junejo, R. T., Lip, G., Fisher, J. P. (2020). Cerebrovascular Dysfunction in Atrial Fibrillation. Frontiers in physiology, 11, 1066. https://doi.org/10.3389/fphys.2020.01066.
    5. Gardarsdottir, M., Sigurdsson, S., Aspelund, T., Rokita, H., Launer, L. J., Gudnason, V., et al. (2018). Atrial fibrillation is associated with decreased total cerebral blood flow and brain perfusion. Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 20(8), 1252–1258. https://doi.org/10.1093/europace/eux220.
    6. Smith, E. E., Schneider, J. A., Wardlaw, J. M., Greenberg, S. M. (2012). Cerebral microinfarcts: the invisible lesions. The Lancet. Neurology, 11(3), 272–282. https://doi.org/10.1016/S1474-4422(11)70307-6.
    7. Conen, D., Rodondi, N., Müller, A., Beer, J. H., Ammann, P., Moschovitis, G., et al. (2019). Relationships of Overt and Silent Brain Lesions With Cognitive Function in Patients With Atrial Fibrillation. Journal of the American College of Cardiology, 73(9), 989–999. https://doi.org/10.1016/j.jacc.2018.12.039.
    8. Frey, A., Sell, R., Homola, G. A., Malsch, C., Kraft, P., Gunreben, I., et al. (2018). Cognitive Deficits and Related Brain Lesions in Patients With Chronic Heart Failure. JACC. Heart failure, 6(7), 583–592. https://doi.org/10.1016/j.jchf.2018.03.010.
    9. Adamski, M. G., Sternak, M., Mohaissen, T., Kaczor, D., Wierońska, J. M., Malinowska, M., et al. (2018). Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice. Journal of the American Heart Association, 7(7), e007694. https://doi.org/10.1161/JAHA.117.007694.
  • Anniversaries

    HISTORY OF ORTHOPEDIC DENTISTRY DEPARTMENT – 1 KHARKIV MEDICAL ACADEMY OF POSTGRADUATE EDUCATION

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    The article is devoted to the history of the formation and development of the Department of Orthopedic Dentistry 1 Kharkiv Medical Academy of Postgraduate Education. The department was officially established in 1930 as the department of odontologists at the All-Ukrainian Institute for Advanced Medical Studies. Since 1931, the department became known as the dental department and dentists began to improve their qualifications in the department. In September 1941, the department ceased its work. In 1958, the department resumes work. Since 1959, the Ukrainian Institute of Advanced Medical Studies at the Department of Dentistry created an assistant professor specialization course for orthopedic and orthodontic doctors. In 1965 for the first time in the history of the institute, a separate department was created for the teaching of orthopedic dentistry, headed by M.A. Napadov.
    The staff of the department under the guidance of prof. M.A. Napadov Developed the main domestic structural and auxiliary dental materials.
    From 1992 to 1995 – he was in charge of the candidate sciences A.P. Golubnichy. From 1995 the department is headed by a doctor of medical sciences, professor Grizodub V.I.
    Is head of the department of Professor V.I. Grizodub: 12 candidate dissertations were defended and approved by Candidate of Medical Sciences (I. Dnistransky, I. Isakov, L. Ivanishchenko, K.V. Zhukov, A.A. Chelyapina, Badalov R.M., D.V. Gryzodub, E. V. Gryzodub, S. Gordienko and 2 Author of foreign citizens).