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INTRODUCTION. Currently, the choice of tactics in the treatment of esophageal cancer remains an urgent problem. Important factors are: the stage of the disease, the functional state of the patient, as well as the morphological type of tumor. An integrated approach is today the standard for this pathology. However, after radical treatment, a significant number of complications are observed, in particular, the development of leakage of esophagogastroanastomosis. Today, according to world literature, it is generally accepted that the development of anastomotic leakage is associated with the detection of the disease in late stages, the consequences of radiation during combined chemoradiotherapy, and extensive surgical intervention for esophageal cancer.The OBJECTIVE was to improve the results of treatment of patients with malignant neoplasms of the esophagus and esophagogastric junction, through the use of an integrated approach.METHODS AND MATERIALS. During the period of 1988–2022, treated 2784 patients with cancer of the esophagus and esophagogastric junction were treated at the Republican Clinical Oncology Dispensary named after Prof. M. Z. Sigal. The study group included 1,799 patients who received surgical treatment, combined chemoradiotherapy in combination with surgery, and external beam radiation therapy in combination with surgery.RESULTS. Due to changes in treatment tactics for patients with cancer of the esophagus and esophagogastric junction, postoperative mortality after surgical complications decreased from 24.3 % to 6.2 %, and anastomotic leakage in the postoperative period decreased from 27.0 % to 8.1 %.CONCLUSION. Changes in the treatment of patients with cancer of the esophagus and esophagogastric junction made it possible to reduce the development of postoperative complications and increase life expectancy. The molecular genetic approach allows for effective analysis of screening, early diagnosis, treatment and rehabilitation.

The aim. Study of the anti-inflammatory properties of the surface of commercial dental implants made of zirconium and titanium with different processing methods using the example of the course of the first stage of implantation. Materials and methods. The structural (microstructure of the surface, biocompatibility, surface corrosion, elemental surface structures) and clinical (severity of peri-implantitis and mucositis, coefficient of implant stability) characteristics of dental implants made of zirconium with surface treatment by the PEO method and implants made of titanium with DAE surface treatment were studied. Median test (χ2), Kruskal–Wallis test (H), univariate variance analysis (F) were used. The difference in parameters was considered statistically significant at the p ≤ 0.05 level. Results. The PEO surface had a monolithic surface layer with rounded pores averaging 4.51 μm2. The DAE surface had a polyhedral irregular shape, about 7–12 μm2. On the DAE surface: carbon – 4.59 wt%, oxygen – 6.16 wt% and traces of zinc were found. A significant difference in the elemental composition of PEO implants was the presence of chlorine (0.93 wt%), silicium (0.14 wt%), aluminum (0.23 wt%), potassium (0.47 wt%) and magnesium (0.07 wt%). The results of comparing the contact angle of the B&B Dental 29.2 ± 5.9° and Zircon-Prior 21.5 ± 3.3° samples had no statistically significant difference (р > 0.05). After 7 days of exposure in the SBF solution, zirconium implants with a PEO surface increased calcium by 21.87 wt%, phosphorus by 35.68 wt%, sodium by 72.89 wt%, and chlorine by 76.21 wt%. Aluminum, silicium, and zinc were no longer detected. The peculiarity of the titanium implant sample with the DAE surface was only the background level of calcium – 0.06 wt% and the complete absence of phosphorus; the most significant components were oxygen – 16.71 wt%, carbon – 12.37 wt%, sodium – 6.47 wt%, and chlorine – 5.90 wt%. Assessment of cell adhesion to the surface of Zircon-Prior and B&B Dental samples neither on the first nor on the seventh day of incubation did not demonstrate a statistically significant difference. Clinical signs of bone tissue resorption were identified around 30.8 % of implants with a PEO surface and 27.3 % of implants with a DAE surface (p = 0.8); inflammation of the mucous membrane – in the areas of installation of 34.6 % of PEO implants and 72.7 % of DAE (p = 0.009). 3.8 % of PEO implants and 9.1 % of DAE implants were lost (p = 0.44). The average ISQ were significantly different: 59.2 ± 4.1 DAE implants versus 64.4 ± 4.9 PEO implants, p = 0.003. Conclusions. Resorption of bone tissue around zirconium implants with a PEO surface (30.8 %) was more common than around titanium implants with DAE surface treatment (27.3 %), p = 0.8. Clinical signs of bacterial damage were more frequent and more severe around DAE-coated implants (72.7 %) than in the areas of PEO implants (34.6 %), p = 0.009. In zirconium implants with surface treatment by the PEO method (64.4 ± 4.9 units), the index of stability (ISQ) was significantly higher than in titanium implants with surface treatment by the DAE method (59.2 ± 4.1 units, p = 0.003). The probability of “loss” of titanium implants with DAE surface treatment (9.1 %) at the surgical stages of implantation is higher than that of zirconium implants with PEO surface treatment (3.8 %, p = 0.44).

Objective: to evaluate the effect of kinesiotherapy on the intensity of neuropathic pain, physical activity and emotional state of patients with diabetic polyneuropathy (DPN). Material and methods. The study included 65 patients with a painful form of DPN who were randomly divided into two groups: the standard therapy (ST) group and the extended therapy (ET) group, in which three to four additional face-to-face sessions were conducted to create a 15-minute individualized exercise program. The type of neuropathic pain was assessed using the Neuropathy Total Symptom Score – 9 (NTSS-9). Pain intensity was assessed using a visual analogue scale (VAS), patients' emotional state was assessed using the Beck Depression Scale and the Spielberger Anxiety Scale (with an assessment of personal anxiety). The examination was carried out at baseline, and after 3 and 6 months. At baseline, patients in the ST and ET groups did not differ (p ≥ 0.05) in parameters such as pain intensity according to VAS (6.65 ± 1.93 and 6.07 ± 1.91 points respectively), neuropathic pain according to NTSS-9 (13.65 ± 4.54 and 11.79 ± 5.09 points respectively), physical activity according to IPAQ-SF (20.1 ± 10.0 and 18.8 ± 9.1 points), personal anxiety according to Spielberger scale (51.00 ± 6.10 and 47.33 ± 9.73 points), depression according to Beck scale (15.75 ± 7.77 and 14.67 ± 8.73 points). Results. After treatment, there was a more significant reduction in pain intensity according to VAS in the ET group than in the ST group – to 3.67 ± 2.55 and 6.10 ± 1.41 points respectively after 3 months (p < 0.05) and to 2.60 ± 1.45 and 5.80 ± 1.06 points respectively after 6 months (p < 0.001), reduction in neuropathic pain according to NTSS-9 scale to 4.88 ± 4.39 and 13.13 ± 2.96 points after 3 months (p < 0.001) and to 3.55 ± 2.52 and 13.08 ± 3.86 points after 6 months (p < 0.001), a decrease on the personal Spielberger Anxiety Scale to 42.33 ± 7.66 and 51.30 ± 7.22 points after 6 months (p = 0.01), a decrease on the Beck Depression Scale to 10.07 ± 9.31 and 16.70 ± 4.34 after 6 months (p < 0.05). Conclusion. Kinesiotherapy in complex therapy of DPN leads to a reduction in pain and an improvement in functional and emotional state of patients.

