Purpose. Definition of types of crystalluria in various forms of urolithiasis and biochemical signs of phosphate crystals in the urine, while phosphate urolithiasis (infectious origin).

Patients and methods. The study involved 144 patients with recurrent urolithiasis — 75 women and 69 men. Of these, 46 — diagnosed calculi with uric acid, 44 — calcium oxalate or mixed with a prevalence of calcium oxalate, in 54 — phosphate rocks (carbonate-apatite and/or struvite). The age of patients ranged from 21 to 74 years. 93 people have been under long-term, within 2–15 years, outpatient observation. The examination included the collection of anamnesis, general and microbiological analysis of urine, biochemical blood serum and urine on 10 indicators, reflecting renal function, state of the protein, water and electrolyte metabolism, uric acid metabolism, the chemical composition of the stone analysis.

Results. It was found that in patients with calcium oxalate stones phosphaturia has been diagnosed in 2% of cases. And, along with calcium phosphate crystals they had oxalate crystals. In patients with phosphate urolithiasis phosphaturia observed in 96% of patients, in two patients (4%) they determined except phosphates also oxalate salt in urine sediment. Patients with phosphate urolithiasis at occurrence of phosphate crystalluria have metabolic state changes: increased serum uric acid concentration from 0.322 ± 0.009 to 0.367 ± 0.018 mmol/l daily renal excretion of inorganic phosphate 23.94 ± 2.93 mmol/day to 32.12 ± 4.39 mmol/day, and reduced total calcium content in urine 6.61 ± 0.94 mmol/day to 3.37 ± 0.89 mmol/day. The results led to the following conclusion.

Conclusion. Biochemical signs of occurrence of phosphate crystalluria in patients with stones of infectious origin can be: the approaching level of excretion in the urine of inorganic phosphates to 32,12 ± 4,39 mmol/day, serum uric acid concentration to 0,367 ± 0,018 mmol/l, and the total content of calcium in the urine to 3.37 ± 0.89 mmol/day

Purpose. Evaluation of feasibility of colon capsule endoscopy (CCE), as non-invasive method of diagnostics of colon abnormalities.

Patients and methods. From 31.01.2014 to 10.01.2017 we successfully performed 100 CCE in 101 (99,0%) patients (m-50, f-48, mean age 44,7 ± 14,8 years, range 22–81), including 2 twins aged 8 years (CCE was performed with pediatrician). The main indication for colonoscopy was colorectal cancer screening (73 (73,0%) pts). The indication for colonoscopy to 2 twins was complicated Peutz Jeghers syndrome in one of them. CCE was performed using the system PillCam (Given Imaging) and capsule PillCam Colon 2. For the bowel preparation we used two-stage regimen; for the evaluation of preparation — J.A. Leighton scale.

Results. Preparation was adequate in 88 (88,0%) pts, non-adequate — in 12 (12,0%) pts. Total CCE was performed in 82 (82,0%) patients. The mean colon transit time was 4 hours 43 min ± 3 hours15 min. Total evaluation of the colon was performed in 82 (82,0%) pts. Mucosal lesions were revealed in 75 (75,0%) pts, including epithelial polyps in 52 (69,3%) pts. We also revealed comorbid lesions in 41 (54,6%) pts. Colonoscopy after CCE was recommended to 28 (37,3%) pts because of polyp detection, sized ≥6 mm, and because of inflammatory changes of colon mucosa, but only 11 (39,3%) pts were performed colonoscopy.

Conclusion. In this article the experience of colon capsule endoscopy demonstrates the principal possibility of noninvasive evaluation of the colon and detection of colon abnormalities.

Introduction. In recent years, considerable success has been achieved in complex and combined treatment of breast cancer (BC). Reconstructive plastic surgery plays an important role in the rehabilitation of patients with breast cancer and it is currently considered as the causal treatment of mental disorders caused by loss of femininity and integrity of one’s own body. One-step breast reconstruction for cancer treatment makes it possible to use supplementary materials — synthetic and biological implants that can replace muscle autografts and thereby reduce trauma, blood loss, operation time, and thereby help to avoid the defect of donor areas. The authors describe the state of the art at present and demonstrate the results of their own research.

