Subject: development of an algorithm for the rehabilitation of children with congenital cleft lip and palate in a region with petrochemical ecotoxicants. Objectives: optimization of the algorithm for the rehabilitation of children with congenital cleft lip and palate in the region with ecotoxicants. Methods. A retrospective analysis of the medical records of children with a diagnosis of congenital cleft lip and palate was conducted on the basis of the Republican Children's Clinical Hospital in Ufa in the department of maxillofacial surgery. In the period from January 1, 1985 on December 31, 2018 were surveyed 3463 children with congenital cleft lip and palate. Results. Children born and living in the region with the petrochemical industry have a high percentage of concomitant somatic diseases and deviations from the norm in blood tests. An algorithm was developed for the rehabilitation of children with congenital cleft lip and palate in the region with petrochemical ecotoxicants, optimized by including a toxicologist, anesthesiologist, immunologist, otorhinolaryngologist, gastroenterologist, and endocrinologist in the algorithm of consultation and treatment. The algorithm is aimed at improving the health of the child by increasing the effectiveness of prevention and treatment of somatic diseases in the preoperative period. Conclusions. The proposed algorithm for the rehabilitation of children with congenital cleft lip and palate has been developed taking into account the adverse effects on the body of emissions into the air of large petrochemical enterprises. Children with congenital cleft lip and palate, born and living in a region with petrochemical ecotoxicants, have a high percentage of somatic diseases and contraindications to surgical treatment according to accepted terms due to the presence of comorbidities and disorders in blood tests, and need additional treatment from a toxicologist, anesthesiologist and other specialists.
Subject. Dental examination and identification of the features of the dental status of children with congenital cleft lip and palate, born and living in the region with industrial ecotoxicants. Objectives. To study the dental morbidity in children with congenital cleft lip and palate living in a region with industrial ecotoxicants, compare the data with a group of children with congenital cleft lip and palate from an ecologically safe region. Methods. The article presents the results of a dental examination of 195 children with congenital cleft lip and palate, including 108 children aged 3 years, 87 children aged 6 years. Children were divided into two groups depending on the place of birth and residence: 113 children were born and lived in regions with a developed petrochemical industry, 82 children from relatively ecologically safe regions. In the examined children, the prevalence and intensity of dental caries, malformations of hard dental tissues, periodontal diseases, dentoalveolar anomalies, and the hygienic state of the oral cavity were assessed. To determine the intensity of dental caries in children of 3 years old, the index "KPU" was used, in children of 6 years old - the index "KPU+kp". The hygienic state of the oral cavity was assessed by the Fedorov-Volodkina index (1968), the periodontal condition in children of 6 years old was assessed by the KPI index (Leus P.A., 1988). Results. Our data indicate that children from regions with the petrochemical industry have higher rates of dental caries intensity in the age groups of 3 and 6 years, there is a decrease in the resistance of the tooth enamel, and periodontal diseases are more common. Conclusions. The results of the study made it possible to obtain clinical and dental data characterizing the negative impact of industrial petrochemical ecotoxicants on the condition of the dentition in children with congenital cleft lip and palate, which is the rationale for the development of methods for optimizing and increasing the effectiveness of therapeutic and prophylactic measures in this group of patients.
Study of the determination of the polymorphic variants -1298A> C and -677C> T of the gene of methylenetetrahydrofolatereductase (MTHFR) in predicting the congenital pathology of the maxillofacial area. Objectives. To study the role of polymorphisms -1298A> C and -677C> T of the MTHFR folate cycle gene in the formation in patients with congenital pathology of the maxillofacial area. Methods. We analyzed the frequency distribution of genotypes and alleles according to polymorphism 1298 A> C of the MTHFR gene. We also analyzed the frequency distribution of genotypes and alleles according to polymorphism 677C> T of the MTHFR gene in a group of patients (n = 37) with congenital pathology of the maxillofacial area and control group (n = 46). Results. Genetic marker of the disease congenital pathology of the maxillofacial area is the genotype of the SS polymorphic locus 1298 A> C of the MTHFR gene. Its frequency was 13.6% against 2% in the control. In the calculation of odds ratios index following values were obtained: OR-7,32; CI95% -1.51-48.51. The results confirm the predictive value of a mutant CC genotype -1298A>C MTHFR gene as a risk of congenital disease pathology maxillofacial area. There was no statistically significant differences between patients and the control group for the distribution of frequencies of genotypes and alleles of the locus 677 C> T of the MTHFR gene. Conclusions. Genetic marker of congenital pathology of the maxillofacial area is the genotype of the SS polymorphic locus 1298 A> C of the MTHFR gene. The obtained data can be used, to predict a congenital pathology of the maxillofacial area with the purpose of treatment and prevention.
