№4' 2019



Study of activating effect of surfactant drugs on pulmonary macrophages in vitro in patients with bronchiectasis
5 - 8
The activating effect of surfactant preparations on pulmonary macrophages in vitro in patients with acute bronchiectasis has been studied. The results of electron microscopic examination of the macrophage elements of bronchoalveolar lavage in patients have shown that after incubation of cells with Curosurf there have been a pronounced activation of a cell surface, formation of phagocytic vacuoles containing membranes of exogenous surfactant.
Prediction and prevention of purulent−inflammatory complications of post−surgery wounds
9 - 12
Prediction and prevention methods of purulent−inflammatory complications of post−surgery wounds have been developed and improved. The study of blood serum of patients at risk to determine the inhibition rate of the mechanism of anti−infective resistance of a body allows to objectively assess the probability of their post−surgery purulent−inflammatory complications. The results of it can be used as one of the criteria for performing the additional preventive measures.
Influence of right ventricular lead implantation site choice on pacing efficiency
13 - 17
The effect of myocardial dyssynchrony on the pacing efficiency depending on a location of the right ventricular lead was studied. It has been found that the best results were obtained when stimulating the middle and lower septal zone of the right ventricle, the worst ones were noted when its apex was stimulated. The expediency of determining the magnitude of a longitudinal strain for assessing the myocardium functional status and effectiveness of pacing were emphasized.
Tactics of surgical treatment for isolated duodenal injury
17 - 19
The results of treatment of the patients with isolated duodenal injuries are presented. The diagnostic and surgical algorithm is designed depending on the time of patients admission to hospital, the size and localization of the defect of duodenum wall, size and localization of the defect of duodenum wall.
Antiphospholipid syndrome and pregnancy
20 - 22
The main issues of etiopathogenesis, clinics, diagnostics of antiphospholipid syndrome have been considered. The protocols of treatment of the women during pregnancy, childbirth and postpartum period have been presented.
State of the art of discoordinated labor problem
23 - 30
The course and outcome of labor for mother and fetus were evaluated by comparing various methods to correct discoordinated labors as follows: according to clinical protocols, using epidural ane sthesia, using the combined method with phosphatidylcholine. The use of phosphatidylcholine in a combined treatment of discoordinated labor was concluded to allow a significant reduction of the frequency of cesarean sections, improvement of fetus and newborn conditions by normalizing the biologically active substances in blood of mother and fetus, blood flow in fetoplacental complex, as well as elimination of abnormal labor.
Current approaches to treat gestational period complications in women with Graves’ disease
31 - 34
The development of chronic disseminated intravascular coagulation syndrome has been established to be characteristic of pregnant women with the Graves' disease, leading to a complicated gestational period for mother and fetus. For these patients a natural anticoagulant sulodexide was included into a treatment protocol, which contributed to a reliable normalization of hemostatic index, improved blood supply in the placental and fetal complex, and thereby it reduced the rates of obstetric and perinatal morbidity and mortality.
Features of external rod−controlled fixation in calcaneal fractures
35 - 39
Using the Ilizarov apparatus details a new device for rod−controlled fixation of the calcaneus has been developed. It has an external support as a screw pin and segment of a ring of one quarter of a circle with the rods located on it to secure the screw rods, as well as a removable retractable assembly. The proposed design provides the technical ability to reposition all the types of intraarticular fractures of calcaneus.
Treatment advantages of patients with ureterolithiasis by lithotripsy contact methods in comparison with open surgery
40 - 43
The results of treatment of patients with ureterolithiasis by means of laser ureterolithotripsy and open ureterolithotomy have been analyzed. Lithotripsy with the help of a holmium laser is an effective method of crushing the ureteral concretions of any mineral composition not exceeding 2 cm in size. The use of holmium laser is indicated in combination of stone with the ureteric stricture as well as in the presence of ligature calculi.
Non−standard approaches to upper urinary tract reconstruction
44 - 49
Among all the presented methods of reconstruction of the upper third of ureter, a priority is given to surgeries using the autologous urothelium−containing tissues, which are the least traumatic and the most physiological. At the same time the tissues having similar histological structure, similar system of blood supply and innervations are compared. If such a surgical approach is impossible, the alternative and non−standard methods of urethral reconstruction are considered as well.
