bluuebunny/crossref_metadata_2025 huggingface dataset:
Is This the Right Way to Teach Economics to School Students?
Authors:   Siberian Institute of Management – the branch of the Russian Presidential Academy of National Economy and Public Administration, Novosibirsk, Russian Federation, Khanin Grigory
Published: January 2021

Due to the extremely low level of current Russian economic scientists and practitioners, we can only place our hope on the younger generation. In this regard, the article considers the textbook on Economic Theory recommended by the Ministry of Education of the Russian Federation for students of 10-11th grades, currently in its 26th edition. The textbook arouses no interest, only antipathy to Economics among school students. It is unjustifiably focused on economic theory, not practice. The textbook is too complicated and boring, almost completely ignoring the economic problems of Russia and Third World countries. It is argued that the course of Economics for high school students can be not only informative and useful, but also involving. The Soviet and Russian economies are full of mysteries, which can make use of the enthusiasm school students have for solving mysteries and puzzles. The author suggests a program for a course in Economics for school students, comprising 10 new chapters, as well as a summary of the new chapters. The author also presents economic entities interested in high-quality school textbooks. The textbook recommended by the Ministry of Education of the Russian Federation is compared to the previously published more informative and involving textbooks for high school students.
Moral Principles in the Life of Society, or “Metaphysics of History”
Authors:   National Research Tomsk State University, Russian Federation, Cheshev Vladislav
Published: January 2021

The article investigates the influence of moral principles on historically developing social relations. The appeal to this problem is based on a conceptual approach to the origin of human morality, which arises in the course of sociogenesis as a set of behavioral principles that provide the intraspecific cultural (non-genetic) solidarity necessary for human societies. It is noted that the moral consciousness of individuals, which regulates interpersonal relationships, is a necessary but insufficient means for transmitting moral principles. Morality is expressed in the relationship between society and an individual. Society solves the problem of reproduction of moral regulators, it brings them into the nature of social relations by necessity. In this regard, attention is drawn to the role of elite groups in solving the aforementioned problem, in particular, it points out the peculiarities of the formation of an elite layer in Russian history. The elite is the bearer of moral images of social behavior, which expresses the attitude to public goals, interests, historical meanings of social life. The task of the elite is the implementation of these principles in the nature of social relations. The egoism of individuals and social groups can impede the solution of such a problem. Overcoming difficulties of this kind can be achieved by an awareness of history, which provides the basis for public consensus. The article focuses on the ethos of the “spirit of capitalism”, which enters into the social environment through the principles of the organization of economic activity. The paper shows the relevance of the problem of interaction of economic ethics and moral foundations of society as a systemic whole.
National-Cultural Organisations in Contemporary Siberian Cities: Issues of Ethnic Representation
Authors:   Irkutsk State University, Russian Federation, Dyatlov Victor ,   Tomsk State University, Russian Federation, Nam Iraida ,   Tomsk State University, Russian Federation
Published: January 2021

The so-called ‘national-cultural’ (natsional'no-kul'turnye organizatsii, NKO, or natsional'no-kul'turnye avtonomii, NKA), or ethnicity-based organisations, that started to emerge in Russia at the turn of the Soviet and the post-Soviet epochs have become an ordinary attribute of the country’s urban space. We were interested in the question of why and how these organizations have found themselves at the intersection of ethnic and migration discourses. For nearly 30 years we have been studying the case of Tomsk and Irkutsk national-cultural organisations (based on observations, participation in the events and activities organised by NKO/NKA and in the meetings of specialised advisory boards, interviews and surveys, materials released by national-cultural organisations and municipal authorities, mass media reports, etc.). This allows us to understand what role migrants themselves had to play: whether they were subjected to paternalistic care or contributed to accumulation of social capital by leaders and activists of national-cultural organisations, or both. Local authorities have come to see such organisations as a convenient tool to manage ‘diasporic’ communities, that is, organised ethnic groups, whose membership is associated with one’s ethnic origin or ethnicity and which are entitled to act independently as agents of social relations. NKO/NKA leaders are considered to be ‘diasporic bosses’ exercising the right to control and regulate their ‘diaspora compatriots’. That these organisations serve to meet specific ethnic groups’ cultural needs is not their single and possibly not even their main function. Their legal status (resulting from a special law on organisations of this type and a law on public organisations more generally) allows them to be in close contact with the authorities, and, in fact, to have a symbiotic relationship with them. As a result, these organisations have come to be informally tasked with assisting adaptation of migrants in Russian cities. Enthusiasts developing national/ethnic culture (‘ethno-entrepreneurs’) enjoy a certain degree of power given by the state and receive limited but important material and symbolic resources to present their activities as a consolidated ethnic group (‘diaspora’) in urban space. Leaders of ethnic organisations can also benefit from their status in both symbolic and material terms, serving as intermediaries between the ‘diaspora’ they construct and the authorities, and maintaining a relationship with their historical homeland.
AUDIOLOGICAL EVALUATION OF TRAUMATIC BRAIN INJURY – A CASE STUDY
Authors: Donadon Caroline , Ferrazoli Natalia , Gusmão Reinaldo , Rezende Adriano , Skarzynski Piotr H , Capra Daniela , Sanfins Milaine
Published: January 2021

Background

Traumatic brain injury (TBI) is a pathology frequently causing mortality or serious sequelae. About 20% of individuals with TBI will have some degree of auditory alteration. The aim of the present study was to use behavioural and electrophysiological assessments to analyse the hearing of a patient with TBI.