The article deals with highlighting the results of clinical investigations of 49 dogs with cutaneous mastocytomas (MCTs), which during 2016-2024. took a full course of diagnostic and therapeutic measures in the clinic of the Department of Surgery of Stepan Gzhytsky LNUVMB. 26 male dogs and 23 female dogs were involved in the research, they were of different breeds, uncastrated, aged from 4 to 16 years (median 9.5 and mode 9-10 years). The purpose of the current stage of research was clinical and experimental substantiation of the complex treatment of dogs for skin mastocytomas, setting its therapeutic effectiveness and animal survival. It was established that in the structure of skin tumor lesions in dogs, MCTs reach 17.2 %. During the initial examination of animals, in accordance with the criteria of the clinical TNM classification of neoplasias, at the time of admission to the clinic, the following were diagnosed: in 20.5 % of dogs - I, in 26.53 % - II, in 51.02 % - III and in 2.04 % in some cases - the IV clinical stage of the development of the tumor process. The diagnosis of mastocytoma was set up on the basis of the data of the physical examination of animals and cytological verification of the biopsy material got during targeted, ultrasound-guided, fine-needle biopsy of neoplasias and regional lymph nodes. The final diagnosis was got based on the results of a histological investigation of the excisional material taken during the operation. According to the criteria of the two-stage histological classification (Kiupel), skin mastocytomas were verified as low-malignant in 33 (67.3 %) dogs and highly malignant in 16 (32.7 %). For experimental research, sick dogs were divided into four groups: the first (n = 16) and second (n = 17) included animals with low malignancy, and, accordingly, the third (n = 8) and fourth (n = 8) with high malignant MCTs. In the scheme of treatment of all animals, a surgical method was used, while in the first group, surgical removal of tumors was the main treatment measure, in the second, third and fourth groups, surgery was only the first stage of treatment. In order to prevent the degranulation of mast cells and, accordingly, to prevent the occurrence of inflammation and swelling in the tumor and in the surrounding tissues after surgery, as well as to reduce the volume of tumors before surgery, neoadjuvant glucocorticoid therapy was performed. After the surgical removal of tumors, the animals of the first group were only observed for their recovery and further life. At the same time, in the dogs of the second group, after extirpation of neoplasms, the immunostimulating preparation anfluron was used for 24 days. The dogs of the third group were given two courses of chemotherapy according to the vinblastine, cyclophosphamide, and dexamethasone scheme after the operation. In the dogs of the fourth group, similarly to the third group, tumors were surgically removed, chemotherapy was performed according to the same scheme, however, after completion of the latter, the animals were used anfluron, according to the scheme as in the second group. According to the results of the use of dexamethasone by means of neoadjuvant therapy in 77.5% of dogs, a decrease in the size of tumors by 19.2- 25.8 % was set up, which made it possible to extirpate tumors within a wide range of the surgical field (with a margin margin >2 cm), in 18.4% of animals the size of the tumors did not change and in 4.1% a slight increase in neoplasia was noted. The therapeutic effectiveness of the performed measures was got based on the results of the clinical condition investigation, as well as indicators of overall survival, recurrence-free survival of animals, and median life expectancy. The survival rate was also evaluated by constructing graphs and analyzing Kaplan-Meier curves. According to the results of clinical researches and two-year observations, the survival rate of dogs in the first and second groups was 100 % during the first year, 50.0% in the third, 62.5 % in the fourth, and 62.5 % in the first, 62.5 % in the second, and 62.5 % in the fourth. 70.6 %, the third 12.5 % and the fourth - 25 %. It was set up that the median life expectancy among dogs with highly malignant mastocytomas was 7 months in the third group and was significantly shorter compared to the animals of the fourth group of 19 months (P < 0.05), which were treated with anfluron (recombinant α-γ-interferons). At the same time, among dogs with mastocytomas of low malignancy, after surgical removal of neoplasias and the use of immunotherapy, a smaller number of cases of local recurrence and metastasis to lymph nodes were got. Therefore, it can be concluded that a multimodal approach to the treatment of dogs with MCTs, which includes a combination of surgery, chemotherapy and immunotherapy adapted to the profile of each patient, can improve the survival rates and quality of life of the animals. [ABSTRACT FROM AUTHOR]

Aim of the study - To improve the treatment tactics of perianal CK in children with the aim of improving the treatment results by using a multidisciplinary combined approach with the use of minimally invasive surgical techniques and conservative therapy. Materials and methods. The results of the diagnosis, treatment, and follow-up of 12 pediatric patients with perianal CK were analyzed. Complaints, anamnestic data were collected for all patients. Laboratory, physical and necessary instrumental examinations and morphologic study of samples of clinical material (tissues of removed fistula ducts, polyps, rectal crypts, condylomas, etc.) were performed. The leukocyte index of intoxication (LII) and the hematological index of intoxication (HPI) were calculated for each of the studied group of hospitalized patients. The work uses generally accepted methods of statistical processing of medical and biological research data. The results. In the studied group, 66.7 % were boys, 33.3 % were girls. In 25 % of patients HC was diagnosed at the age of 2-12 years, in 75 % - at the age of 13-15 years. On hospitalization all patients had complaints and local symptoms characteristic for perianal HC of the corresponding localization, were in severe or moderate condition with signs of intoxication. 75 % of patients have a wide range of extraintestinal manifestations of CK. The mean values of LII and GPI indicators were 4.26 and 6.82, respectively. In all patients the presence of anemia, leukocytosis, increased ESR, level of C-reactive protein, fecal calprotectin, hypoalbuminemia, hyperglobulinemia (IgG), intestinal dysbiosis with Candida albicans colonization were determined. The necessary physical and instrumental examinations to determine the anatomy of the perianal lesions were performed under anesthesia. Drainage of open purulent foci and fistulae was performed with permanent draining ligature, which was removed after 3-6 months in the absence of signs of inflammation and determination of healing of the affected area. Determination and correction of specific and anti-relapse therapy for CK, anemia, laboratory-confirmed inflammatory changes, dietary nutrition was carried out jointly with a gastroenterologist, a hematologist and an immunologist. A geneticist was consulted for all patients. Conclusions. 1. The majority of cases of perianal HC in children occur during adolescence - 75 % of patients in the study group were 13-15 years old. 2. The diagnostic search and treatment process of perianal HC in children requires a multidisciplinary approach with the participation of a gastroenterologist, a pediatric surgeon, a hematologist, a geneticist, an immunologist, a morphologist, etc. Supervision of the patient by the specified specialists should be carried out both during inpatient and outpatient treatment with the aim of timely correction of the manifestations of HC. 3. In the treatment of children with perianal CK, minimally invasive methods should be preferred to aggressive surgical interventions. 4. Surgical treatment is appropriate in cases of complex high rectoperitoneal fistulae when specific conservative treatment is ineffective. 5. The use of seton drains in the surgical treatment of perianal HC in children, in combination with pathogenetic conservative therapy, leads to healing of perianal lesions, shortening of hospital treatment terms and improvement of patients' quality of life. [ABSTRACT FROM AUTHOR]

