Abstract:

Surgical treatment of destructive and degenerative diseases of the hip arthroplasty technology with the modern development of science, technology and medicine is considered the most effective method of providing social and personal reintegration. However, the opinion of experts, arthroplasty increases the complication rate in patients after osteosynthesis and osteotomy of the proximal femur. The purpose of research - to compare patient outcomes Technology hip arthroplasty after-reducing reconstructive interventions at the proximal femur. Material and Methods: The study group comprised 42 patients who underwent hip arthroplasty after-reducing reconstructive interventions at the proximal femur. The control group consisted of 43 patients with idiopathic hip osteoarthritis who underwent primary arthroplasty. Results: conducting joint replacement in patients of the main group was accompanied by an increase in the frequency of intraoperative and postoperative complications. Therefore, this group of patients requires a special approach to diagnosis and treatment.

Abstract:

Objective. Analysis of short-term outcomes patients with low rectal cancer after cylindrical abdominoperineal resection.

Materials and methods. This study enrolled 20 patients with locally advanced low rectal cancer who underwent preoperative chemoradiotherapy and surgery or surgery alone after using the technique of CAPE.

Results. Analysis of short-term outcomes after CAPE showed a high frequency of postoperative complications, especially in group of patients who underwent preoperative chemoradiotherapy. On the one hand it dictates need for careful patient selection for this type of operation, and on the other hand encourages us to improve the technique of operations.

Conclusions. The cylindrical abdominoperineal resection allows to achieve good local control in patients with locally advanced low rectal cancer.

Abstract:

Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.

Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.

Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%).

Abstract:

Purpose. The examination of the comparative aspect of the physical parameters of the boys in the pre - and puberty in different ecological zones (EZ) of the Republic of Dagestan (RD): mountain, foothills and plains of the taxiway.

Materials and Methods. The study in 3 eco-geographic zones of the Republic of Dagestan in 2641 a boy aged 11 to 17 years. Inclusion criteria were: age of onset of puberty and the completion of 11-17 years, male gender and residence in the territory (extragenital diseases). We compared the following anthropometric indicators: height, weight, body mass index.

Results and conclusions. The analysing of the physical parameters of development in different areas of extragenital diseases RD identifies the following pattern: the lowest height and weight were boys living in the foothills of the taxiway. Their peers living in highland and lowland extragenital diseases taxiway growth were similar and statistically significant differences were found statistically significant differences are particularly evident with 13-14 years in boys from foothills of RD, especially when compared with their peers plain COPIES. Thus, the overall physical development of boys RD closes to those boys Russia, although the tendency to reduce them was determined. Comparative physical development of boys in various extragenital diseases RD, the worst performance demonstrated teenagers from foothill extragenital diseases.

Abstract:

Effective treatment of patients with infectious and inflammatory diseases of the skin and mucous membranes often involves the use of antimicrobial agents.

The purpose of the study was an in vitro estimation of cytotoxicity and the efficiency of national resources for local use: gel with bacteriophages («Otofag», «Fagogin», «Fagoderm», «Fagodent») and antiseptic — «Сhlorhexidine» and «Miramistin».

Materials and Methods. To study the effectiveness of antimicrobial agents they used to provide crop strains of Staphylococcus aureus and Streptococcus pyogenes as one of the most common representatives of pathogens. The study of cell viability and cytotoxicity antimicrobials performed on cell lines KB — epidermoid carcinoma of the oral cavity of a human. For this purpose we use mikrotetrazoly test, which is widely used in the assessment of the effects on the cells of toxins, pharmaceuticals, adverse environmental factors, allowing to evaluate the toxicity of investigational drugs in vitro.

The results showed that the efficacy against pathogens Staphylococcus aureus and Streptococcus pyogenes, has even a 10‑fold dilution of «Сhlorhexidine» 0.05% and gels with bacteriophages. Antiseptic «Miramistin» is effective only on the initial concentration. The study of cytotoxicity showed that the processing of epidermoid carcinoma cells with «Chlorhexidine» and «Мiramistin» invokes the irreversible reactions, while the composition processing of gels based on bacteriophages not further affect cell viability.

Conclusions The results of the experiment confirmed the significant toxicity of tools such as «Сhlorhexidine» and «Miramistin» in proposed concentrations in the pharmacy network. Despite the high efficiency of these vehicles with regard to the studied pathogens, their long-term use in treatment of inflammatory diseases of the skin and mucous membranes can cause a slowing of repair processes. Gel means with bacteriophages «Fagodent» «Otofag» «Fagogin» and «Fagoderm» are highly effective and have no toxic effects on the cells. In this regard, they can be an effective and safe alternative to the popular antiseptic.

Abstract:

Introduction. Abnormal mobility of kidney - a combination nephroptosis with abnormal rotation in one or more static state. The main beam is at present diagnostic methods. Only ultrasound has the functionality, the ability to use polypositional.

The purpose of the study. Development of functional radiological methods of diagnosis of pathological mobility of the kidney and its complications.