Case report

A young male adult who had suffered severe TBI caused by a motorcycle accident was evaluated. The patient underwent a peripheral hearing evaluation and electrophysiological assessment. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear and normal hearing in the right. In the electrophysiological assessment, an ABR click test showed the presence of a response in the right ear at 80 dB HL but no response in the left ear at 90 dB HL. Evaluation of the Middle Latency Response revealed the presence of both an electrode effect (C3) and an ear effect (A1). The P300 wave showed an event-related potential within normal limits in the right ear and no responses in the left.

Conclusions

The present case study verifies the importance of assessing the peripheral and central auditory nervous system in cases of patients with a history of TBI. It reinforces the need for diagnosis and audiological monitoring of these patients.
Новые форматы общественно-государственного управления в России
Authors: Якимец Владимир Николаевич
Published: January 2021

В статье рассматриваются новые форматы и механизмы общественно – государственного управления (ОГУ) в России. Дано определение ОГУ. Приведен перечень десяти из более сотни новых механизмов, получивших применение. Обсуждаются терминологические и методологические аспекты развития ОГУ. Подробно разбираются три кейса: поэтапный доступ СОНКО-ИОПУ к 10% бюджетных средств соцсферы; конкурсный механизм предоставления субсидий СОНКО г.Москвы и развитие конкуренции на социально значимых рынках субъекта РФ (стандарт развития конкуренции).
Стратегии политического участия в глобальной сети студентов Крыма и Севастополя.
Authors: Бродовская Елена Викторовна , Домбровская Анна Юрьевна , Карзубов Дмитрий Николаевич
Published: January 2021

В статье представлены результаты эмпирического исследования характеристик использования студенческой молодежью Крыма и Севастополя сети Интернет как средства реализации политического участия. Проанализированы показатели наличия опыта у крымской и севастопольской студенческой молодежи взаимодействия с властью с помощью официальных сайтов и порталов органов власти, наличия установок и опыта систематического поиска информации политического характера в Интернете, отношения к проблемам свободы в глобальной сети и контроля над Интернет-контентом. Выявлена специфика установок на политическое участие у представителей крымской и студенческой молодежи, принадлежащей к различным кластерам, выделенным по критериям степени ресоциализированности, их интегрированности в российское общество. Результаты исследования позволяют разработать рекомендации по развитию альтернативных информационных потоков в глобальной сети, направленных на формирование конструктивной, конвенциональной стратегии социального и политического участия крымских и севастопольских студентов
Государственный PR в интернете (на примере правительственных микроблогов в Китае)
Authors: У Юаньи
Published: January 2021

В данной статье определяются понятие «государственный PR» и понятие «государственный PR в интернете», раскрываются основные задачи и инструменты коммуникации государственного PR в интернете. В статье также проанализированы современное состояние правительственных микроблогов и преимущества и способы работы правительственных микроблогов в кризисных ситуациях в Китае. В последние годы правительственные микроблоги играют важную роль в качестве инструмента государственного PR в Китае. Но в процессе бурного развития правительственных микроблогов в Китае существуют некоторые проблемы и недостатки. В статье представлены выявленные проблемы и рекомендации по совершенствованию правительственных микроблогов в Китае.
Развитие цифровой экономики: подходы ОЭСР и приоритеты для России
Authors: Александров Олег Владимирович , Добролюбова Елена Игоревна , Талапина Эльвира Владимировна
Published: January 2021

Цифровая экономика рассматривается международными организациями как один из ключевых факторов роста производительности труда и повышения качества жизни граждан; развитие цифровой экономики рассматривается в качестве одного из стратегических приоритетов и в России. В статье рассматривается эволюция подходов к определению цифровой экономики и формированию государственной политики в сфере ИКТ в странах ОЭСР. Показано, что все большее внимание уделяется вопросам государственного регулирования и создания благоприятной среды развития, внедрения и активного использования цифровых технологий, инвестициям как в инфраструктуру, так и в человеческий капитал, обладающий навыками, необходимыми в новых условиях. Действующие российские стратегические документы недостаточно учитывают развитие цифровой экономики, в том числе, ее отраслевые особенности. Целевые установки государственной программы «Информационное общество» не позволяют претендовать на укрепление российских позиций в глобальной цифровой экономике. Исходя из международного опыта, авторы формулируют предложения по цели, ожидаемым результатам и показателям реализации долгосрочной стратегии развития цифровой экономики в России. С учетом значимости мер государственного регулирования в стимулировании развития и использования цифровых технологий, в статье приведены рекомендации по широкому спектру мер, актуальных в российском контексте: от использования цифровых технологий в налоговом администрировании, сборе и обработке статистических данных, ведении государственных реестров, до реформирования трудового законодательства, законодательства о регистрации предприятий, действующих подходов к классификации продукции и декларированию соответствия с целью содействия использованию передовых технологий в различных отраслях и секторах экономики и социальной сферы.
Oral hygiene in patients with fixed orthodontic appliances
Authors: Daurova A. Z. , Lapina N. V. , Izhnina E. V. , Kochurova E. V. , Seferyan K. G. , Starchenko T. P.
Published: January 2021