Thing. Studying the frequency of birth of children with congenital malformations in a city with a petrochemical industry. The goal is to identify the effect of industrial emissions from enterprises in Ufa on the frequency of birth of children with congenital cleft lip and palate. Methodology. In the Department of Oral and Maxillofacial Surgery of the Republican Children's Clinical Hospital from 1985 to 2019, the medical documentation of children born in the city with a petrochemical industry with a cleft lip and palate was studied. Results. In industrial areas of Ufa, the average rate of birth of children with clefts is 3.65 ± 0.31 (Kalininsky) and 2.34 ± 0.29 (Ordzhonikidzevsky). According to our studies, it was found that in the industrial zone, the frequency of birth of children with congenital facial pathology is significantly higher than in environmentally safe areas, and ranges from 1: 282 (3.5) in the Kalinin industrial northern region to 1:859 (1.1) in the southernmost, ecologically safe Demsky district (p<0.01). On the whole, in Ufa, the average rates of the birth rate of children with congenital cleft lip and palate were 1:454 (2.204 ± 0.11). Conclusions. The correlation between the value of gross emissions of harmful substances into the atmospheric air and the frequency of congenital cleft lip and palate in the zone with emissions of 135,114―180,120 tons per year, then in the zone with the amount of emissions of 20,000―135,114 tons per year, and the frequency in the zone with emissions of 11,000 is less ― 20,000 tons per year. The average birth rates for children with ARVH in the cities of the Republic of Bashkortostan were per 1000 children born: in cities with NHP ― 2.44; in cities without NHP ― 1.13. The frequency of birth of children with ADV in cities with NHP is more than 2 times higher than the frequency of birth of children with ADV in cities without NHP (p <0.001).
Introduction. Gestosis (late toxicosis of pregnant women) — pathological conditions of the second half of pregnancy, characterized by a triad of main symptoms: edema (hidden and visible), proteinuria, hypertension. In the third trimester, during physiological pregnancy of women and, especially when it is complicated by gestosis, there is a decrease in salivation, an increase in the viscosity and acidity of the oral fluid, which significantly increases the severity of the course of inflammatory periodontal diseases. We have developed a method for local treatment and prevention of gingivitis in women with pregnancy complicated by preeclampsia using a chewing phyto-substrate. Purpose: to assess changes in the physicochemical and biochemical parameters of the oral fluid during the local treatment of gingivitis using a chewing phyto-substrate in pregnant women with gestosis. Materials and methods: the examination of pregnant women was carried out in cooperation with obstetricians-gynecologists at the clinical base of the Department of Obstetrics and Gynecology No. 2 at the City Clinical Hospital No. 8, Ufa. Physicochemical (salivation rate, kinematic viscosity, pH) and biochemical parameters (calcium, magnesium, phosphorus, protein) of the oral fluid were determined before and after complex treatment of gingivitis with the inclusion of a chewing phyto-substrate in pregnant women with gestosis. Conclusion: in the third trimester during physiological pregnancy and, especially when it is complicated by gestosis, there is a decrease in salivation, an increase in the viscosity and acidity of the oral fluid. The use of chewing phytosubstrate plates in complex treatment, containing 0.1 g of dry extract of the collection (oak bark, licorice alder, birch buds, chamomile flowers, thyme herb) and 1.0 g of beeswax, increases the rate of salivation by 1.5 times, reduces the viscosity of the oral fluid by 1.3 times and its acidity, which indicates the effectiveness of the proposed method of local treatment of gingivitis in pregnant women with preeclampsia.