Research methods. The methods of determining the angle of rotation according to the kidney excretory urography performed in wedge and orthostasis, ultrasound sonography, Doppler, dynamic indirect kidney scan and computed tomography. Statistical processing of the data using the package STATISTICA 6.0 software licensing and computer programs, correlation analysis, frequency and multiple correspondence analysis.

The main results. To determine the location of each case properly distributed in accordance with the classification matrices further method was used polypositional ultrasound, which allowed to determine the position of the patient, which revealed significant correlated with the RMS, hemoand urodynamic changes. Application rentgenradiological diagnostic methods in the corresponding position of the fixed kidney complications pathological mobility.

The main conclusions. The combination of ultrasonic, radiographic, radioisotope diagnostic PMK and its complications allows us to supplement the information content of these studies and to expand the diagnostic value of each of them. An integrated approach to the implementation of diagnostic tests will improve the efficiency of the treatment of complications PMK, reduce material costs, which in turn will improve the quality of treatment of patients with this pathology.

Abstract:

Lichen sclerosus is a chronic inflammatory disease of the skin and mucous membranes coated with squamous nonkeratinizing epithelium. The etiology of this disease is not completely clear. The exact prevalence of the disease is quite difficult to establish due to a lack of awareness of medical staff about the disease and relatively few patients visit medical specialists. Many researchers lean towards autoimmune theory of the origin of the disease. This is the basis for the most common methods of treatment. We have the information that lichen sclerosus may be caused by trauma, hormonal disorders and infectious lesions. In some cases genetic predisposition is observed. Standard treatment for lichen sclerosus is the topical application of glucocorticosteroids. If this treatment is ineffective topical calcineurin inhibitors are used. However, in many cases both treatments of lichen sclerosus are ineffective. In response to the problem alternative therapies can be used. Efficiency of phototherapy and photodynamic therapy for some cutaneous diseases is well known, in this regard it is important to examine in depth possibilities of these methods for treatment of lichen sclerosus.

Abstract:

Acute pyelonephritis is one of the common diseases both in outpatient and in the hospital practice. The leading causative agent of this disease is E. coli. Obstructive uropathy, foreign body, vesicoureteral reflux, sexual activity, use of local contraceptives contribute to the upward development of urinary infection. The goals of antimicrobial therapy for acute uncomplicated pyelonephritis are: relief of symptoms, restoration of social activity, prevention of complications and relapse prevention. The choice of an antimicrobial agent in most cases is carried out empirically based on the data on the dominant pathogens and their regional resistance. In acute uncomplicated pyelonephritis duration of antimicrobial therapy should be 7–14 days. The drugs of choice for treatment of acute uncomplicated pyelonephritis non-severe in adults are ciprofloxacin and levofloxacin, ceftibuten and cefixime. Patients with acute uncomplicated pyelonephritis severe emergency hospitalization is shown in urological outpatient and parenteral antimicrobial therapy (carbapenems or protected aminopenicillins combined with or without amikacin) with subsequent conversion to oral drugs and infusion therapy.

Abstract:

The article is devoted to studying the prospects of the use of selective intra-arterial chemotherapy in the treatment of locally advanced breast cancer IIIA, B, C stages. A review of literature on the methods of targent intra-arterial infusion of cytostatics and tumor embolization is performed, also it shows the results of treatment with different chemotherapeutic agents — epirubicin, doxorubicin, taxotere, cisplatin, 5‑fluorouracil, cyclophosphamide.

Abstract

Widely used nowadays hemodialysis and hemofiltration cannot replace completely the excretory function of human kidneys in the natural conditions of physiological regulation. The aim of our study is to develop and create a new method and apparatus for CRF patients «symbiotic» compensation, based on hemofiltration and healthy humans kidneys natural physiological functions, excluding mixing of partners blood.

Method of «symbiotic» hemofiltration is based on mutual exchange of equivalent blood ultrafiltrate volumes between healthy person and CRF patient, needed to be cleansed from metabolites. During exchange procedure patient’s and a healthy person’s circulations are separated by hemofilters excluding blood mixing.

During CRF patient’s blood cleansing from metabolic products separate hemofiltration of healthy donor and CRF patient in equal volumes is processed. Patient’s blood ultrafiltrate enters the bloodstream of a healthy person, as a healthy person ultrafiltrate in the same extent enters the bloodstream of CRF patient. At the same time remaining after filtration blood components of donor and patient are returned in their bloodstream respectively.

Fundamentally important advantage of «symbiotic» hemofiltration is that CRF patient’s blood is cleansed from uremic metabolites due to healthy human kidneys natural physiological functions. «Symbiotic» hemofiltration is a highly effective physiological method of CRP patient’s blood purification from the uremic substances.