Introduction. The theme of a healthy lifestyle remains relevant at the present time. The function of the dentofacial system is an integral and important component of human health in general, is responsible for speech formation, respiration and nutrition. The goal of orthodontic treatment is to preserve the health of ones own teeth, to establish the correct function of the masticatory apparatus, to create a smile aesthetics, to exclude or facilitate other dental procedures without resorting to more invasive methods of treatment. Orthodontic treatment directly affects the quality of human life, so it is important to understand the need for its timely implementation. A large number of people seek orthodontic care in connection with raising awareness among the population and its availability.Results. The fast pace of development of dentistry and modern technologies allow us to correct both congenital and acquired defects of the dentition. For the adult population, one of the main means of orthodontic treatment is a fixed orthodontic technique, in the form of a bracket system. The average duration of treatment with this method is 1.5-2 years. But already in the first month, the orthodontist dentist observes the presence of plaque in his patients, which occurs due to insufficient oral hygiene.Conclusion. Studies have shown that a low level of hygiene entails the growth of carious and periodontopathogenic microflora, as a result of which irreversible changes occur on the surface of the teeth, leading to enamel demineralization and hypersensitivity, the occurrence of gingivitis and periodontitis. These changes, or the risk of their occurrence, force the dentist to prematurely remove orthodontic equipment without achieving the desired result. An analysis of the causes of this problem and the coverage of research results indicate the need to improve the methodology of individual oral hygiene in order to avoid the side effects of orthodontic treatment.
The use of ultrasound and ozone therapy in the complex treatment of periodontitis
Authors: Akhmedbaeva S. S. , Volkov A. G. , Dikopova Natalya Zh. , Paramonova I. A. , Paramonov Yu. O.
Published: January 2021

Physiotherapy makes it possible to effectively influence all the links in the pathogenesis of periodontitis. The use of ultrasound plays a special role in the treatment of periodontal diseases. With the help of ultrasonic vibrations, drugs (ultraphonophoresis) can be introduced into the tissue. For its implementation, water and oil solutions of medicinal substances are used. In periodontal practice, ultrasound is most often used to remove dental plaque. It is of scientific interest to use low-frequency ultrasound in combination or in combination with physical factors that have a pronounced antibacterial effect, such as ozone . High oxidizing properties of ozone provide its therapeutic effect, manifested in disinfecting, metabolic, immunomodulating and deodorizing effects. When conducting local ozone therapy in the oral cavity, it is necessary to accurately dose the concentration of ozone, therefore, in our opinion, the use of ozonized solutions and oils in dentists is safer and more promising. The combined and combined effects in the treatment of periodontitis of low-frequency ultrasound and ozone therapy, in the production of ozone using short ultraviolet radiation, will provide a comprehensive therapeutic effect, which consists in suppressing the vital activity of pathogenic microorganisms and stimulating metabolic processes in the tissues of the macroorganism.
Features of the dental status of athletes of teams of olympic teams as a reflection of the regional level of dental assistance and high psychophysical loads
Authors: Olesov Egor E. , Novozemtseva T. N. , Makeeva I. M. , Olesova V. N. , Salamov M. Ya. , Martynov D. V. , Sakaeva Z. U.
Published: January 2021

The purpose of the study: Comparison of indicators of dental status in athletes of the Olympic national teams and the population of Moscow of the same age.Material and methods: Dental examination of 132 athletes of the Olympic national teams and 104 residents of Moscow, males aged 2035 years was carried out using the modified World Health Organization Dental Status Assessment Card.Results of the study: Analysis of the prevalence and intensity of dental diseases showed that the dental status of athletes is worse in such areas as the detection of previously performed endodontic treatment and its unsatisfactory quality (with more endodontically treated teeth), the detection of large fillings and poor-quality fillings among existing fillings, prevalence pathological abrasion, the prevalence of periodontitis, the detection of unsatisfactory levels of oral hygiene, yyavlyaemost pathology of the temporomandibular joint. The obtained patterns reflect the untimely and insufficient quality of dental care for adolescents-athletes in the regions, as well as indicate higher psychophysical loads in athletes compared to peers. This necessitates special therapeutic and preventive approaches in the implementation of dental care aimed at reducing the parafunctional overload of the dentition in athletes.
An experimental study using known variants of transport immobilization and comparing them with the original temporary splint for the treatment of jaw fractures
Authors: Mitin N. E. , Zolotova Maria I. , Mitina E. N.
Published: January 2021

Academician I.P. Pavlov Ryazan state medical University of the Ministry of health of the Russian Federation, 390026, Ryazan, Russian Federation