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Purpose of the study. Evaluation of the diagnostic value of vacuum-assisted biopsy (VAB) based on pathomorphological studies in patients with breast cancer (BC) who have achieved a complete clinical response (cCR) after neoadjuvant polychemotherapy (NACT).Patients and methods. In the study, conducted from 2021 to 2023 at the P. A. Hertsen Moscow Oncology Research Institute – a branch of the National Medical Research Radiology Center of the Ministry of Health of Russia, 35 patients with BC cT1–3N0–3M0 of various molecular-biological types who were diagnosed with cCR after NACT were included. All patients underwent VAB (needle size 7–10 G) of the breast followed by histological examination, after which surgical treatment was performed. Subsequently, histological conclusions of VAB and surgical materials were compared with each other for the presence and degree of pathomorphological response.Results. According to the pathomorphological conclusion when conducting VAB, the following results were obtained: 1 – true positive, 29 – true negative, 3 – false negative, and 0 – false positive. No statistically significant results of the association between complete pathomorphological response and the molecular-biological type of breast cancer were obtained (p > 0.05), however, there is a tendency towards the greatest number of complete pathomorphological responses in Her2-neu-positive (luminal – 100 %, non-luminal – 90.9 %) and triple-negative (87.50 %) types of breast cancer. The overall sensitivity of the method was 25.0 % (CI 6.8–60.2 %); specificity – 100 % (CI 88.1–100 %); false-negative result (presence of tumor cells in the surgical material and a negative result of VAB) – 9.1 % (CI 3.4–20.2 %); false-positive result (absence of tumor cells in the surgical material and a positive result of VAB) – 0 % (CI 0–10.6 %). The overall diagnostic accuracy of the method was 90.9 % (CI 79.8–96.6 %).Conclusion. The results of the conducted research allow for the consideration of excluding surgical treatment when a complete pathomorphological response is obtained by VAB. However, further research is required with the inclusion of a larger number of patients.

This study aims to review the psychosocial characteristics of acne vulgaris. The biomedical literature on the disease is abundant, and the treatment of the disease tends to follow this approach. However, the scientific results point to the fact that a deeper understanding of the experience of the affected person, support for coping with the disease, and enhancement of quality of life can be achieved more effectively in a complex biopsychosocial framework. The paper reviews the evidence that illustrates the extent to which the quality of life of people with acne is most affected and in what areas and attempts to outline the psychological and psychophysiological processes that may underlie these interactions. It addresses the prevalence of mental disorders (depression, anxiety), the negative impact on body image, the experience of stigma, and the possible social consequences. It describes the findings and central mechanisms of stress and the most relevant lifestyle issues and highlights the importance of individual treatment plans and psychological interventions. The review concludes by attempting to argue for the need for complex, biopsychosocial treatment and outlines areas where psychologists or other mental health professionals may have a priority role to play. [ABSTRACT FROM AUTHOR]

Stress urinary incontinence and atrophic colpitis are among the most common pathologies in women in late reproductive and premenopausal age, which occur against the background of the progression of estrogen deficiency in late reproductive age. In recent years, laser energy has been actively used in clinical practice to correct the manifestations of genitourinary syndrome. A special feature of laser technology is the use of a package (sequence) of laser pulses with a low energy density, the duration and frequency of which are programmed in such a way that, providing a deep thermal effect, tissue ablation is not allowed. The objective: to evaluate the effectiveness of an integrated approach in the treatment of atrophic colpitis and stress urinary incontinence in women of late reproductive and premenopausal age. Materials and methods. 69 women aged 45-55 years with manifestations of GUS were examined. In all women, the intensity of vaginal symptoms, the effect of urinary incontinence on quality of life, urinary incontinence symptoms, female sexuality, vaginal pH were examined, and light-microscopic and morphometric studies of vaginal biopsies were performed. For the purpose of treatment, women were offered 3 sessions of therapy, of a CO2-laser and the appointment of vaginal suppositories, which include natural substances with expressed regenerative, antiseptic, anti-inflammatory and immunostimulating properties. The total duration of treatment was 8 months. Results. The average pH value of vaginal contents in patients with Hus was 4.9±0.3. Complaints of burning and tingling, dryness and itching in the vagina and external genitalia prevailed among vaginal smptomas. On the D.Barlow scale 6 (8.7%) and 12 (17.4%) respondents rated their symptoms at 1 and 2 points. According to the results of the UDI-6 questionnaire, a significant majority of women complained of loss of urine associated with coughing, sneezing or laughing, loss of urine associated with the need for urgent urination, and loss of a small amount of urine not associated with physical activity. Light-microscopic and morphometric analysis of biopsies revealed the presence of significant thinning of the vaginal epithelium with a decrease in the cells of the intermediate line, a decrease in the content of glycogen in the cytoplasm and smoothness of the basal relief. Conclusions. The effectiveness of the proposed treatment complex is confirmed by a significant decrease in the number of vaginal symptoms, an increase in the number of women who evaluated the intensity of existing symptoms on a D Barlow scale scores of 1 and 2 points, a decrease in the number of women with urinary incontinence symptoms in the UDI-6 questionnaire, and an increase in the number of women with mild to mild urinary incontinence in the ICIQ-SF questionnaire. The positive effect of the proposed combined complex on the condition of the vaginal mucosa was confirmed by activation of remodeling processes, which was reflected in an increase in the proliferative activity of multilayer flat non-keratinized epithelium in response to photothermal laser exposure. [ABSTRACT FROM AUTHOR]

Summary. Objectives: to analyze the immediate results of the complex treatment of complicated forms of erysipelas. Methods: A retrospective analysis of the immediate results of complex treatment of 67 patients with complicated forms of erysipelas was conducted. There were 29 (43.3%) men, 38 (56.7%) women. The average age was 65.1 years. Results: The duration of symptoms of the disease before hospitalization varied from 3 to 14 days. The erythematous form of erysipelas was found in 7 (10.5%), erythematous-hemorrhagic – in 14 (20.9%), erythematous-bullous – in 21 (31.3%), bullous-hemorrhagic – in 25 (37.3 %). According to the localization, erysipelas of the head was found in 5 (7.5%), upper limbs - in 3 (4.5%), lower limbs - in 59 (88%). Primary erysipelas was present in 39 (58.2%), recurrent – in 28 (41.8%). In the picture of peripheral blood, leukocytosis is determined with a shift of the leukocyte blood formula to the left. The level of C-reactive protein is 18 - 100 times higher than the upper limit of normal. According to the results of cultures of scrapings of affected tissues, the dominance of Staphyloccus haemolyticus in associations with other gram-positive and gram-negative microorganisms was revealed. High polyresistance of Staphyloccus haemolyticus strains to antibacterial drugs with preservation sensitivity to Clindamycin, Vancomycin, Linezolid, and Teicoplatin was inserted. Conclusions: Complicated forms of erysipelas are found in 89.5% of patients who are being treated in the surgical department for erysipelas. The most frequent localization is erysipelas of the lower limbs, which is found in 88%. Staphylococcus haemolyticus is dominant among the causative agents of erysipelas in various associations with other gram-positive and gram-negative microorganisms. A high polyresistance of Staphylococcus haemolyticus strains to antibacterial drugs is determined, while sensitivity to clindamycin, vancomycin, linezolid, and teicoplanin is preserved. Treatment of erysipelas is complex, including antibacterial therapy, surgical treatment of complications, local treatment of wounds, drug corrective therapy of concomitant chronic pathology.

