Objective:To update the prognostic value of scan strategy with pharmacological stress agent in chest pain (CP) patients presenting with normal electrocardiography (ECG) and troponin.Methods:Two consecutive nonrandomized series of patients with CP and negative first-line workup inclusive of serial ECG, serial troponin, and echocardiography underwent myocardial perfusion imaging single photon emission computed tomography (SPECT) in the emergency department. Of 170 patients enrolled, 52 patients underwent dipyridamole-SPECT and 118 adenosine-SPECT. Patients with perfusion defects underwent angiography, whereas the remaining patients were discharged and followed-up. Primary endpoint was the composite of nonfatal myocardial infarction, unstable angina, revascularization, and cardiovascular death at follow-up or the presence of coronary stenosis > 50% at angiography.Results:At multivariate analysis, the presence of perfusion defects or hypertension was independent predictor of the primary endpoint. Sensitivity and negative predictive value were higher in patients subjected to adenosine-SPECT (95% and 99%, respectively) versus dipyridamole-SPECT (56% and 89%; yield 70% and 11%, respectively; P < 0.03). Of note, sensitivity, negative, and positive predictive values were high in patients with hypertension (100%, 93%, and 60%, respectively) or nonischemic echocardiography alterations (100%, 100%, and 100%, respectively).Conclusions:In CP patients, presenting with normal ECG and troponin, adenosine-SPECT adds incremental prognostic values to dipyridamole-SPECT. Costly scan strategy is more appropriate and avoids unnecessary angiograms in patients with hypertension or nonischemic echocardiography alterations.

The relevance of the study is due to the high prevalence of inflammatory periodontal diseases in patients with cardiovascular pathology. Currently, for the treatment of ischemic heart disease (IHD), statins are used, which, in addition to hypolipidemic action, have anti-inflammatory properties, which can lead to an increase in the pressure of the inflammatory process, not only in heart vessels, but also in paradonte.The aim of the study was to study the effect of prolonged use of statins on the course of inflammatory periodontal diseases in patients with IHD.Materials and methods. A dental examination and study of the quality of life of 122 patients with ischemic heart disease (IHD) were performed. Surveyed were divided into two groups depending on the duration of receiving lipid-corrective therapy.The results of the study. It has been established that in patients with coronary artery disease who take statins for a long time, the periodontal inflammation activity and the severity of its clinical manifestations are lower than in patients not using lipid-correcting therapy, which was accompanied by improvement in certain parameters of quality of life.

Relevance. The COVID-19 pandemic significantly affected the stress levels of healthcare workers. Like some other medical specialties, dentists have the highest risk of infection due to close contact with the patient's oral cavity and aerosol-generating procedures.Purpose. The study aimed to study the impact of the COVID-19 pandemic on the stress level of dentists in Novosibirsk.Material and methods. The study involved 273 dentists of various specialties aged from 20 to 65 years. The study assessed the overall level of perceived stress, overstrain and counteraction to stress using the "Perceived stress scale" (PSS-10). The Peritraumatic Distress Inventory (PDI) evaluated the level of distress associated with the pandemic.Results. The overall level of perceived stress is sufficiently high in all groups; the indicators increase with age from 6.9% in the younger age group to 95.7% in the older one. Older dentists are aware of the higher risks of a severe course and consequences of the disease and fear for the lives of loved ones. In the middle and younger age groups, the level of distress associated with professional activities is within the normal range. The older age group showed a high peritraumatic distress level associated with practising medicine during the COVID-19 pandemic. Gender differences in the perceived stress and distress levels were not found.Conclusion. The COVID-19 pandemic caused an increase in the psychological stress level among dentists, especially among older age groups. The study allowed us to identify factors affecting stress levels, which must be considered when organizing effective psychological assistance to doctors during epidemics of infectious diseases and providing targeted help to those in need.

Relevance. Inflammatory periodontal diseases, with a 68-98% prevalence, are a risk factor for developing cardiovascular diseases (CVD). There is simultaneously a low awareness of dental diseases and their role in assessing general health. The patient's understanding of the need for prevention and treatment of dental diseases is essential in the successful treatment of cardiovascular diseases. In this regard, the study of dental treatment adherence in patients with cardiovascular diseases is particularly relevant. Purpose – to study the level of adherence to dental treatment in patients with cardiovascular diseases.Materials and methods. We conducted a dental examination and survey of 121 patients aged 18 to 89 years during treatment of coronary artery disease clinical manifestations, including 48 men and 73 women. The average age of the surveyed was 65.2 ± 0.44 years. Patients completed a modified Morisky-Green questionnaire, which included four questions. We used a written questionnaire, which included 21 closed questions of the original questionnaire, to study the factors affecting adherence to dental treatment.Results. The study found that 87.6% of cardiovascular patients poorly adhered to dental treatment, 9.1% of patients were at risk, and only 3.3% had strong adherence to treatment. Only half of the respondents (52%) believed that oral diseases could affect the underlying disease course. Adherence to dental treatment did not depend on the age of the examined patients. Adherence was higher among women and those with higher education.Conclusion. The study revealed that patients with cardiovascular diseases have a high prevalence and intensity of inflammatory periodontal diseases and low adherence to their treatment. Only half of the patients know the relationship between cardiovascular diseases and inflammatory periodontal dis eases.

АННОТАЦИЯВ исследовании, посвященном оценке стоматологического статуса у пациентов с редкой формой диабета -MODY, приняли участие 9 чел. (3 женщины и 6 мужчин). Диагноз MODY-диабета им был поставлен на основании результатов молекулярно-генетического исследования. У обследованных с разными подтипами (2, 6 и 12) MODYдиабета выявлена высокая интенсивность кариеса, воспалительных заболеваний пародонта и зубочелюстных аномалий, что существенно не влияло на качество жизни обследованных. В полости рта у больных MODY-диабетом подтипа 2 отсутствовали выраженные специфические проявления нарушений углеводного обмена, что, вероятно, может быть связано с хорошей компенсацией диабета. Также представлено клиническое описание MODY-диабета подтипа 2 у представителей двух поколений -отца и сына.Ключевые слова: MODY-диабет, стоматологический статус, гликированный гемоглобин, кариес, индекс гингивита, индекс пародонтита. ABSTRACTIn a study on the assessment of dental status in patients with a rare form of diabetes -MODY, 9 people were involved (3 women and 6 men). The diagnosis of MODY was based on the results of molecular genetic research. In patients with different subtypes (2, 6 and 12) of MODY a high intensity of caries, infl ammatory periodontal diseases and dental anomalies was detected, which did not signifi cantly affect the quality of life of the patients. In the oral cavity of patients with MODY subtype 2 there were no pronounced specifi c manifestations of disorders of carbohydrate metabolism, which probably can be associated with good diabetes compensation. Clinical descriptions of MODY subtype 2 in representatives of two generations -father and son -is also presented.