Patients with injuries of the maxillofacial region make up about 30% of all patients treated in the in-patient departments of maxillofacial surgery. Meanwhile, fractures of the lower jaw account for about 70%85% of all fractures of the bones of the face. The need for immobilization is due to the risk of pain and complications (bleeding, microbial contamination, asphyxiation, damage to nerves and blood vessels). The article provides a comparative analysis between temporary immobilization of the jaws using well-known designs and a new universal temporary bus with a channel. We conducted the experiment under simulated conditions using the following splinting structures: a smooth splint bar and a patented temporary splint with a channel for treating jaw fractures (Application No. 2020103350/14 (005106) (22) Application submission date 27.01.2020). From the experimental research complex, it was possible to verify that the methods of temporary splinting of the jaws have their own characteristics of superposition and displacement of structures. It is worth noting that the displacement of jaw fragments occurred in each splinting and this should definitely be taken into account at the stage of first aid. The study also revealed that that the splinting technique for the splint has a number of disadvantages, the most significant of which are the negative impact on periodontal disease, a significant decrease in oral hygiene, and the possibility of secondary infection. Among the obvious advantages of a universal temporary bus with a channel, include the simplicity of applying and fixing fragments, the ability to supply the patient, receive fluids and drugs through the probe, as well as ensuring full breathing in the absence of nasal breathing.
Expression of CD44, CD29 and osteocalcin differentiation factors in the alveolar bone during past fixation of a free gingival graft
Authors: Edranov S. S. , Matveeva Natalya Yu. , Kalinichenko S. G.
Published: January 2021

Aim: To study the localization of stem stromal cells on the surface of a free gingival graft.

Material and methods: We studied the immunolocalization of stem cell markers (CD29, CD44 and osteocalcin) the mucosa plate and bone tissue of the lower jaw of outbred miniature pigs with bone fixation of a free gingival graft.

Results: In the third month after the operation, a new bone tissue is formed in the contact area, characterized by formed bone plates, osteons, and a system of Havers and Volkman channels. When studying the immunolocalization of CD29, CD44, and osteocalcin, we detected a heterogeneous distribution. CD29and CD44-immunopositive cells prevail at the border of the newly formed bone and its own gingival plate, as well as in the cavity of the Havers canals. Osteocalcin-positive cells are localized mainly in the layer of common plates, on the surface of the bone plates of osteons surrounding the Havers channel and in its cavity, which are in close proximity to the graft.

Conclusion: Bone fixation of SDT remodels the alveolar bone, showing signs of a reparative process. The presence of expression of CD29 and CD44 in bone tissue indicates the activation of mesenchymal cambial cells, which differentiate into osteocalcin-containing osteoblasts. The inducing role of a free gingival graft in the formation of a new bone is determined by the ability of its cells to synthesize trophic factors stimulating the proliferation and differentiation of MSC and vascular growth. Thus, the model on miniature pigs is a useful tool for studying this process.
Analysis of readiness of medical university graduates for labor activity
Authors: Alekseeva M. V. , Nikolaev A. I. , Shashmurina Victoria R.
Published: January 2021

Purpose of work orders to study the readiness of the Medical University graduates for work, a survey of 90 students of the dental and pediatric faculties of Smolensk State Medical University was conducted.Material and methods. Characteristics common to graduates were revealed: lack of confidence in the beginning of work, difficulties in communicating with patients, colleagues, employers, desire to work in budget medical organizations. The specifics of the faculty did not play a significant role in the choice of answers. Students in the pediatric faculty are more knowledgeable in continuing professional development, medical standards and clinical guidelines than dentistry students. Dentists are more practical in professional path choosing. For faculty of pediatrics graduates the last year of study escalates the problem of further professional choice, literally introducing young professionals into a stressful state who declare complete disappointment in choosing a profession.Results of the survey emphasize the need for vocational guidance, educational work with students of a medical university.Conclusion. Adaptation to work improving should be reflected in the content of work programs, activities to promote the employment of graduates, the possibility of obtaining legal advice at the university, the creation of a portal for posting resumes, and the widespread use of internships at workplaces.
Dynamics of hygienic and periodontal indices at the stages of implantological treatment
Authors: Ivanov A. S. , Sakaeva Z. U. , Morozov D. I. , Martynov D. V. , Salamov M. Y. , Olesov Egor E. , Olesova E. A.
Published: January 2021

The level of oral hygiene among many patients with implants is insufficient. In the absence of clinical examination and occupational hygiene, there is an averagely frequent development of inflammation in peri-implant tissuesperi-implantitis, which can cause implant disintegration. It is necessary to control hygiene indicators at the different stages of implantation.

Objective: to analyze changes in hygiene and periodontal parameters during implant treatment.

Materials and methods: At the stages before implantation, during osseointegration and the year after prosthetics on implants, the hygiene indicators and periodontal and microbiota status of 60 patients with dental implants were analyzed. Control methods used include Oral Hygiene Index Green J.C., Vermillion J.R. (OHI-S); gingivitis index Loe H., Silness J. (GI); Muhllemann index modified by Cowell; and PMA index modified by Parma. The level of halitosis was determined using the organoleptic index and the Halimeter instrument. Molecular genetic diagnosis of periodontopathogenic bacteria in the periodontal and peri-implant space was carried out.

Results: Hygiene and periodontics after preimplantation tooth restoration, and periodontal deterioration by the time the implants open, then before replacing the temporary prostheses with permanent ones and after three months of functioning of the prostheses on the implants, which necessitates professional oral hygiene before these stages.