Materials and methods. The object of study was 38 of breast cancer cases and 1 case of multiple gelioma caused by silicone implant rupture. 44 operations have been completed: 21 — radical subcutaneous mastectomy, 1 — subcutaneous mastectomy, 17 — skin-sparing radical mastectomy with one-step reconstruction with mesh implant (12 — titanium, 16 — polyester), 11 — acellular dermal matrix Permacol, 5 — prophylactic contralateral subcutaneous mastectomy with one-step reconstruction with silicone implant and a mesh implant due to a mutation of the BRCA1 gene. The technique of operations and the results of studies have been described in detail.

Results. In the late post-operational period, the implants were removed in 5 cases: in 2 patients due to the development of inflammation of ADM, 3 — in connection with the development of bedsores and diastasis of the skin in the wound area when synthetic implants were used. From the total number of patients in the group (n = 39) excellent cosmetic results were reported in 21 cases (54%), good — in 13 (33%) and unsatisfactory — in 5 (13%) cases due to the removal of the implants.

Conclusions. Biological and synthetic materials are significantly important options for breast reconstruction. They are adequate substitutes for autologous muscle flaps if the patients for the operation are properly select.

According to WHO, the world takes place every year approximately 500 000 suicides and suicide attempts of 7 million. Since 1994, Russia ranks 2nd in the world after Lithuania, in the level of suicides, and is among the countries with the linear dependence of frequency of suicides on the level of alcohol consumption.

Purpose. Install a quantitative connection between the frequency of suicide with alcohol consumption and mortality from alcoholism in the world.

Material and method. For studies we used the mortality coefficient (MK) from suicide and alcohol abuse (number of people/100 thousand of age standardized the population) in 159 countries according to the WHO in 2004, the average daily consumption levels of alcoholic beverages: spirits, wine and beer (g/person/day) according to the FAO (Food and Agriculture Organization of the United Nations). For data analysis we used correlation and regression methods.

Results. We found significant positive correlation of mortality coefficient (MK) from suicide for men and women with consumption of alcoholic beverages (spirits, wine and beer) and mortality from alcoholism. The gender differences are revealed. Included in the regression model independent variables (levels of alcohol consumption and mortality from alcoholism) explain 66% and 52% of the variability in the frequency of suicides of men and women (dependent variables). A complete rejection of the consumption of alcohol reduces the MK from suicide of men in the world at 39.5 percent, in Russia — at 76.5%; women — 37.9%, in Russia — by 54.3%. According to the regression analysis the average daily level of consumption of strong alcohol in the world is 10.4 g (3.8 kg per year) for men, in Russia — 91.8 g (of 33.5 kg per year). The increase in the consumption of strong alcohol to 3 g per day (1 kg per year) increases the MK from suicide in men up to 10.8% (1.6 people) in the world, in Russia — 2.4% (1.6 people). The increase in the MK of alcoholism of men in the world for 1 person on 100 thousand population per year increases, the MK of suicides of men in the world by 5.8% (0.8 persons), in Russia — 1.3% (0.9 persons).

Conclusions. Population studies generally confirm the existence of a positive correlation between the level of suicides (MK) and alcohol consumption, both in the world and in Russia. The frequency of suicides is more influenced by the level of consumption of strong alcohol and the MK from alcoholism. Our results support the General opinion on expediency of change of structure of consumed drinks in favor of lighter (low alcohol content), especially in Russia, which has a positive impact at the population level of suicide and alcoholism.

Currently, malignant tumors of ovaries take the third place in the structure of oncogynecological diseases, being a leading cause of death among pathology of female reproductive system. Due to the lack of effective screening programs and asymptomatic course of the disease in its early stages, in the majority of cases ovarian cancer (OC) is detected in form of disseminated process, what greatly reduces the effectiveness of primary treatment and has a negative impact on the further prognosis. In connection with the above, timely diagnosis and organization of OC screening, as well as monitoring of its recurrence is a major problem for oncologists around the world.