Relevance. Unreasonably high pollutant emissions into the environment, the ill-considered use of natural resources and the raw material orientation of exports have led to an environmental crisis in many areas.Purpose. To study the effect of ecotoxicants on the histochemical structure of tooth and jaw germs in laboratory rats and ways to reduce this effect during perinatal prevention.Materials and methods. The experiment included 50 white outbred rats weighing 180-250 grams. All animals formed five groups: 1 control and four experimental. All animals of the experimental groups were subject to gasoline and formaldehyde vapours inhalation exposure; Group 1 (control) was subject to only poisoning with ecotoxicants, Group 2 had peptinsorbent associated with ecotoxicant poisoning, Group 3 – a membrane protector – magnolia vine, Group 4 – beet, Group 5 – peptinsorbent, membrane protector and beet.Results. The histochemical study of tissues around the tooth germs in pup rats born from the control group rats after poisoning with ecotoxicants revealed an increased mast cell number in the tissues compared to intact rats. The samples of Group 2 rats showed that the mast cell number and characteristics practically did not differ from the control group after ecotoxicant poisoning. In the rats of Group 3, the number of mast cells was slightly lower than in the control group. In Group 4, the number of mast cells was not significantly lower than in the control group. In the rats of Group 5, the number of mast cells significantly decreased compared to the control and other experimental groups.Conclusion. Thus, during subchronic poisoning of pregnant female rats with ecotoxicants, the number of mast cells in the gingiva of rat pups increases against the background of microcirculation disorders. The number of mast cells in gingiva significantly decreases and approaches the normal values in rat pups after feeding pregnant rats with the combined mixture (peptinsorbent+membrane protector Schisandra+beetroot).
Monitoring of congenital malformations and concomitant somatic diseases in children is one of the important indicators of the causal influence of environmental factors on the health of the population. From the moment of birth, a child with congenital cleft lip and palate differs significantly from healthy peers not only externally, but also morpho-functional features of the structure of the primary section of the digestive and respiratory systems and often has a greater number of previous diseases in the history. Purpose: To determine the structure and frequency of somatic morbidity in children with congenital cleft lip and palate in regions with petrochemical ecotoxicants. Materials and methods: During the study, 3463 children from birth to 16 years old with congenital cleft lip were treated and monitored at the Department of Maxillofacial Surgery at the Republican Children's Clinical Hospital, Ufa for the period from January 1, 1985 to December 31, 2019 and / or sky. The diagnosis of concomitant systemic pathology was recorded based on the findings of the district pediatricians, ENT doctor, gastroenterologist, immunologist, allergist, rheumatologist from outpatient and inpatient records of the examined patients. Conclusion. In the course of our study, a direct relationship was noted between the level of environmental pollution by ecotoxicants and the frequency of concomitant somatic diseases in children with congenital cleft lip and palate. This must be taken into account in the pre- and postoperative algorithm for the rehabilitation of children with congenital cleft lip and palate with the involvement of pediatricians to improve the general somatic state of children when planning reconstructive surgery.
Objective. To evaluate the incidence of somatic diseases in children with congenital cleft lip and palate residing in regions with industrial pollution. Patients and methods. We analyzed medical records of the Department of Maxillofacial Surgery of the Republican Children's Clinical Hospital in Ufa made between January 1, 1985 and December 31, 2019. A total of 3.463 children with congenital cleft lip and/or palate aged 0 to 16 years were treated and followed-up during this period. Results. We found that 2017 children with congenital cleft lip and/or palate (58.24%) were born and resided in areas with welldeveloped petrochemical industry, whereas 1446 children (41.76%) were born and resided in the areas without petrochemical pollution. Clinical analysis of the health status of children with congenital cleft lip and/or palate living in the areas with petrochemical pollution demonstrated high incidence of respiratory tract diseases and acute respiratory viral infections. Conclusion. We observed a positive correlation between the level of environmental pollution and incidence of concomitant somatic diseases in children with congenital cleft lip and/or palate. This should be considered in pre- and postoperative rehabilitation of children with congenital cleft lip and/or palate with the involvement of pediatricians. Key words: congenital cleft lip and palate, industrial pollutants, concomitant diseases, preoperative preparation
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