Conclusion. Occupational hygiene every three months provides a stable adequate level of hygienic and periodontal indicators for users of prostheses on implants, and also reduces the detection of peri-implantitis.
Interdisciplinary approach to the rehabilitation of patients with a need for complete dental reconstruction: a clinical case
Authors: Utyuzh A. S. , Dzalaeva Fatima К. , Chikunov S. O. , Mikhailova M. V. , Budunova M. K.
Published: January 2021

This study aimed to test the algorithm of complex clinical, functional, and instrumental analysis in the context of treatment for patients with a need of complete dental reconstruction.
Materials and methods. A rehabilitation program for patients with adentia was proposed, which was based on the objective examination data obtained comprehensively with multiple diagnostic methods. Particular attention was paid to the temporomandibular joint function and symptoms of maxillofacial muscle abnormalities.
Results. The clinical case report covers the results of the examination and treatment of a patient who previously received implants in one of the clinics without an appropriate examination and an operating template. A set of diagnostic and therapeutic procedures was defined that included clinical, functional, and instrumental analysis of condylographic and cephalometric data. The outcomes from treatment and rehabilitation allowed the optimal occlusal load distribution, and the oral hygiene improved. The approach that was used here enabled a timely correction of functional and esthetic disorders.
Conclusions. The algorithm to treat patients who need complete dental reconstruction should include asking the medical history, clinical instrumental analysis (condylography), recording and evaluating the static and dynamic occlusal characteristics, and assessing cephalometric and esthetic characteristics. The algorithm is anatomically and pathogenetically justified, since it takes into account all alterations and interconnections between dentofacial structures and other body systems that underlie the clinical manifestations in patients with adentia who have a need for complete dental reconstruction.
Demographic characteristics of patients of the center for pain treatment
Authors: Khinovker V. V. , Yushkova V. V. , Fedorov D. А.
Published: January 2021

The treatment of chronic pain is one of the most important and unresolved medical problems in the world. The aim of the study was to assess the demographic characteristics of patients with chronic pain who applied to a specialized center for the treatment of pain syndromes of Federal Siberian Research Clinical Centre FMBA of Russia.
Material and methods. A retrospective analysis of 316 outpatient patient records was performed. The demographic characteristics of the patients, the frequency of types of pain syndromes and the results of the examination (PainDetect questionnaire, visual analogue scale) were evaluated.
Results. The age of patients ranged from 18 to 90 years, while patients with working age accounted for 56.7% of the total. The number of women significantly exceeded the number of men: 68.4% vs 31.6%. More than 70% of cases were diagnosed with chronic pain. 73% of patients had lower back pain, radicular and facet pain syndromes were recorded in 34.6% and 36.7%, respectively.
Conclusion. Significantly more often women sought help. 70% of patients were diagnosed with chronic pain. The most common radicular and facet pain syndromes.
Comparative evaluation of the effectiveness of the transdermal therapeutic system with fentanil and gabapentine in head pain therapy
Authors: Bayalieva A. Zh. , Shpaner R. Ya. , Ganeeva I. R.
Published: January 2021

The study was conducted to comparatively evaluate the effectiveness a transdermal therapeutic system with fentanyl and gabapentin in the treatment of headache in patients with non-traumatic subarachnoid hemorrhage. When assessing the intensity of headache in patients, it was found that with severe pain immediately after endovascular occlusion, the use of transdermal fentanyl with dexketoprofen or paracetamol is most acceptable, and the combination of gabapentin with dexketoprofen / paracetamol is better in case of headache in a more delayed period.
Neuroaxial methods analgesia of labour
Authors: Nejmark Mihail I. , Ivanova O. S.
Published: January 2021

The aim of study is a comparative evaluation of the efficacy and safrty of ultra-low-dose spinal analgesia, epidural and paravertebral analgesia to labor pain relief.
Material and methods. Four groups of 40 women tookpart in the study: one group is 40 patients, the labor pain was relieved by epidural analgesia. The second group consisted of 40 women in labor, anesthesia was carried out with ultra-low-dose spinal analgesia, 3rd group is 40 women who were anesthetized with paravertebral analgesia. The control group is 40 patients without anesthesia. The parameters of central hemodynamics were monitored: heart rate, blood pressure, mean arterial pressure. The motor block was estimated on the Bromag escale. The dynamics of the opening of the cervix, the duration of the first and second stages of labor was estimated. Implications and negative inluence of the anesthesia, the effect of analgesia on the fetus were also registered.
Results. Epidural analgesia showed high efficiency and safety, but the frequency of hypotension in this group was significantly higher than in other groups, an inrease in the positivity of the exacerbation period was found. Ultra-low-dose spinal analgesia also had a sufficient analgesic effect in the first stage of labor. However, short-termeffect did not always provide effective analgesia of the second period of labor in comparison with other methods. In general the advantages of paravertebral analgesia in the form of a significant acceleration of cervical dilatation and a decrease in the time of delivery are revealrd. There were no cfses with score of 2 of Bromage scale of a motor block with paravertebral analgesia, while in the epidural group and the ultra-low-dose spinal analgesia isolated cases with a score of 1 and 2 were encountered. Paravertebral analgesia does not result to hypotensionas against other neuro-axial methods of analgesia.
Conclusion. Neuroaxialmethods provide a sufficient level of analgesia can reduse anomalies of labor and do not affect negatively the fetus. All presented methods of analgesia have their place in obstetric anesthesiology. There is the possibility of choosing the most appropriate method of anesthesiain every obstetrical situation.
Dexmedetomidine as an adjuvant to local anesthetics in ophthalmic surgery
Authors: Oleshchenko Irina G. , Zabolotskii D. V. , Iureva T. N. , Koryachkin V. A. , Kuzmin S. V.
Published: January 2021