Secondary edematous breast cancer: when to be operated on background of neo−adjuvant chemotherapy?
50 - 54
Ways of increasing the effectiveness of a combined treatment of the patients with secondary edematous breast cancer, namely, the tactics of personalized treatment on the basis of assessment of molecular−biological markers of tumor and MRI data are considered. The proposed method of assessing the prevalence of tumor process in such patients allows to determine the size of the tumor and edema, as well as to optimize the treatment tactics.
Determination of expression rate of molecular biological markers in tumor of patients with stage I−IV endometrial cancer to predict the disease relapse
54 - 58
The expression of molecular biological markers (VEGF, Bcl−2, Ki67, p53) in tumors of the patients with stage I−II cancers has been investigated to determine their prognostic value in the development of disease relapse.
Direct results of surgical treatment of three−negative breast cancer
59 - 62
Direct results of surgical treatment of women with three−negative breast cancer have been analyzed. The patients underwent a radical mastectomy for Madden and breast resections. It has been found that performing to some patients of alloplastic breast prosthetics, neoadjuvant chemotherapy contributed to an increase in an incidence of wound complications, which was also associated with a rise in body mass index and lesion of lymph nodes.
Radiotherapy in combined treatment of recurrent stage 3 laryngeal cancer
63 - 66
The paper describes the method of a combined treatment of laryngeal cancer. There are presented the results of such a combined treatment using both chemo− and radiotherapies, providing the efficiency of this type of tretament in the patients with recurrent cancer of the larynx, as well the options of preoperative radiotherapy for operable forms of laryngeal cancer are under discussion.
Pathogenetic predictor of endothelial dysfunction in patients with cardioembolic and atherothrombotic transient ischemic attacks
67 - 71
The results of the study of endothelial dysfunction in the patients with transient ischemic attack have been presented. The predictor of development of cardioembolic and atherothrombotic transient ischemic attacks for differential diagnosis has been established. It was determined that the increase in the ratio of nitric oxide and endothelin−1 in cardioembolic transient ischemic attack occurred due to a decrease in nitric oxide, and in atherothrombotic it was due to an increased endothelin−1.
Features of autonomic nervous system and cerebral neurodynamics state in young patients with chronic vertebrogenic pain syndromes
72 - 76
Based on the results of clinical−neurological and experimental analysis of vegetative functions and the study of neurophysiological state of suprasegmental vegetative systems in the patients with chronic vertebrogenic pains revealed a syndrome of autonomic dystonia with sympathetic−tonic orientation of vegetative functions, which combined with desynchronization of brain non−specific structures. Vegetative dystonia syndrome is, on the one hand, a response to the development of chronic pain syndromes of vertebrogenic origin, and on the other, a background that complicates the course of the disease.
Cognitive impairment in neurodegenerative pathology as index of neuroplasticity in psychoneurological model of adaptation of patients
77 - 83
The relevance of the study of the problem of cognitive deficit in neurodegenerative diseases has been analyzed. The study of a neuropsychological profile has been shown to possible more accurate representation of the picture of involvement into a pathological process of different brain structures. Timely identification of cognitive and emotional−personality changes can not only improve the quality of life of patients, but also may act as an independent link in a psychoneurological model of adaptation of this category of patients.
Features of ophthalmic care for patients with complicated cataracts
84 - 89
There has been presented the classification of modifications of complicated cataract phacoemulsifications, developed on the basis of techniques and a sequence of surgeries, using the notion of diagnostically related groups. The advantage of the proposed approach is a more compact and comprehensible integration of the patients, which is important for an optimal choice of the modification of phacoemulsification and tactics of surgery as well as post−surgery treatment of patients.
Experience of aflibercept application in patients with exudative age−related macular degeneration
90 - 96
Significant increase in visual acuity and a decrease in the index of central retinal thickness in the patients with age−related macular degeneration after a four−fold intravitreal injection of aflibercept during the 6 months' observation period were noted, that confirms the need for a systematic administration of this drug to achieve stable anatomical results.
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