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The article deals with the studies on complex sorption treatment of industrial waste of various industries to obtain new C, S, N-containing plastic lubricants, which provide antiwear, antifriction, high load-bearing and heat-resistant properties. The conditions for obtaining diethylammonium salt from the obsolete pesticide Banvel D and its sorption on a mixed sorbent, which consist of activated carbon (AC) and kieselguhr (K), have been established. The conditions for obtaining potassium diethyldithiocarbamate and its adsorption on the surface of the mixed sorbent (AC + K), followed by treatment with copper(II) sulfate of corresponding bis-(diethyldithiocarbamato) copper(II) sorbed on a solid surface, have been examined. The obtained substances of general composition [sorbent (AC + K)]·[(C2H5)2NS(=S)S]2Cu were studied as active components of plastic lubricants, which provide their thickening, antiwear and antifriction properties. Industrial tribological research was carried out for friction pairs of four-row roller bearings of roller equipment used at private enterprise (PE) "Exim" (Kherson, Ukraine). [ABSTRACT FROM AUTHOR]

Objectives. To carry out a comparative assessment of the results of morphometric study of infectious and inflammatory focus and the density of vessels of the microcirculatory bed at different periods of laser radiation application in the postoperative treatment for experimental periostitis of the jaws. Material and methods. The experiment was performed on 56 rabbits. 54 of them had simulated acute purulent periostitis (APP) of the lower jaw. All the animals were divided into the following series. Series 1 – 12 rabbits which, after the creation of the APP model, were treated with laser therapy on the 1st, the 3rd and the 5th days after surgery. Series 2 – 16 rabbits which underwent laser therapy treatment on the 3rd, the 5th and the 7th days after surgery. Series 3 (control) – 26 rabbits which were not treated after the creation of the APP model. Series 4 – 2 animals whose jaw fragments were taken as a standard. Results. In all series 1 micropreparations, after completing the experiment the changes can be characterized as minimally residual inflammatory ones. Complex treatment of periostitis, including laser treatment, applied from the first day of the postoperative period, is effective for relieving infectious inflammation and creating optimal conditions for tissue regeneration. Conclusions. Despite the similarity of the schemes of complex postoperative treatment for experimental periostitis using the effect of laser on the focus of inflammation in series 1 and 2, it has been found that its positive influence is due to a greater degree of complementarity when used as early as possible after surgery.

Acquired enterocutaneous fistulas are a considerable problem of abdominal surgery. In most cases, they result from surgical intervention. There are different classifications based on different signs and factors. We aimed to summarize the management principles for patients with acquired enterocutaneous fistulas. Critical evaluation of the data available from existing studies. The therapeutic regimen includes nutritional support, sepsis control, skin care, and, possibly, surgical treatment. Surgical interventions are considered in high-output small bowel fistulas. The treatment is continuous and requires a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Introduction. Ectropion of the cervix (EC) is a condition when there is a cicatricial deformity of the uterine cervix (as a result of traumatic injuries) with visualization of the ectopic columnar epithelium on the vaginal part of it. The ectopia is currently classified as a variant of the normal histophysiological state of the cervix. This article discusses the features of the course and methods of treatment of complicated EC.Objective of the study is: to develop and evaluate the effectiveness of a new method of complex treatment of CE.Material and methods. In an open prospective study, 133 patients with CE (groups 1 and 2) and 56 healthy women (group 3) has taken part. In group 1 (n = 83), we have used a method for treating CE developed by us, which included two stages: stage I – elimination of microbial and viral pathogen in combination with immunomodulatory therapy, II – electrosurgical treatment (Leep biopsy) and treatment of the cervix with Galavit (100 mg of dry matter) dissolved in 5 ml of Miramistin (Patent for invention RU 2568768 C1). In group 2 (n = 50), surgical treatment of CE has been preceded by vaginal sanitation, empirical antibacterial and antiviral therapy. Diagnostic measures, in addition to standards, have included: determination of interleukins IL-1β, IL-6, IL-8, IL-10 in the discharge of the cervical canal, ultrasound diagnostics with Doppler measurements in the vessels of the central zone of the cervix. Statistica 7.0, SPSS 17 packages have been used for statistical processing.Results and discussion. Before the start of treatment, patients in groups 1 and 2 have been found to have a combination of CE with cervicitis (100%), ASCUS cytological picture (more than 60%), abnormal colposcopic signs (100%), imbalance of the local immune system with a predominance of Th1 cytokines (the content of IL-8 increased 2.6 times; IL-1b – 13 times; IL-6 – 20 times, and IL-10 – in 1.7 times) against the background of increased vascularization and cervical perfusion. The reparative process after Leep biopsy in group 1 has ended by the end of 3 weeks in 65.6% of patients, in group 2 – in 25.5%, after 5 weeks – in 100% and 57.4%, respectively, after 8 – in group 2, 91.5%. The average period of epithelialization of a wound on the cervix in group 1 was 27.4 ± 4.3 days, in group 2 – 39.5 ± 5.6 days (p = 0.01). After 2 years, the recurrence of cervical pathology has been recorded only in group 2 (34.0%).Conclusion. The use of the developed method of two-stage complex therapy for CE increases the effectiveness of treatment, prevents complications after Leep biopsy, accelerates epithelialization by 30.6% and avoids recurrence of the disease.

Patients with chronic non-specific low back pain (CNSLBP) often have sleep disturbances (insomnia), which negatively affects pain severity, mental state, activities of everyday living, and the overall quality of life. The prevalence of insomnia in patients with CNSLBP and the effectiveness of its therapy require further investigation.Objective: to identify the prevalence of insomnia and the effectiveness of its treatment in CNSLBP.Patients and methods. The study included 71 patients aged 18–75 years (mean age 55.09±13.0 years) with CNSLBP. A single sleep hygiene educational session was run in the standard treatment group (n=34; mean age – 51±14 years). Intervention in the extended therapy group (n=37; mean age – 59±12 years) included an educational program dedicated to sleep, which was an individual face-to-face course of 4–5 sessions over two weeks and a telephone survey after three months. We used the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) to assess sleep disturbances, a numerical rating scale (NRS) to assess pain, the International Physical Activity Questionnaire (IPAQ-SF), and the 12-item short form health survey (SF-12) to assess physical activity and quality of life. The survey was carried out three times (at the admission, after 7–10 and 80–90 days).Results and discussion. In both groups of patients with CNSLBP, PSQI scores improved in a week and after 3 months compared with baseline (p

The existence of tumor heterogeneity is widely recognized; however, heterogeneity of the antitumor response in multiple tumor nodules in the same patient has not been reported. Sintilimab, a monoclonal antiprogrammed cell death receptor-1 (PD-1) antibody, was used to treat patients with unresectable hepatocellular carcinoma (HCC). In the present study, we report a case of therapeutic heterogeneity in relapsed HCC with lung metastases. A 57-year-old female patient was diagnosed with HCC and underwent radical hepatectomy. One and a half years later, imaging scans found multiple metastatic tumors in the lung, which were accompanied by an increased a-fetoprotein (AFP) level. The patient then started to receive sintilimab. In the first 6 months after sintilimab treatment, all the metastatic nodules regressed gradually and ultimately disappeared, except for one nodule, which remained stable in the following 3 months. Finally, the patient underwent pulmonary lobectomy to remove the remaining nodule. Thereafter, follow-up visits showed the AFP level decreased to normal and imaging scans showed no signs of recurrence, confirming that the patient exhibited a clinically complete response. Pathological assessments showed that in the primary tumor site, the tumor comprised moderately differentiated HCC with a few infiltrated cytotoxic T cells and negative PD-L1 expression. While in the metastatic site, the nodule was composed of poorly differentiated HCC with cytotoxic T-cell infiltration with few cells inside the tumor and expressed PD-L1 in some areas of the tumor. There were dynamic alterations of PD-L1 expression and cytotoxic T-cell infiltration in the primary and relapsed HCC lesions after anti-PD-1 treatment. This case presented the heterogeneities of both the tumor microenvironment and the following antitumor response among the metastatic nodules in the same patient and revealed the importance of comprehensive therapy in cancer treatment. [ABSTRACT FROM AUTHOR]