In the present literature review the opportunities of magnetic — resonance imaging (MRI) in detection of primary ovarian cancer and its recurrence are considered, the analysis of the method diagnostic efficiency based on the use of various techniques is done. The opportunities of MRI show a lot of information necessary for the characterization of detected ovarian formations, estimates of the prevalence of primary ovarian cancer and its recurrence. However, the analysis of performed literature revealed a significant lack of materials devoted to the definition of the diagnostic capabilities of various MRI techniques, including diffusion — weighted imaging (DWI), what indicates the necessity for further studies in this direction.

The review summarizes the results of studies of levels and/or activity in the blood serum of a metabolic marker thymidine kinase-1 (TK-1) of proliferating cells in patients with lymphoproliferative diseases (LPD) and malignant neopasms (NM).

Comparison of the data in the literature in some cases have been difficult due to the fundamentally different methods of detection the activity or concentration of TK-1, used by authors, even despite the presence of relatively high (but not absolute) correlation between these parameters (maximum 0.8).

Many clinical and laboratory studies have shown levels of correlation and/or TK-1 activity with clinical stages and different types of LPD and solid MN and can serve as a prognostic factor for overall and recurrence-free survival of patients. When solid MN shown that the activity of TK-1 accurately reflects the proliferative status of tumor.

A comparison of the dynamics of TC-1 in the process of chemotherapy and its clinical efficacy, different authors have received fundamentally different results: in some cases the marker reduction was associated with treatment efficacy, and in part of publications they show that the clinically relevant effects of the treatment observed increase in the marker after the first chemotherapy.

The entire set of received data demonstrates the relevance of the further development of the algorithm use of TK-1 in oncology practice.

The incidence of primary malignant tumors of the skeleton is an average of 1.5 for men, for women – 0.9 per 100 000 population. Morphologically most common are: osteosarcoma (55-63%), chondrosarcoma (17–25%) and Ewing’s sarcoma family of tumors (8–15%). Metastatic lesions of long bones occurs 2-4 times more common than primary tumors and often are diagnosed with breast cancer in 65–73%, of prostate cancer in 56–68% and lung cancer in 30–36% of patients. World Data standard treatment for patients is a combined approach, one of the stages is a surgical treatment. In modern oncoorthopedics the standard of surgical treatment of patients with tumor lesions of bone is the conduction of segmental bone resection and oncological arthroplasty. However, just as with other surgical interventions, in arthroplasty with large joints that is associated with the introduction of foreign material into the body, there are complications which usually are infectious by nature. Complications associated with the continuous use of immunosuppressive therapy include bacterial and viral infections. It must be emphasized that in the context of immunosuppression bacterial infection is much greater and is accompanied by greater mortality than in patients without immunosuppression. The frequency of complications in patients who undergo total joint replacement after organ transplantation can be significantly reduced by the correction of metabolic disorders, the purpose of broad-spectrum antibiotics in the perioperative period and careful rehabilitation. It is necessary to work closely with the transplantologists. Also the method of using a local antibiotic administered directly to the site of surgery can be used. This method has significant advantages because of the high local concentrations with minimal risk of systemic toxicity. In this paper we present a clinical case of performing resection of the proximal humerus to the shoulder joint arthroplasty in patient on immunosuppressive therapy.

Malignant breast tumors are one of the causes of disability due to lack of breast or having operational defects. In most cases, the quality of the operation depends on the further social and active patient behavior.

This article presents a clinical case of the use of lipofilling with reconstructive plastic surgery in breast cancer patients after complex treatment. In the particular example we show the positive effects after one session of conducted lipofiling in front of the chest wall to the right with Body-Jet hardware techniques. The purpose of this procedure was to improve the quality of cover fabrics in postoperative scar on the anterior chest wall right after comprehensive treatment, including also a cover for the such aggressive tissue treatment, as radiotherapy.

It is proved that mesenchymal stromal cells, or cell-messengers that are present in all the fatty tissues, contribute to its regeneration by forming new blood vessels, or act directly on the damaged or exposed to aging structure — restore and rejuvenate the field of lipofilling. Therefore, adipose tissue is laid down by the nature of the human body a source of regeneration. In this clinical example, after successfully conducted one session of lipofilling marked improvement in skin quality in postoperative scar made after mastectomy and radiotherapy. Good autofat graft survival rate is also fixed, which was enough to implement further stages of breast reconstruction.