Vitreoretinal surgery aims to restore the structural relationships of the posterior segment of the eye, with the possibility of partial or complete restoration of visual functions, and imposes certain requirements to the anesthetic support of operations. These are injuries, operations length, age, and concomitant pathology of organs and systems of patients. In this regard, there is a recent tendency to use different pharmacological groups as adjuvants to local anesthetics to enhance or prolong their analgesic effect. Purpose to evaluate the effectiveness of dexmedetomidine as an adjuvant in retrobulbar blockades. Materials and methods. Retrobulbar block bupivacaine with dexmedetomidine at a dose of 0.25 mg/kg was performe in the 1st group (n = 22), retrobulbar block was performed with a mixture of bupivacaine in the 2nd group (n = 22). Changes in hemodynamics at the stages of surgery were evaluated. To assess the oxidative status, the evaluation of the redox coefficient (FORT/FORD) was conducted before and after the surgery. The level of comfort of the operation by the surgeon and the patient. Assessment of pain was performed by a VRS in the points. Results. In patients of the 1st group the decrease in SAD was more pronounced and persisted throughout the entire period of surgical treatment. 54.5% of patients of group 1 and 18% of group 2 had no pain 8 hours after the surgery. 82% of patients of group 2 reported moderate pain that required medication (p 0,05). In patients of group 1, it increased from 0.45 0.5 to 0.62 0.2 (p 0,005) by 37% of the initial value, in patients of group 2, it was shown to decrease by 5% (p 0,05). In group 1, the comfort of the operation was estimated by ophthalmic surgeons as satisfactory in 77.3%, and in group 2 in 54.5% (p 0,05). Conclusion. The use of dexmedetomidine as an adjuvant of local anesthetics in ophthalmic surgery provides the necessary analgesia, hemodynamic profile of the patient, antioxidant effect and affects the quality of the surgeons work, which affects the duration of operations.
Relationship between catechol-o-methyltransferase gene polymorphism and pain syndrome in breast cancer patients
Authors: Spasova Arina P. , Kurbatova I. V. , Barysheva O. Y. , Tikhova G. P.
Published: January 2021

The goal of the study was to explore the influence of single-nucleotide polymorphisms of the COMT gene on the formation and features of pain syndrome, the level of anxiety, and the need for narcotic analgesics in patients with breast cancer.
Materials and methods. The intensity of pain and opioid consumption in the postoperative period were evaluated in 58 patients who met the inclusion criteria of the study and were operated for breast cancer. The frequency of chronic pain syndrome after mastectomy was studied in the same group of patients after a year by using short pain questionnaires, McGill Pain Questionnaire and PainDetect. The anxiety level was assessed by using the HADS questionnaire. Genotyping was performed for single-nucleotide polymorphisms, rs4680, rs740603, rs2097603 = rs2070577, rs4633, of the COMT gene localized in the 22q11.21 region in the studied group of patients. The relationship between the carrier of different genotypes and the intensity of acute and chronic pain, the severity of the pain rating index for sensory and affective characteristics, the presence of a neuropathic component of pain, and the severity of anxiety were studied in the entire sample. The use of narcotic analgesics was evaluated in the postoperative period (IU/day and IU/course) and for the relief of chronic pain.
Results. It is shown that the intensity of postoperative pain and the severity of anxiety do not depend on the presence of a mutant allele for the studied polymorphisms of the COMT gene, while the postoperative consumption of opioids in patients with the rs4680 missense mutation in the exon of this gene is significantly less. The dependence of the intensity of chronic pain syndrome and the severity of anxiety on the presence of a mutant allele for the polymorphic locus rs4680 localized in the exon of the COMT gene was established. No significant relationship was observed between the mutant alleles and the use of opioids for chronic pain relief after mastectomy.
Conclusion. Genotyping for the COMT gene polymorphisms can be useful for choosing the optimal tactics of pain management in patients with breast cancer.
The optimal method of anesthesia for transurethral resection of a lateral bladder wall
Authors: Rychkov Ivan A.
Published: January 2021