The purpose of the work is to evaluate the efficacy and tolerance of extemporal dosage form with pyroctone olamine in the local treatment of patients with seborrheic dermatitis. Under our supervision there were 78 patients with seborrheic dermatitis aged 18 to 57 years. The average age of the patients was 29.5±2.1 years. Comprehensive treatment of patients with seborrheic dermatitis in both groups depended on the severity of clinical manifestations, the duration of the disease, and information on the effectiveness of previous therapy. For external treatment of the main group of patients with seborrheic dermatitis, an extemporaneously prepared gel with pyrocton olamine was used. Local treatment of patients in the comparison group consisted of the appointment of 1% cream of clotrimazole. An analysis of the results shows good therapeutic, microbiological effectiveness and good tolerance of extemporaneously prepared gel with pyrocton olamine in the complex treatment of patients with seborrheic dermatitis. The period for resolving the clinical manifestations of seborrheic dermatitis among patients in the main group was 2.5±0.1 days shorter compared with patients in the comparison group. The intensity of clinical manifestations in patients with seborrheic dermatitis of the main group decreased twice on the second day of complex treatment. In control patients with comparative seborrheic dermatitis, similar therapeutic efficacy was achieved on the fourth to fifth day. Long-term results of the study showed that the recurrence of the disease among patients of the main group was 5 (6.4%), and in patients of in the comparison group was 14 (17.9%). Clinical studies have shown good therapeutic efficacy and tolerance of the extemporal gel with pyroctone olamine in the complex treatment of patients with seborrheic dermatitis, which gives reason to recommend this dosage form for wider use in the practice of dermatovenerologists.

Background. In destructive forms of pulmonary tuberculosis, especially in the presence of drug resistance of mycobacteria, one of the ways to increase the effectiveness of therapy is the use of collapse therapeutic techniques in various modifications. Purpose of the study: to develop and substantiate an algorithm for complex treatment of destructive forms of pulmonary tuberculosis, using artificial pneumothorax (AP). Material and methods: A cohort of 84 people with destructive pulmonary tuberculosis was formed. It was divided into two groups: 42 patients in the main group (chemotherapy (ChT) + AP) and 42 in the comparison group (ChT). Results: an algorithm for the treatment of patients with destructive forms of pulmonary tuberculosis was formulated. Within a period of up to 6 months, abacillation was achieved in 61.9% of cases in the main group (MG), and in 18.9% (p

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Objective: This article provides an updated overview of restorative procedures of endodontically treated teeth. Clinical considerations: The different techniques and procedures to restore an endodontic treated tooth were considered in the last decades. While they are generally performed using bonding procedures in combination with or without the placement of a post into the root to build up the abutment, there has been a lack of interest in restorative difficulties that can be faced. Failures are represented such as debonding of the post, fracture of the root, decementation, and/or fracture of the restoration, microleakage of the margins. Essentially, the presence of a sufficient failure is considered a key point of a long prognosis. Different clinical factors can directly influence the type of restoration and the longevity of the treatment. The restorative difficulty evaluation system (RDES) is proposed in this article. This new system is composed of eight different clinical factors that are divided into six levels of difficulties. The RDES is composed of 1. Endodontic complexity and outcome, 2. Vertical amount of coronal residual structure and dimension of the pulp chamber, 3. Horizontal amount of coronal residual structure, 4. Restoration marginal seal, 5. Local interdisciplinary conditions, 6. the complexity of the treatment planning, 7. Functional need, 8. Dental wear and esthetic need. Conclusion: This article reviews the RDES and outlines critical steps and tips for clinical success. Clinical significance: The RDES allows to any clinician to evaluate restorative difficulties when an endodontic treated tooth must be restored, combines clinical aspects that can involve from the single tooth to a full mouth rehabilitation. [ABSTRACT FROM AUTHOR]

One of the most effective ways to reduce the brittleness of boride layers is the formation of layers with a composite structure. To create a composite structure of the diffusion layer, it is proposed to form, in addition to borides, several additional phases that are located in the layer arbitrarily or in an orderly manner. For this purpose, the samples made of 38Cr2MoAl steel are strengthened by a complex chemical-thermal treatment, namely, boriding is carried out after cementation or nitrocementation. The analysis of microstructures shows that after various modes of surface hardening of steel, it can be argued that complex chemical-thermal treatment leads to the formation of a composite structure of steel with the grinding of borides in the layer, the dispersion of which increases with an increase in the temperature of diffusion saturation. The paper shows that the main mechanisms of boron diffusion are such mechanisms as reaction (the movement of atoms is carried out by moving the chemical reaction front); diffusion along dislocations, block boundaries, subgrains and grains, etc. reaction diffusion occurs by diffusing boron everywhere the boride layer to the main reaction front, which is located at the boundary of two phases: iron-boride Fe2B and boride Fe2B-boride FeB. First, the embryos are formed, and then--the needles of boride Fe2B. These needles grow until they close and form a continuous layer of Fe2B borides. Individual needles are then formed on the surface of this boride layer, which also form a second continuous layer of FeB boride. The needle-like structure of the boride layer indicates rapid growth of boride zones in the di-rection perpendicular to the surface of the samples, while along the surface the development of these phases was insignificant. This formation is due to the peculiarities of the structure of these phases, due to which boron atoms move rapidly only in a certain direction. As found, the boride layer displaces the carbon that is in the layer hardened by cementation (nitrocementation) deep into the steel. Due to the preliminary hardening treatment by cementation (nitrocementation), boride needles with rounded edges are formed and then crushed to the depth of the diffusion layer, which is due to the presence of a large number of carbides (nitrides, carbonitrides) in the surface layer, which do not allow boride needles to grow in the direction perpendicular to the surface of the samples due to their high density. Grinding and rounding of boride needles has a positive effect on the further operation of the product, thereby making it possible to eliminate stress concentrators and local zones that can cause cracks in the presence of sharp needles and reduces surface brittleness due to the formation of a crushed composite structure. [ABSTRACT FROM AUTHOR]