Purpose. Simplify and increase the accuracy of the questionnaire method of predicting breast cancer (BC) for subsequent computer processing and Automated dispensary at risk without the doctor.

Materials and methods. The work was based on statistical data obtained by surveying 305 women. The questionnaire included 63 items: 17 open-ended questions, 46 — with a choice of response. It was established multifactor model, the development of which, in addition to the survey data were used materials from the medical histories of patients and respondents data immuno-histochemical studies. Data analysis was performed using Statistica 10.0 and MedCalc 12.7.0 programs.

Results. The ROC analysis was performas and the questionnaire data revealed 8 significant predictors of breast cancer. On their basis we created the formula for calculating the prognostic factor of risk of development of breast cancer with a sensitivity 83,12% and a specificity of 91,43%.

Conclusions. The completed developments allow to create a computer program for automated processing of profiles on the formation of groups at risk of breast cancer and clinical supervision. The introduction of a screening questionnaire over the Internet with subsequent computer processing of the results, without the direct involvement of doctors, will increase the coverage of the female population of the Russian Federation activities related to the prevention of breast cancer. It can free up time for physicians to receive primary patients, as well as improve oncological vigilance of the female population of the Russian Federation.

Malignant neoplasms (MN) are the second cause of death for the population of Russia, resulted in 15.5% of all deaths in 2015. Their share in the structure of the male population mortality rate was 16.4%, female — 14.4%. Among both sexes, deaths of working age, the proportion of deaths from MN was 16.0%, among women of reproductive age — 16.3%. More than half of the working age population of deaths in Russia falls on the disease from the group of preventable death, and a third — to preventable causes, depending on the primary and secondary prevention, quality of care, along with a high prevalence of behavioral risk factors (RF), demographic characteristics, marked medical and social reasons for the high mortality rate of the MN: late uptake of the population for health care, lack of alertness in oncology healthcare professionals, patients defects in routing.

The leading factor in increasing life expectancy is prevention. Today, prevention is regarded as active method of strengthening and preservation of health, and the currently existing approaches in promoting healthy life mostly only directed at the prevention of behavioral risk factors: tobacco use, poor diet, physical inactivity and harmful use of alcohol. Experts estimate the impact on them will prevent, at least 40% of the cases of MN.

In Russia we have a 3-step system of health care. In general preventive health orientation is implemented on the 1st level: in the provision of primary health care. In this regard, particular attention should be paid to the implementation of measures for specific clinical examination of the adult population, which plays an important role in the early detection of both the disease and the risk factors for their development. Properly organized conduct of the clinical examination can provide a substantial, up to 30%, the contribution to the reduction of total mortality, including mortality from MN. The necessity of increasing the role of the oncology service in the organizational and methodological support of the preventive measures implemented by primary health care is performed.

By 2010, on the background of the steady increase in the incidence of malignant tumors in the Vladimir area, primary oncological care level worked inefficiently.

Condition of material and technical base of the Vladimir Regional Clinical Oncological Dispensary was also unsatisfactory. All these problems required solution in the form of the National Oncology Program realization in the region. The National Oncological Program has begun to work in the Vladimir region since 2011. Target indicators of the oncological program implementation by 2015 were established. They are: Increase of 5-year survival value of patients with malignant tumors after diagnosis date to 51.4%; Increase the number of malignant tumors early detection cases at the I–II stages up to 51%; Decrease the mortality rate of working age population to 99 per 100 000; Decrease of mortality within one year from the first time of cancer diagnosis to 27%. The following main objectives such as radically improved the material and technical base of oncology dispensary; modern methods of prevention, diagnosis and patients treatment improvement and introduction; the system providing population cancer care focused on the cancer early detection and the specialized combined antitumor treatment provision are realized in order to achieve these goals. The implementation of the tasks allowed to achieve positive dynamics of Vladimir region population cancer care indicators. All the main targets of the National Oncology Program for the Vladimir region were achieved successfully. Implementation of the National Oncology Program has had an extremely positive effect on the cancer services development of, as well as for the health of the entire population of the Vladimir region.