In our prospective randomized study, 130 patients underwent a transurethral resection (TUR) because a neoplasm was located on the side wall of the bladder. In the neurostimulation (NS) group (n = 50), a spinal anesthesia with an obturator nerve block was made under the control of a neurostimulation; in the ultrasound (US) + NS group (n = 50), a spinal anesthesia with an obturator nerve block was made under the double control of ultrasound navigation and neurostimulation; in the general anesthesia (GA) group (n = 30), a general anesthesia with a deep myoplegia was made.
Results: The obturator nerve reflex was recorded for three (6%) patients from the NS group (p 0.001); it caused a bladder perforation in one patient. The frequency of a sinus bradycardia in the NS (18%) and US + NS (20%) groups was lower than in the GA (43%) group, p = 0.008. Arterial hypotension was observed only in the OA group for 8 (27%) patients (p 0.001). In the NS and US + NS groups, the patients time in the surgery room was significantly less (p 0.001) than in the OA group averaging 48.36 17.58 min and 50.82 23.6 min, respectively.
Conclusion: The combination of a spinal anesthesia with obturator nerve block under the dual control of an ultrasound navigation and a neurostimulation can be considered as a reliable and safe method of an anesthetic maintenance of the TUR on the wall of the bladder. If it is impossible to provide such a control over the implementation of the blockade, it is necessary to resort to a GA with a deep myoplegia.
Propofol and postoperative pain. Time to change priorities?
Authors: Ovechkin A. M.
Published: January 2021

Currently, the use of inhalational anesthetics is the basic method of general anesthesia.Propofol-based total intravenous anesthesia (TIVA) is not widely used.However, over the past years, evidence-based medicine data have been obtained on a decrease in the intensity of postoperative pain and the need for analgesics in patients operated on under the conditions of propofol-based TIVA, compared with inhalation anesthesia.It is possible that this fact will form the basis for revising general anesthesia regimens.
Obturator nerve block
Authors: Koriachkin V. A. , Zabolotskii D. V. , Gribanov D. V. , Antoshkova T. A .
Published: January 2021

One of the forgotten techniques of regional anesthesia is blockade of the obturator nerve, which was performed using anatomical landmarks and neurostimulation. In recent years, ultrasonic navigation methods have gained wide popularity when using regional blockades. The purpose of the review is to present the current understanding of the use of obturator nerve block in clinical practice. The review presents the anatomical features of the obturator nerve passage, surgical and therapeutic indications for the use of its blockade. The technique for performing obturator blockade using ultrasound navigation is described in detail. Blockade of the obturator nerve using ultrasound navigation can reduce the likelihood of surgical complications during transurethral resection of a tumor located on the lateral wall of the bladder, improve analgesia after hip and knee surgery, and effectively relieve spastic conditions of the adductor muscles of the hip.
Postoperative anesthesia for vitreoretinal surgery in children
Authors: Oleshchenko I. G. , Zabolotskii D. V. , Iureva T. N. , Zaika V. A. , Koriachkin V. A.
Published: January 2021

Vitreoretinal surgery for retinal detachments in children is an effective, sometimes the only method to restore vision. As practice shows, the use of minimally invasive regional techniques is increasingly used for combined anesthesia in ophthalmic surgery in children. In the postoperative period, the use of blockades can provide prolonged analgesia, thereby improving the childs comfort level after the surgery. All types of blockades in ophthalmology have certain risks, but the pterygopalatine blockade has not any, since it is performed outside the eye structures. The research of the use of the pterygopalatine blockade after surgery in children is important not only for creating prolonged analgesia, but also for reducing vegetative reactions that can complicate the recovery period.
Purposeof the study isto increase the pain management efficacy in the postoperative period in children who have undergone extensive surgery for retinal detachment.
Materials and methods. 1st group (n= 32) received postoperative analgesia pterygopalatine blockage with ropivacaine 0.5%, 2nd group (n= 28) systemic analgesia. Changes in hemodynamics and stress index in the postoperative period were evaluated. Cortisol levels in the intensive care unit was evaluated in 2 hours later. The time and frequency use of antiemetics in the occurrence of PONV were recorded. The level of patients comfort after surgery and the pain intensity were evaluated on an integral scale and on the Verbal Rating Scale (VRS) in points.
Results.The children of 1st group did not have significant changes in heart rate and SBP in the intensive care unit. In group 1, the TI decreased by 13.2% in the intensive care unit, and in group 2, the TI increased by 28.5% after 2 hours and by 88.6% after 8 hours. 2 hours after the surgery pain was 2 points in 12.5% of the patients (1st group) and 39.2% of patients (2nd group). After 8 hours, 35.7% of patients (2nd group) reported moderate pain that required medication. There were no PONV in group 1, and it occured in 28.5% of patients in group 2. In group 1, 75% of children rated the postoperative period as comfortable, and in group 2 21.4% (p 0,05).
Conclusion. Pterygopalatine blockade as the main method of postoperative analgesia in the early postoperative period has got a long-term analgesic effect, reducing the frequency of nausea and vomiting, improving the quality of the postoperative period in children.
Epidural analgesia in patients with thrombocytopenia. Clinical case
Authors: Goncharova E. V. , Polushin A. Y. , Kucher M. A. , Ermolova M. V. , Zalyalov Y. R. , Portnyagin I. V. , Bogomolny M. P. , Sokolov A. Y. , Ulrikh G. E.
Published: January 2021