Introduction. In the case of gastroesophageal reflux disease (GERD) on the background of undifferentiated connective tissue dysplasia (UCTD) causes an even more significant deterioration in the QOL, including sleep disturbances and the onset of excessive daytime sleepiness (EDS). Thus, the study of the peculiarities of GERD on the background of connective tissue dysplasia and determining the impact of comorbid pathology on the QOL of patients with GERD is a topical issue in internal medicine. It has significant socio-economic significance. We believe that monitoring the most important variables that affect the quality of life of patients with GERD can help raise public awareness in this regard. In addition, it can guide the health care system to address these issues. Purpose. The purpose of the work is to increase the awareness of medical workers about the scale of the problem and ways to solve it. to study the features of the dynamics of quality of life in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of the proposed complex therapy. Methodology. 120 patients were included: 65 men and 55 women. In 75 of them (Study Group) GERD was in the background of UCTD, in 45 (?omparison Group ) - developed as an independent disease. The Study Group was divided into three groups. ?omparison Group - 45 patients with GERD without UCTD, received basic standard therapy, which included PPI "Panocid" 40 mg once a day and alginate-antacid formulation (Gaviscon Double Action Liquid) 20 ml, 3 times per day after meals and before bedtime. I Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Magne-B6" for 2 tablets 3 times per day. II Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Calcium-D3 Nicomed" 1 tablet 3 times per day. III Group - 25 patients with GERD +UCTD, who used the drug "Magne-B6" 2 tablets 3 times per day and "Calcium-D3 Nicomed" 1 tablet 3 times per day on the background of standard basic therapy. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36), the Gastrointestinal Symptom Rating Scale (GSRS), and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. A comprehensive examination of patients was performed twice: before and after 30 days of comprehensive treatment. Results and Discussion. Under the influence of the basic therapy in Comparison Group the General Health (GH) improved by 33.03%. While in the groups on the background of complex treatment is increased by 42.52% in patients of the I Group, by 13.10% in patients of the II Group, and 46.28% in patients of the III Group (p1, p2, p3

Objective: Diabetic foot syndrome is the most dramatic complication of diabetes mellitus. The treatment success is impossible without improving blood circulation and the elimination of hemodynamic disorders in the affected limb.The study aim was to evaluate mini-invasive revascularization operations effectiveness on the lower limbs peripheral arteries in neuro-ischemic and ischemic diabetic foot syndrome forms. Materials and methods: The study enrolled 104 patients with purulent-necrotic complications of diabetic foot syndrome. 54 (51.9%) patients underwent stenting and balloon angioplasty (the main group). The comparison group included 50 (48.1%) patients, undergoing indirect revascularization surgeries in complex treatment. Results and discussion:After endovascular interventions, the API index increased by 47.6% (p<0.01) after 20 days compared to the admission index, the average blood flow rate increased by 1.8 times (p<0.01), and the tPo2 value improved by 67.8% (p<0.01). In the control group, the tPo2 value increased by 40.3% after 20 days, and API – by 34.4%. In the main group, the swelling disappearance in the foot wounds area was by 3.7±0.5 days faster (p<0.001), wounds purification by 4.1 days (p<0.001), granulation appearance by 3.5±0.4 days (p<0.001), wound margins infiltration disappearance happened 3.3±0.9 days earlier (p<0.001), and the wound epithelization was 2.9 days earlier (p<0.01) than in the control group patients. Conclusion: Foot support function at discharge from hospital was preserved in 94.4% of the main group and in 84% of the control group. [ABSTRACT FROM AUTHOR]

The peculiarities of clinical course and algorithm of actions at a burning mouth syndrome the caused galvanic syndrome are presented. In complex treatment of this pathology joint efforts of the stomatologist-therapist, stomatologist-orthopedist and doctor-neuropathologist are necessary.

In structure of stomatologic diseases the periodontitis takes the third place after caries of teeth and a pulpitis, in an age group of 34-47 years the frequency of this form of complications of caries reaches 50%. Results of treatment of a chronic apical periodontitis at 45 patients are given in article. The total of the cured teeth made 47. In the main group (25 patients) applied complex treatment with use of introduction in a periodontium the center of the destruction of tissues behind an apex of osteoplastic materials namely enriched with blood plasma thrombocytes. It is established that use of the specified combination by 30 days promotes acceleration of processes of a reparation of a bone tissue of a periodontium and leads to reduction of terms of treatment. It is confirmed with indicators of optical density of a bone tissue at a chronic apical periodontitis by means of methods of a radioviziografiya and a computer tomography.

Primary headaches are common diseases in the clinical practice. Affecting the active, able-bodied population, impairing the quality of life and causing social maladjustment, they are of immense social significance. The medical care for patients with headaches ought to be complex and include a patients educational program, rational pharmaceutical therapy, detection and correction of comorbid functional disorders, nonpharmaceutical therapy. Despite an adequate therapy, the treatment satisfaction remains low and stimulates development of individualized treatment algorithms, that take into account the patients personal characteristics. They should be applicable both for the self treatment and for the use in the neurological and general practice.

Purpose of the study. Improvement of the results of treatment of patients with arteriovenous forms (AVF) of congenital vascular malformations (CVM) of the extremities based on the development of the classification scheme of CVM and the study of proliferative activity of the pathology. Materials and methods. The clinical data of 155 patients with AVF of CVM of extremities were analyzed in terms of observation from 1 month to 10 years. Patients of sex of men there were 65 (42%), women – 90 (58%), their correlation – 1 : 1,4; the average age was about 25,1 ± 10,4, children's age group – 53 (34%). The division into clinicalanatomical forms (11 groups) was carried out on the basis of the «working» classification scheme «VASC + T». Expression proliferation markers VEGF and KI-67 woos study were performed by immunoperoxidase method with additional hematoxylin staining. Results and discussion. Pathomorphological (66; 45,8%) and immunohistochemical studies (10; 7%) revealed the presence of proliferative activity of angiomatous tissues and degenerative changes in the walls of the vessels both due to developmental defects and disorders of hemodynamics, while the source of progression of the AVF of CVM there are vessels of the microvasculature. Conclusions. The application of the CVM classification scheme and the step-by-step complex treatment approach, depending on the clinical and anatomical AVF of CVM, led to the absence of major postoperative complications. This tactic made it possible to achieve satisfactory long-term results in 136 (94,4%) cases.

The article is devoted to the use of the combined drug Coryzalia in the treatment of acute rhinitis. The advantages of Coryzalia are the possibility of using it at any stage of treatment, combination with other drugs. The complex of active ingredients that make up the drug, has anti-inflammatory, antisecretory and detoxifying effects. The results of various studies confirm the high safety profile and efficacy of Coryzalia not only for adults, but also for treatment of children.

We have analyzed the experience of treatment of 563 patients with diabetic foot syndrome. We have developed an algorithm for the treatment of patients, including modern diagnostic and treatment methods, in particular - endovascular correction of vascular disorders and vacuum aspiration. The use of new technologies in the treatment of patients with diabetic foot syndrome improves their quality of life and social adaptation.

Background. The key links in the etiology and pathogenesis of periodontal tissue diseases are the quantitative and qualitative changes in the composition of the microflora of oral cavity, with the simultaneous deterioration of oral hygiene, reduction of local and general immunity, which occurs more often in the presence of somatic diseases. Objective. The aim of the research was to determine the clinical and microbiological efficacy of the developed treatment-prophylactic complex in the adolescents with catarrhal gingivitis and chronic gastroduodenitis before and after treatment. Methods. Changes were made to and before the treatment of clinical parameters, gingival microbiocenosis of 38 adolescents with generalized catarrhal gingivitis and chronic gastroduodenitis aged 12-18 years old, who comprised the main group. In the comparison group 25 adolescents of similar age diagnosed with generalized catarrhal gingivitis without any somatic diseases were involved. Results. It has been established that used combination (drug of plant origin with antimicrobial properties + dental gel with Metronidazole benzoate and Chlorhexidine digluconate + capsules of probiotics) yields the conventional treatment as well as exceeds it for examined clinical indicators and indexes. The treatment and prophylaxis with suggested complex have proved a significant positive effect on the gums microbiocenosis in adolescents with generalized catarrhal gingivitis and underlying concomitant gastroduodenitis. Conclusions. The suggested therapeutic and prophylactic complex provides a reduction in the massiveness and colonization frequency of the gum mucosa by pathogenic aerobic microflora (β-hemolytic streptococcus, golden staphylococcus, and yeast-like Candida fungi).