Abstract:

Prostate cancer (PC) is one of the most urgent problems in modern oncourology. Every year the world is recording more than 900 thousands new cases of prostate cancer. For this reason, the diagnosis and treatment of this disease has recently been given more attention, both abroad and in the Russian Federation. Despite improvements in diagnostic methods and implementation of programs for active detection of the disease in its early stages, the number of patients suffering from advanced forms of prostate cancer remains high. Currently, the main method of treatment in patients with metastatic prostate cancer remains the hormone therapy (HT). Patients with metastatic prostate cancer most frequently have localization of metastatic lesions in the lymph nodes and bones. Frequent localization of metastatic lesions in the bones is due to tumor cell tropism of prostate cancer to the bone. Metastatic bone disease, as well as long-term HT conducted in patients with metastatic prostate cancer, leads to irreversible disruption of bone remodeling, which may be accompanied by osteoporosis and fragility fractures. Bone metastases in patients with PC are the most common cause of complications and significantly impair the quality of life of patients. Therapy underlying the prevention of bone complications can be specific, aimed directly at the tumor tissue and non-specific, to strengthen bones and decrease its resorption processes. The article provides an overview of the literature covering the effectiveness of modern drugs, aimed at non-specific prevention of bone complications in patients with metastatic prostate cancer, such as bisphosphonates, and inhibitors of the ligand RANKL, as well as an overview of studies to assess the effectiveness of domestic analogue zolendronovoy acid preparation Resorba in the prevention of osteoporosis.

Abstract:

Malnutrition occurs in 40 to 80 percent of cancer patients. Malnutrition in cancer patients is associated with poorer overall survival, reduced benefit from surgical and medical therapies, increased therapy-related toxicity, poorer quality of life. Early diagnostics of malnutrition and purpose of nutritional therapy is one of important components of supportive care at all steps of anticancer treatment. The modern tools for evaluation of the nutritional status and the principles of nutritional support at cancer patients, including oral nutritional supplements (siping) are presented in the article.

Abstract

The liver, lungs, parietal and visceral peritoneum have traditionally been considered to be the main target organs of metastatic colorectal cancer. The isolated adrenal metastasis in colorectal cancer is rare, in the literature there are single observations of clinical cases of successful surgical treatment of such patients. This article presents the clinical observation of successful surgical treatment of patients with colorectal cancer with massive isolated adrenal metastases.

Abstract:

One of the variants for the surgical treatment of patients with bilobal liver metastases is to perform two-stage anatomic resections. Thus, at least in a quarter of the patients it is impossible to perform the second stage of intervention because of absence of hypertrophy of the remaining liver parenchyma or progression of disease during standby. The most modern and promising way of overcoming this obstacle is to perform the so-called ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) or «in situ slit» liver resections. In this article we present a clinical case of performing a two-stage hepatectomy by type ALPPS in patients with metastatic colorectal cancer liver, who previously undergone the anatomic bisegmentectomy SVI-SVII. The present observation is the first in the available literature, evidence of justification perform repeated liver resections in patients with metastatic colorectal cancer and demonstrates the possibility of ALPPS techniques when performing extensive anatomical liver resections in patients who have undergone previous removal of the parenchyma of the right lobe.

Abstract:

The Operative Information Support Service for Scientific Research of the Medical Radiological Research Center named after A. F. Tsyb — Branch of the FSBI «National Medical Research Radiological Center” of the RF Health Ministry presented a report on providing off-budget support for scientific activities over the period from 1993 to 2014 using domestic and foreign information resources. The dynamics of employee activities in institutional sectors with aim to receive financial support for fundamental and applied scientific research on a competitive and non-competitive basis was given. The analysis of the obtained data indicated that a multi-channeling in off-budget funding was formed. It also showed to some extent a situation at the open market of grants in the field of medical radiology, radiobiology, and radiation epidemiology among leading investors in intellectual products.

Abstract:

In the article they discuss the status and problems of modernization of doctors in the context of the implementation of the state policy in the national system of Russian health care. The author presents judgments about the role and certification of postgraduate training of physicians, the directions of the improvement of professional education of doctors.

Abstract:

One of the leading causes of reduced quality of life, disability and premature mortality were urologic diseases. Improving the provision of urologic care to the population — one of the major problems in the system. The team of authors developed a model of restructuring urological service to the region with a total population of 2 million people, and a regional center with a population of 1 000 thousand people. The article provides the calculation of normative number of beds and doctors’ rates for the urology department three-tier system of care, depending on the population of the region. The calculation of staffing urologist and urological department heads. Computer simulation is performed in accordance with the current legislation (about health care) and regulations. The standardized software development methodology inter-networking model units have practical value and can be used by the executive bodies of state power in the health sector of any region of each profile of care.

Abstract:

The globally increased concern with the situation, existing in oncology, is conditioned by a steady incidence rate of malignant neoplasms, having a tendency to its growth. Annually over 7 million people die in the world due to cancer, by 2020, according to WHO estimations, this index will increase to 10 million. By the end of the 2013 report year patient population with cancer, registered in cancer care facilities of the Russian Federation, is 3 098 855 (2 995 566 in 2012), i. e. 2,1% of the population of the country. The system of cancer care delivery to the population in the Russian Federation and in Moscow is aimed at an early diagnostics and prevention of malignant neoplasms. Municipal cancer care service establishes the patients’ routes at suspicion on oncological disease and determines the functions of all links of health care for this type of patients. Stateof-the-art delivery of oncological specialty care has been built up with account of modern demands and is functionally structured in accordance with tree-level municipal health care system.