The article presents a clinical case of a 25-year-old patient with progressive diffuse B-cell lymphoma with lesions of the S2 nerve root, accompanied by pain syndrome that is not relieved by systemic multimodal analgesia using opioids, antiepileptic and non-steroidal anti-inflammatory drugs. Polyneuropathy, secondary immunodeficiency, thrombocytopenia grade IV refractory to platelet concentrate transfusion, Guillain-Barre syndrome, impaired the somatic status and intensified the pain syndrome. Local anesthetics epidural port was successfully implanted to improve quality of analgesia. As a result of prolonged epidural infusion of 0.2% ropivacaine with titration rate from 4 to 7 ml/hour depending on the severity of the pain syndrome, that significantly improved patients quality of life was achieved by reducing the intensity of pain and increasing duration of night sleep. In the early postoperative and long-term follow-up periods (14 days), there were no hemorrhagic and infectious complications associated with the use of the epidural port.
Basal cell skin cancer: modern clinical and diagnostic aspects and the role of early diagnostics
Authors: Tarasenko G. N. , Kolenko N. G. , Tarasenko Yu. G.
Published: January 2021

Skin cancer is the leading cancer type (12.6%) in both men and women in Russian Federation. Basal cell skin cancer is the most common non-melanoma, malignant epithelial skin tumor. The identification of skin tumors in the early stages is one of the priority purposes of modern medicine because it facilitates the radical treatment of these diseases. Notably, an examination by a dermatologist should be performed in conjunction with non-invasive diagnostic methods.
Promising fields in the study of the pathogenesis of necrobiosis lipoidica
Authors: Teplyuk N. P. , Shimanovskiy N. L. , Varshavsky V. A. , Koroleva V. S.
Published: January 2021

The diagnosis of necrobiosis lipoidica is gaining significance owing to the increase in the incidence of diabetes mellitus. Several theories regarding the etiopathogenesis of necrobiosis lipoidica indicate the distinctive role of transport proteins of the Glut family, as well as the role of matrix metalloproteinase in the development of this dermatosis.
Prospects of using biological products in vitiligo
Authors: Tavitova A. R. , Krinitsyna A. A. , Lomonosov K. M.
Published: January 2021

A literature review is presented regarding the vitiligo reaction to biological agents for treating this dermatosis itself and as a side effect of the treatment of other diseases. Notably, the results of therapy with biological products and the researchers opinions on this subject are ambiguous because of the positive evidence of repigmentation of vitiligo foci, as well as cases of vitiligo in patients who received biological products for the treatment of another pathology.
Differential diagnosis of rosacea
Authors: Akimov Vsevolod G. , Kruglova L. S.
Published: January 2021

The clinical picture of rosacea, including facial skin erythema, telangiectasia, and popular, and pustular elements, is similar to other dermatoses, thereby causing difficulties in the differential diagnosis. Original photos and descriptions of the clinical signs that distinguish these diseases from rosacea are provided. Therefore, the possibility of rare skin lesions that are sometimes mistaken for a more frequent pathology should be considered to avoid diagnostic errors.
PROBLEMS AND FEATURES OF THE MODERN COURSE AND TREATMENT OF BEHCET’S DISEASE IN THE CENTRAL ASIAN REGION
Authors: Porsokhonova D. F , Novoselov V. S , Yakubovich A. I , Radzhabova Yu. N , Maximov Ivan S.
Published: January 2021

Actual problems of etiopathogenesis, clinic, diagnostics and treatment of Behcet’s disease are described. The importance of a comprehensive analysis of the causes and characteristics of the course of Behcet’s disease is shown. The need to take into account the appropriateness and financial capabilities of the patient when prescribing various diagnostic and treatment techniques is described. The importance of uniform diagnostic algorithm for the diagnosis and treatment of the disease in order to avoid iatrogenic complications and deaths is shown.
DIAGNOSING OF DRUG TOXIDERMIA CAUSED BY NUROFEN BY THE METHOD OF BARIUM SULFATE STIMULATED LUMINOL-DEPENDENT CHEMILUMINESCENCE OF LEUKOCYTES
Authors: Teplyuk N. P , Kadyrova Zilola S.
Published: January 2021

Objective. to determine the general patterns of changes barium sulfat stimulated luminol-dependent chemiluminescence of leukocytes in patients with drug toxidermia caused by taking nurofen (ibuprofen) and in the control group, as well as to select NSAIDs for replacement therapy. Material and methods. the object of the study were 15 patients (11 women and 4 men) with drug toxidemia (7 patients with toxidermia, 4 patients with acute urticaria) developed after taking nurofen (ibuprofen), and a control group consisting of 15 people (9 women and 6 men) who were not intolerant to this drug. The study participants were aged 18 to 75 years, median - 53. Measurement of barium sulfate-stimulated luminol-dependent chemiluminescence (SLCL) of leukocytes was performed on the Lum-100 chemiluminometer. The calculations were carried out using the computer program PowerGraph. Results. during the influence of nurofen (ibuprofen) on the blood of patients with intolerance to this drug and the control group dose-dependent changes in SLCL were observed. The relative intensity and relative light sum of blood SLCL in patients was significantly lower than in the control group at all studied drug concentrations (p < 0.01). SLCL indices in different forms of LT do not differ significantly (p < 0.01). The relative intensity and relative light sum of blood SLCL in patients were significantly lower in samples with the drug that caused the development of the disease than with drugs for replacement therapy (p < 0.01). At minimum concentration, there are no significant differences (p > 0.05).