We present an observation from practice, which describes a multidisciplinary approach to the treatment of patient with acute mesenteric ischemia.

In the work the analysis of the results of treatment of 48 patients with ischemic and neurotrophic forms of diabetic foot syndrome has been performed. All patients had diabetes mellitus and IV degree of ischemia by Fontaine. After carrying out revascularization operations, a complex treatment was used that included phototherapy, the phase closure of tissue defects with synthetic coating with the application of fibrin clot and plasma enriched with platelet growth factor, vacuum therapy of wounds, autodermoplastics by Tirsch, free autodermoplastics with split skin scar. The im­plementation of the developed tactics allowed to achieve complete wound healing in 91.7% of patients, partial healing – in 8.3% of patients and to avoid high amputations.

Hearing loss is socially significant problem. About 30% of all cases are due to sensorineural hearing loss. Taking into consideration its polyethiologic nature treatment tactics should be complex. Drugs, that are able to reduce neuropathy development, should be an integral part of treatment. Most of neurotropic vitamins improve metabolic and enhance the regenerative processes in neuroepithelium. For this purpose vitamins B1, B6 and B12 are ordinary used, for many years they are included in the complex treatment of diseases of the peripheral nervous system. One of the combined medicinal vitamins is neuromultivitis.

Objective. Investigation of quality of life (QL) in patients, suffering inoperable forms (locally-spread) of mammary gland cancer (MGC), before and after conduction of neoadjuvant courses of systemic polychemotherapy (SPCHTH) and selective intraarterial polychemotherapy (SIAPCHTH) in combination with SPCHTH. Маterials and methods. Complex treatment was conducted in 154 patients, suffering locally-spread MGC T4A-DN0-3M0 in a period 2000 -2017 yrs, on base of Donetsk Regional Antitumoral Centre and The University Clinic of Odessa National Medical University. All the patients were divided into two groups. Tо Group I (control) were included 65 patients, suffering inoperable forms of a locally-spread MGC, to whom as a neoadjuvant course a SPCHTH was conducted; and to the Group II (investigating) - 89 patients, suffering inoperable forms of locally-spread MGC, to whom a SIAPCHTH was conducted as a neoadjuvant course. Results. Through the period of treatment a wave-like dynamics of the quality of life index was observed, which indicated a definite advantage of SIAPCHTH over SPCHTH. A limited statistically trustworthy difference in favor of regional polychemotherapy was formed between the Groups of patients in accordance to the quality of life index. Conclusion. Investigation of quality of life constitutes a secure, informative and economic method of estimation of a patient state of health on the groupings and the individuals levels. In oncological investigations the QL assessment constitutes an important criterion of the treatment efficacy estimation and has a prognostic significance. Estimation of quality of life in clinical investigations improves the investigation quality itself.

Predictive determination of tumor volume is a significant task in cancer treatment. The importance of predictive definition is due to its relevance in research and clinical practice. The use of predictive models makes it possible to evaluate the effectiveness of the treatment used in the early stages and decide on its correction in case of unsatisfactory prognosis. The paper investigates models for predictive determination of tumor volume after applying a complex treatment that combines chemotherapy and hyperthermia. Considered machine learning models are ensembles of decision trees, regression based on Gaussian processes, ridge regression, and Bayesian regression. The raw data for machine learning comes from an experiment on laboratory rats. As part of the experiment, all animals received an injection of the fast-growing Walker-256 carcinoma into the left thigh. After the injection, the animals were subjected to complex treatment with cyclophosphamide and hyperthermia. During the study, the rats were divided into three groups. The division into groups depended on the dose of cyclophosphamide received. The determination of informative features is based on the application of greedy and genetic algorithms. The analysis of the selected features with their use in various types of models. The projections of remission and the depth of remission were calculated based on the tumor volume's predicted values. The applicability of several investigated models for predictive assessment of the therapeutic effect of combined treatment has been shown using Student's and Friedman's statistical tests. [ABSTRACT FROM AUTHOR]

The purpose of the work is to evaluate the efficacy and tolerance of extemporal dosage form with pyroctone olamine in the local treatment of patients with seborrheic dermatitis. Under our supervision there were 78 patients with seborrheic dermatitis aged 18 to 57 years. The average age of the patients was 29.5±2.1 years. Comprehensive treatment of patients with seborrheic dermatitis in both groups depended on the severity of clinical manifestations, the duration of the disease, and information on the effectiveness of previous therapy. For external treatment of the main group of patients with seborrheic dermatitis, an extemporaneously prepared gel with pyrocton olamine was used. Local treatment of patients in the comparison group consisted of the appointment of 1% cream of clotrimazole. An analysis of the results shows good therapeutic, microbiological effectiveness and good tolerance of extemporaneously prepared gel with pyrocton olamine in the complex treatment of patients with seborrheic dermatitis. The period for resolving the clinical manifestations of seborrheic dermatitis among patients in the main group was 2.5±0.1 days shorter compared with patients in the comparison group. The intensity of clinical manifestations in patients with seborrheic dermatitis of the main group decreased twice on the second day of complex treatment. In control patients with comparative seborrheic dermatitis, similar therapeutic efficacy was achieved on the fourth to fifth day. Long-term results of the study showed that the recurrence of the disease among patients of the main group was 5 (6.4%), and in patients of in the comparison group was 14 (17.9%). Clinical studies have shown good therapeutic efficacy and tolerance of the extemporal gel with pyroctone olamine in the complex treatment of patients with seborrheic dermatitis, which gives reason to recommend this dosage form for wider use in the practice of dermatovenerologists. [ABSTRACT FROM AUTHOR]

Objective: to improve the results of complex treatment of patients with trophic venous ulcers of the lower extremities by developing and introducing new methods of pharmacotherapy with morphological, immunohistochemical and biochemical evaluation of the reparative processes. Materials and methods: 72 patients with chronic venous insuffi ciency of C6 class under CEAP, in two clinical groups, underwent complex treatment and morphological features of trophic ulcers biopsies and monitoring of neopterin level were prospectively studied. In both groups, multicomponent antibacterial water-soluble ointments were used for topical treatment, which was supplemented with compression therapy and use of phlebotonics. Th e fi rst group consisted of 52 patients who additionally received magnesium orotate and enterosorption with dioctahedral smectite in the complex treatment of trophic ulcers, and the second group included 20 patients who did not receive the proposed additional therapy. Results: The effectiveness of the combined use of magnesium preparations and enterosorption has been proved. Conclusion: Th e inclusion of preparations of organic magnesium and enterosorption in complex treatment of trophic ulcers of venous etilogy allows the accleration of the healing process and shorten the period of stay of patients in the hospital.

The serious physical mental and psychosocial morbidity due to anorexia nervosa is often perceived by sufferers as less serious than from their environment. Doctors and other healthcare professionals are therefore confronted with the difficulty that urgent medical treatment is considered as unnecessary or even threatening by those affected. Although patients with anorexia nervosa usually wish to improve their condition, they are usually only able to tolerate treatment aimed at normalizing eating behavior and gaining weight in response to high external pressure. In view of this situation, an interdisciplinary team with experience in these treatments is required to treat these patients. Close cooperation is necessary to ensure a supporting treatment framework. [ABSTRACT FROM AUTHOR]

Purpose: comparative evaluation of surgical methods of treatment of decompensated cicatricial-ulcerative stenosis of the duodenum and rationale for the choice of optimal tactics in complex treatment of these patients.Materials and Methods: summarizes the experience of complex treatment of 112 patients with decompensated cicatricialulcerative stenosis of the duodenum. 82 patients underwent radical duodenoplasty, aimed at restoring the motor-evacuation and secretory functions of the stomach, selective proximal vagotomy. 30 patients underwent resection of 2/3 of the stomach in various modifications.Results: The highest number of complications in the main group account for those patients who were simultaneously performed duodenoplasty and SPV. With the transition to a two-step method of surgical treatment postoperative complications almost never met. Almost all the pathological conditions in the long-term period after surgery is more pronounced in patients who underwent resection of the stomach.Summary: adical duodenoplasty allows to demonstrate the possibility of full recovery of gastric function after radical removal of pathological substrate and the preservation of the pylorus.

Background. The causes of decubitus ulcers include ischaemia and neurotrophic tissue changes induced by their chronic compression, continuous pathologic moisture and shift of tissues that determine local ishaemia. The aim of the article: to study clinical options and suppurative complications of decubitus ulcers in patients with type 2 diabetes mellitus (DM) in terms of insulin resistance (IR) in the context of combined treatment optimization. Materials and methods. Total sample of retro- and prospective analyses involved results of comprehensive treatment of 112 patients. Type 2 DM was diagnosed in 37 patients, I comparison group included 27 patients with decubitus ulcers without complications (I–III stages) and DM, with decubitus ulcers stage IV — II comparison group; and the control group included other 75 individuals. Results. The patients with type 2 DM (I comparison group) had considerable decrease in HOMA index of β-cell function and increased HOMA index of IR (8.31 ± 0.02, р

Odontomas are formations which are still classified as benign tumors by the World Health Organization. They are lesions on any odontogenic tissue – enamel, cement and dentin, which are affected in different proportions and degree. We present a case of compound odontoma on upper jaw, on a 15 year-old girl, causing retention of a permanent canine tooth. After the extirpation 16 tooth-like structures were uncovered. The mandible was diagnosed with hypodontia of both 2nd premolars. Patient’s history showed that there was a trauma in the area of the upper jaw at younger age. In this article we will present the clinical and radiographic examination, the stages of the complex surgical-orthodontic treatment and a discussion of the etiology of the diagnosis, complications and the treatment itself.

The study included 103 patients with stage T1–3N0–3M0 breast cancer who received multimodality treatment including neo- and adjuvant chemotherapy according to CMF and CAF schedules, hormonal therapy, radical mastectomy and adjuvant radiation therapy. All patients were divided into two groups depending on the volume of postoperative radiation therapy. Group I patients (n=48) received 40–44 Gy external radiation therapy to the areas of potential regional spread. Group II patients (n-55) additionally received radiation therapy delivered to postoperative scar area at a total dose of 38–44 isoGy. The comparative analysis of long-term results showed a significant decrease in the rate of local recurrences and increase in the 5-year recurrence-free and overall survival rates in the group of breast cancer patients who received adjuvant radiation therapy to the areas of potential regional spread and postoperative scar. In order to plan adequate radiotherapyand to minimize local radiation-induced reactions, it is necessary to consider clinical and morphological prognostic factors.

The issue of sphincter preservation when low rectal cancer (rectal adenocarcinoma 0–6 сm from marge anal) remains topical.Objective: to increase the number of sphincter preservation operations in patients with low rectal cancer.Materials and methods. We analyzed data on 110 patients with low rectal cancer randomized into 3 groups: in the 1st group surgery was performed following 0–3 days after the end of short-term radiotherapy (RT) 25 Gy. In the 2nd group the interval before surgery after the identical RT was 42 ± 3 days. In the 3rd group, in 2 cycles of capecitabine chemotherapy were performed starting on the 1st day of RT.Results. pCR was observed obly in 2nd and 3rd group: in 16.6 % patients in the 2nd group, and 12.8 % in the study group. The sphincter preservation rate was 40.0 % in the 1st control group, 70.0 % in the 2nd group and 77.0 % in the 3rd group. The postoperative complications rate was 37.5 % in the 1st group, 26.6 % in the 2nd group and 17.9 % in the 3rd group.Conclusions. Preoperative chemoradiotherapy may increase sphincter preservation rate without increase in the number of postoperative complications.

Purpose. To show the basic regulations of the complex retinopathy of prematurity (ROP) treatment with use of retinal pattern scanning laser coagulation and early vitrectomy. Material and methods. Pascal pattern scanning retina laser coagulation of (RLC) was performed in children for stage 2 ROP type 2, stage 3 ROP type 2 and subclinical stage and early clinical stage of aggressive posterior ROP according to the classification developed at the Kaluga Branch of the S. Fyodorov Eye Microsurgery State Institution. Early 3-ports 25G vitrectomy was carried out in case of ROP progressing 2-4 weeks after the laser treatment. Results. Between 2003 and 2011 total 823 different surgical interventions for infants with active ROP was performed: 737 retinal laser coagulations, 3-port lens preserving vitrectomy – 72, 3-ports lensvitrectomy – 14. Treatment efficacy was in classical ROP course 98.6% for stage 2 and stage 3 ROP (regress of the disease occurred in 557 of 565 eyes), and 74.4% for aggressive posterior ROP (regress of the disease occurred in 128 of 172 eyes). The total efficacy of the complex treatment was 92.9% (regress of the disease occurred in 685 of 737 eyes). Conclusion. The basic regulations of the complex ROP treatment are an early, within first 6 weeks of chronologic age, photocoagulation to delay progression of the retinal detachment and to stabilize vascularity, and an early vitrectomy in case of ROP progressing after the laser treatment.

The study included 41 patients aged 50.0 (39.0, 55.0) years, of which 29 men (70.7%) and 12 women (29.3%) with diabetes type 2 and metabolic syndrome in terms of voluntary informed consent. We studied the effect of combined treatment (correction of physical activity, the formation of healthy food, metformin) for the maintenance of premature aging markers p53 protein in these patients. Apoptosis was studied by determining serum - p53 (U/ml) by ELISA. In patients with type 2 diabetes and metabolic syndrome increased apoptosis - the content of p53 in the serum reaches 1,9 (1,79; 2,3) U/ml. Against the background of complex treatment of the protein content decreased to 0,98 (0,93; 1,1) U/ml.

The article presents the results of treatment of 201 patients with neuroischemic form of diabetic foot syndrome. The research included 158 women and 43 men of the middle age of 62,5±11,2 years. The complex approach was applied in treatment includ ing medicamentous treatment, revasculization of extremity, an application of modern combined collagenous coating and foot relieving using silicone insoles and orthopedic footwear. The endovascular and open reconstructive operations were performed in order to obtain the revasculization of extremity. Given complex approach allowed reducing the terms of hospital stay, the rate of ulcerous defects recurrences and relapses of ischemia of lower extremities during one year after endovascular interventions.